Contact: Ellen Bank
843.792.2626
Oct. 5, 2000
CHARLESTON, S.C. -- Improving the health of African Americans is the goal of a five-year, $10.1 million research project at the Medical University of South Carolina (MUSC).
African Americans in South Carolina have more hypertension, diabetes and AIDS and poorer health outcomes with these diseases than the population as a whole. Nationally, life expectancy for African American men born in 1997 is 66 years compared to 74 years for Caucasian men. For African American women life expectancy is 74 versus 80 years for Caucasian women. "Clearly there are major problems and hurdles to the improvement of the health status of African Americans in general and particularly African Americans in South Carolina," said Barbara C. Tilley, Ph.D., professor and chair of MUSC's Department of Biometry and Epidemiology, College of Medicine, and principal investigator for the project.
Under the grant, a multi disciplinary team will analyze causes and contributing factors for inequalities related to the delivery and practice of health care, and identify and implement strategies to improve the process.
Tilley said that the project is far more than a research protocol. "Our intention is not to come in, introduce a program and then leave," she said. "We want to make permanent changes that will truly improve the health of African Americans in South Carolina. If we find that our interventions work, we are prepared to deliver the new program to those in communities who didn't receive the intervention initially. In addition, we will be working with state policymakers and state agencies to insure a continuation of our efforts."
But the project doesn't stop there. Tilley anticipates that information gained from this comprehensive project will be applicable to areas outside the state and extend beyond the African American community.
The study emphasizes the roles and activities of providers of health care. For example, one project investigates expanding the role of the pharmacist. Instead of merely filling a prescription and providing drug counseling to the patient, the pharmacist will actually call patients who have not renewed prescriptions for medications for chronic conditions such as hypertension and diabetes. The pharmacist will determine why the patient has not renewed the prescription and take appropriate action to see that the patient gets the medication. If it
is a matter of cost, the pharmacist might work with the physician to identify a lower cost generic substitute. Or the pharmacist might help the patient find sources of funding.
The funding for the project comes from the Agency for Healthcare Research and Quality (AHRQ). It is an agency of the U.S. Department of Health and Human Services charged with supporting research designed to improve the quality of healthcare, reduce its cost, improve patient safety, decrease medical errors, and broaden access to essential services. AHRQ sponsors and conducts research that provides evidence-based information on healthcare outcomes; quality; and cost, use, and access. The information helps healthcare decision makers ø patients and clinicians, health system leaders, and policymakers ø make more informed decisions and improve the quality of healthcare services.
"Since the planned interventions will have an impact on both patients and providers, the satisfaction of both groups is important to the success of the endeavor," said Tilley. "For this reason, we have assembled a Community Advisory Group for the project to help assure that proposed interventions are acceptable to the communities where the projects will be implemented."
The major components of the MUSC project are:
* reducing the racial disparity in cardiovascular disease by working with community providers to achieve better blood pressure control in their patients. (Project leaders -- Brent Egan, M.D., departments of Cell & Molecular Pharmacology & Experimental Therapeutics and Medicine and Deanna Cheek, Department of Medicine,);
* improving economic access to antiretroviral prescription drugs and adherence to antiretroviral guidelines for African American Medicaid enrollees with HIV disease in South Carolina. (Project Leader -- Kit M. Simpson, Ph.D., Department of Pharmacy Practice, College of Pharmacy and the Center for Health Care Research);
* exploring racial difference in the provision of end-of-life care for cancer and congestive heart failure patients in South Carolina (Project leaders -- Jerome Kurent, M.D., departments of Neurology and Medicine, College of Medicine, and Susan DesHarnais, Ph.D. American College of Surgeons); and
* performing a randomized trial of a pharmacist-intervention to increase prescription refills. (Project leader -- Deborah Carson, Pharm. D., Department of Pharmacy Practice, College of Pharmacy).
Co investigators on these projects include Barbara Powe, Ph.D., Department of Health Management Outcomes, College of Nursing, and Walter Jones, Ph.D., Department of Health Administration and Policy, College of Health Professions. "Investigators represent numerous departments and colleges of the Medical University, making it truly a cross-university effort," said Tilley.
The grant also provides a core of support for data collection, data management, and data analysis led by Stuart Lipsitz, Ph.D., Department and Epidemiology, College of Medicine. The Biostatistical Core includes funding for the Office of Research and Statistics (ORS) at the State Budget and Control Board led by Walter P. Bailey. Data from ORS will help to document improvements brought about by the project through use of statewide statistics. The
Core also includes support for Thomas Brown, Ph.D., a health services researcher at Richland Memorial Hospital who will provide a link to other researchers in the Columbia area and to a consultant at Johns Hopkins who is an expert in assessing patient and provider satisfaction. Gardinia Ruff, Office of Minority Health, Department of Health and Environmental Control, will serve as a scientific advisor to the project.
Funding also supports the development of new investigators, particularly minority investigators with an interest in research to reduce disparities in minority health. New investigators receive funding for pilot studies, 25 percent salary support and mentoring from senior investigators. The pilot programs are evaluating new models for health care delivery. Pilot projects include:
* implementing successful managed care models of healthcare delivery in a medically underserved African American Patient Population with Type 2 diabetes. (Pilot leader -- Dawn Clancy, Department of Medicine, College of Medicine);
* implementing ARQ guidelines concordant care to African American with Type 2 diabetes mellitus and depression (Pilot leader -- Leonard Egede, M.D., Department of Medicine, College of Medicine and Center for Health Care Research); and
* improving the evaluation of therapist adherence to multisystemic therapy with ethnically diverse, adolescent drug offenders (Pilot leader -- Stanley J. Huey, Ph.D., Department of Psychiatry, College of Medicine).
Tilley hopes to join with the many other ongoing activities in the state to form a broad-based, collaborative, state-wide initiative focused on eliminating minority health disparities.
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