Taking Action Against CVD: The Social Determinants of Heart Health, Part 3
The following is part 3 of 3 in a series of articles titled, "The Social Determinants of Heart Health" by Jason Ausili, PharmD, MSLS, Head of Pharmacy Transformation for EnlivenHealth, as well as other contributors to Ask Your Pharmacist.
The heart is a tireless engine that powers every beat of our lives. Like any engine, however, it requires care and maintenance to function optimally. When faced with threats like cardiovascular disease, healthcare providers and patients must be prepared to act. But what can they do?
As with most complex problems, there isn’t one simple solution. As pharmacists and patients, what can we do to prevent and/or fight back against cardiovascular disease?
Let’s break it down:
Fighting Cardiovascular Disease: What Patients Can Do
While some cardiovascular disease risk factors like age and family history are unavoidable, many others are changeable through lifestyle changes and proactive management. These risk factors include:
High blood pressure
Unhealthy cholesterol levels
Uncontrolled diabetes
Tobacco use
Physical inactivity
Chronic stress
Identifying these risk factors is crucial for early intervention and preventing the development or progression of CVD. Regular checkups with a healthcare provider—including blood pressure readings, cholesterol screenings, and discussion about lifestyle habits—can help paint a clear picture of a patient’s individual risk profile. By understanding these risk factors, patients and pharmacists can collaboratively develop a personalized plan to optimize cardiovascular health.
For a patient to take charge of their cardiovascular health, they need to do more than simply understand the risk factors. They can actively reduce their CVD risk with a few simple considerations:
Prioritizing a healthy diet: Patients should adopt a diet rich in fruits, vegetables, and whole grains while limiting saturated and trans fats.
Getting and staying active: Many patients at risk for cardiovascular disease have sedentary lifestyles. Regular physical activity is key to a healthy heart.
Kicking the smoking habit: While cigarettes remain the leading cause of preventable disease, disability, and death in the U.S., smoking has decreased 43% among U.S. adults since 2005. Smoking damages the heart and blood vessels.
Learning how to manage stress: Using techniques like meditation, yoga, or breathing exercises, patients can take immediate action to reduce their stress levels.
By integrating these self-management strategies into their daily lives, patients can significantly reduce their risk of cardiovascular disease and promote long-term heart health.
Fighting Cardiovascular Disease: What Pharmacists & Other Providers Can Do
While individual action is crucial, pharmacists and other healthcare providers play a vital role in the fight against cardiovascular disease. Here’s how healthcare professionals can champion cardiovascular health in their communities:
Vaccine Programs
Vaccinations provide a powerful defense against infectious diseases like influenza and pneumonia, which can exacerbate existing cardiovascular conditions. Pharmacists can play a key role by promoting and administering vaccines and by ensuring patients are up-to-date on their immunization schedules. For instance, the CDC recommends the pneumococcal vaccine for individuals with heart disease and those with a history of stroke in addition to the vaccines recommended for all adults (COVID-19, flu, etc.). This proactive approach can significantly reduce the risk of complications that could strain the cardiovascular system.
Medication Adherence Programs
Medication adherence is paramount in managing cardiovascular conditions. Pharmacists can significantly improve patient outcomes by implementing comprehensive medication adherence programs. These programs should encompass personalized strategies tailored to individual patient needs, such as medication synchronization, adherence counseling, and the use of medication aids like pill organizers. Additionally, pharmacists can leverage technology by offering medication reminder apps or text message alerts. By addressing potential barriers to adherence — such as cost, side effects, or forgetfulness — pharmacists can empower patients to take control of their treatment plans and reduce the risk of adverse cardiovascular events.
Patient Education
Knowledge is a powerful tool in the fight against cardiovascular disease. Pharmacists can significantly impact patient outcomes by providing comprehensive education on CVD risk factors, prevention strategies, and the importance of making lifestyle modifications. This includes detailed explanations of conditions like hypertension, high cholesterol, and diabetes, along with their potential complications. By fostering a deeper understanding of these factors, pharmacists empower patients to make informed decisions about their health and actively participate in their care. Tailored educational materials (like handouts, videos, or digital resources) can reinforce key messages and support patients in adopting healthier habits.
Blood Pressure/Cholesterol Management Programs
Effective management of blood pressure and cholesterol levels is pivotal in preventing cardiovascular disease. Pharmacists can significantly contribute to these efforts by collaborating closely with physicians and other healthcare providers. This collaborative approach involves developing personalized treatment plans, incorporating regular monitoring, and implementing patient-centered lifestyle interventions. By leveraging technology and shared data, pharmacists can optimize medication regimens, identify patients at high risk, and provide timely interventions. This collaborative model fosters a comprehensive approach to blood pressure and cholesterol management, ultimately enhancing patient outcomes and reducing the burden of cardiovascular disease.
Readmission Reduction Programs
Hospital readmissions for patients with cardiovascular conditions pose significant challenges for both patients and healthcare systems. These readmissions often signal gaps in post-discharge care and contribute to increased healthcare costs. Pharmacists can play a pivotal role in mitigating this issue through comprehensive medication reconciliation, ensuring patients fully understand their medication regimen, and addressing potential concerns. In addition, pharmacists can screen patients for social determinants of health (SDOH) barriers and make recommendations to community-based resources to eliminate readmission risk factors. By collaborating closely with healthcare teams, pharmacists can identify and address post-discharge medication-related problems, reducing the likelihood of adverse events that might lead to readmission. Moreover, pharmacists can offer ongoing support through medication therapy management services, empowering patients to take an active role in managing their health and preventing future hospitalizations.
Operationalizing a Care Team Dynamic to Reduce Readmissions
Unfortunately, hospital readmissions are a frequent concern for patients with cardiovascular disease. According to a 2021 article in the American Heart Association journal Circulation: Heart Failure, nearly 1 in 4 heart failure patients are readmitted within 30 days of discharge, and approximately half are readmitted within 6 months. By implementing comprehensive readmission reduction programs that address medication management, patient education, and post-discharge support, pharmacists can play a crucial role in preventing these avoidable readmissions, improving patient outcomes, and reducing healthcare costs.
Fostering a collaborative care team dynamic between health systems and community pharmacies is essential for optimizing cardiovascular disease (CVD) prevention and management. This collaborative approach would involve open communication channels and clearly defined roles. Health systems could provide patient data and risk assessments to pharmacists, allowing them to proactively reach out to high-risk individuals. Pharmacists, in turn, could offer medication adherence support, lifestyle counseling, and medication reconciliation upon discharge, reducing the risk of readmission. Additionally, joint educational workshops for patients could be organized, leveraging the expertise of both healthcare providers. This collaborative model would ensure a more holistic approach to patient care, with seamless communication and shared responsibility for managing CVD risk factors.
Ultimately, a strong care team dynamic empowers patients, maximizes the effectiveness of preventative measures, and improves overall cardiovascular health outcomes within the community.
Take an Active Role
While cardiovascular disease may be the leading cause of death—both in the United States and the rest of the world—we are not powerless against it. By adopting a multifaceted approach that includes patient education, medication management, and lifestyle modifications, pharmacists and patients can play a pivotal role in preventing and managing CVD. Through collaborative efforts with healthcare providers and a commitment to patient-centered care, we can significantly reduce the burden of cardiovascular disease and create a healthier future for our communities.