This post was originally published in November 23, 2021 and updated on November 3, 2022.
November is Pulmonary Hypertension Awareness Month, an annual event to raise awareness of this rare and often misunderstood disease in every community. Pulmonary arterial hypertension (PAH) is a rare and progressive condition, characterized by elevated blood pressure in the vessels of the lungs. In PAH, the pulmonary arteries become stiff, narrow or damaged, causing the right ventricle of the heart to work harder to pump blood into the lungs against increased resistance. The symptoms often manifest as shortness of breath, chest pain, light-headedness, palpitations and edema.
PAH affects fewer than 50,000 people in the US, with about 500-1000 new cases being diagnosed each year in the U.S. PAH has no known cure.
Since 2019, Shields Health Solutions (ShieldsRx) has collaborated with four health system partners on the east coast to implement a clinical workflow for PAH care. The care team includes PAH-trained nurses, pharmacists and in-clinic pharmacy liaisons who assist patients with onboarding and monitor the patient throughout their clinical journey. For example, as part of the comprehensive patient care they provide for these complex patients, nurses and pharmacists help ensure patients are taking their medications appropriately as well as monitor labs specific to PAH patients.
Nurse clinicians use a standardized, validated assessment tool that measures the patient quality of life (QOL). This measurement allows the nurses to determine the severity of the patient’s progression and ensures that proper care is managed for those who report poor quality of life. Nurses and pharmacists can then work with the patient’s team of providers to adjust medications as needed to maintain quality of care.
Treatments for PAH include medications such as ambrisentan and bosentan, which are specialty medications that require Risk Evaluation and Mitigation Strategy (REMS) protocols. To date, ShieldsRx partnered pharmacies have achieved full REMS desktop audit compliance for these medications, a testament to the safety and quality of the PAH program, as well as the demonstrated “audit readiness” of the care teams.
ShieldsRx provides manufacturer’s data reporting, REMS clinical compliance, and REMS desktop audit support. Analysis of QOL scores used to risk stratify patients with PAH shows low disease burden for PAH patients on service.
To learn more about Shields’ innovative clinical management model for Pulmonary Arterial Hypertension (PAH), read an article written by Kerry Mello-Parker, PharmD, MBA, and Kristen Ditch, PharmD, BCCCP published in Becker’s Hospital Review.
Also, be on the lookout for an upcoming white paper exploring how a high-touch model of integrated specialty pharmacy can help patients with PAH and other rare diseases overcome barriers to care and improve clinical outcomes.
Want to talk about how our clinical management model can help your PAH patient population? Contact us.