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Study Title: Pharmacy-led Transitions of Care Intervention to Address System-Level Challenges and Improve Medication Adherence in Low-Income Populations

Award Number: R01MD018174
ORGANIZATION: NATIONAL CENTER ON MINORITY HEALTH AND HEALTH DISPARITIES
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)
PERIOD OF PERFORMANCE START DATE: 07/06/2023
PERIOD OF PERFORMANCE END DATE: 01/31/2028

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Study Title: Pharmacy-led Transitions of Care Intervention to Address System-Level Challenges and Improve Medication Adherence in Low-Income Populations - ABSTRACT Low-income populations with multiple chronic conditions have high rates of nonadherence to essential chronic disease medications after hospital discharge. Medication nonadherence after hospital discharge is significantly associated with increased mortality and higher rates of readmissions and costs among these patients. Major patient-reported challenges to essential medication use after hospital discharge among low-income individuals are related to social determinants of health (SDOH) and include: 1) financial challenges (i.e. inability to afford medications), 2) transportation challenges (i.e. inability to access prescribed medications or needed follow-up care), and 3) system-level challenges (i.e. lack of availability of discharge medications and care coordination services to ensure rapid primary care follow-up). Although, medication therapy management and medication reconciliation services are important during care transitions, these services have not proven effective in improving medication adherence after hospital discharge, highlighting a critical need for innovative interventions. Our pilot study has demonstrated the feasibility and potential to improve medication adherence among adult Medicaid and uninsured inpatients through full medication subsidy and/or bedside and subsequent home delivery of medications during and after care transitions. Moreover, our previous research found that support from certified pharmacy technicians trained as coaches effectively increases rapid primary care follow-up after hospital discharge and could improve medication adherence. Yet the effectiveness of interventions that directly address affordability, accessibility, and availability to improve post-discharge medication adherence in low-income populations is still unknown. The Medication Affordability, Accessibility, and Availability in Care Transitions (Med AAAction) Study will test the effectiveness of a pharmacy-led care transitions intervention versus usual care through a pragmatic randomized controlled trial of 388 Medicaid and uninsured hospital in-patients with MCC from three large healthcare systems in Tennessee. The intervention will involve: 1) medications with zero copay, 2) bedside delivery then home delivery of medications, and 3) care coordination provided by certified pharmacy technicians/health coaches to assist with medication access and rapid and ongoing primary care follow-up. We will examine the impact of the intervention during 12 months on 1) medication adherence (primary outcome) and 2) rapid primary care follow-up, 30-day readmissions, hospitalizations and emergency department visits, and costs. We will conduct key informant interviews to understand patient experience with the acre received during and after care transitions. By examining effectiveness of the intervention on outcomes including medication adherence, health care utilization, costs, and patient experience, this study will provide valuable results to health systems, payers, and policymakers to assist in future implementation and sustainability of the intervention for low-income populations.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2026 ( Subtotal = $700,020 )
2026	2026	UNIVERSITY OF TENNESSEE	62 S DUNLAP ST	MEMPHIS	TN	38103	SHELBY	USA	Minority Health and Health Disparities Research	001	4	2/22/2026	NON-COMPETING CONTINUATION	$70,001
2026	2026	UNIVERSITY OF TENNESSEE	62 S DUNLAP ST	MEMPHIS	TN	38103	SHELBY	USA	Minority Health and Health Disparities Research	000	4	1/30/2026	NON-COMPETING CONTINUATION	$630,019
														Subtotal = $700,020

Issue Date FY: 2025 ( Subtotal = $697,762 )
2025	2025	UNIVERSITY OF TENNESSEE	62 S DUNLAP ST	MEMPHIS	TN	38103	SHELBY	USA	Minority Health and Health Disparities Research	002	3	7/31/2025	NON-COMPETING CONTINUATION	$0
2025	2025	UNIVERSITY OF TENNESSEE	62 S DUNLAP ST	MEMPHIS	TN	38103	SHELBY	USA	Minority Health and Health Disparities Research	000	3	2/19/2025	NON-COMPETING CONTINUATION	$627,985
2025	2025	UNIVERSITY OF TENNESSEE	62 S DUNLAP ST	MEMPHIS	TN	38103	SHELBY	USA	Minority Health and Health Disparities Research	001	3	4/24/2025	NON-COMPETING CONTINUATION	$69,777
														Subtotal = $697,762

Issue Date FY: 2024 ( Subtotal = $688,245 )
2024	2024	UNIVERSITY OF TENNESSEE	62 S DUNLAP ST	MEMPHIS	TN	38103	SHELBY	USA	Minority Health and Health Disparities Research	001	2	3/22/2024	NON-COMPETING CONTINUATION	$619,419
2024	2024	UNIVERSITY OF TENNESSEE	62 S DUNLAP ST	MEMPHIS	TN	38103	SHELBY	USA	Minority Health and Health Disparities Research	003	2	8/27/2024	NON-COMPETING CONTINUATION	$0
2024	2024	UNIVERSITY OF TENNESSEE	62 S DUNLAP ST	MEMPHIS	TN	38103	SHELBY	USA	Minority Health and Health Disparities Research	002	2	6/17/2024	NON-COMPETING CONTINUATION	$68,826
2024	2023	UNIVERSITY OF TENNESSEE	62 S DUNLAP ST	MEMPHIS	TN	38103	SHELBY	USA	Minority Health and Health Disparities Research	000	1	3/20/2024	NEW	$0
														Subtotal = $688,245

Issue Date FY: 2023 ( Subtotal = $741,494 )
2023	2023	UNIVERSITY OF TENNESSEE	62 S DUNLAP ST	MEMPHIS	TN	38103	SHELBY	USA	Minority Health and Health Disparities Research	000	1	7/6/2023	NEW	$741,494
														Subtotal = $741,494

Grand Total All Awards = $2,827,521

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Study Title: Pharmacy-led Transitions of Care Intervention to Address System-Level Challenges and Improve Medication Adherence in Low-Income Populations

Award Number: R01MD018174

ORGANIZATION: NATIONAL CENTER ON MINORITY HEALTH AND HEALTH DISPARITIES

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

PERIOD OF PERFORMANCE START DATE: 07/06/2023

PERIOD OF PERFORMANCE END DATE: 01/31/2028

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