title: Improving Health of At-Risk Rural Patients project: A collaborative care model.
abstract: OBJECTIVE
  The design elements of the Improving Health of At-Risk Rural Patients (IHARP) care model are described.
  
  
  CONCLUSIONS
  The IHARP project evaluated the clinical, economic, and humanistic outcomes associated with the collaborative care model relative to usual care in the community. The care model was initiated in 22 level 3- certified patient-centered medical homes. The primary outcomes are the absolute change in all relevant clinical and laboratory values of patients with hypertension, hyperlipidemia, and diabetes within and between the intervention and comparator groups; the change in the absolute number of emergency department visits and hospitalizations; and the change in the cost of care among the Medicare and Medicaid intervention patients. The lessons learned during the implementation and conduction of this project over the past three years are also presented. Patient enrollment ended in December 2014, final patient care visits were concluded in the fall of 2015, and results are expected in late 2016 or early 2017.
  
  
  CONCLUSIONS
  This project will provide information from patients, physicians, and midlevel providers regarding their perceptions of clinical pharmacists as collaborative care team members. Data on health outcomes, health services utilization, and costs of care drawn from over 1600 Medicare beneficiaries will provide a robust assessment of the value of the IHARP care delivery model.
authors.affiliation: Department of Pharmacotherapy and Outcome Sciences, Virginia Commonwealth University School of Pharmacy, Richmond, VA. gmatzke@vcu.edu.
authors.forename: Gary R
authors.initials: GR
authors.lastname: Matzke
authors.affiliation: Department of Pharmacy, Carilion New River Valley Medical Center, Christiansburg, VA.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Czar
authors.affiliation: Carilion Clinic Health System, Roanoke, VA.
authors.forename: William T
authors.initials: WT
authors.lastname: Lee
authors.affiliation: Health Outcomes and Pharmacy Practice Division, College of Pharmacy, University of Texas at Austin, Austin, TX.
authors.forename: Leticia R
authors.initials: LR
authors.lastname: Moczygemba
authors.affiliation: Clinical Pharmacy, Clinical Laboratory and Disease Management, Martin Health System, Stuart, FL.
authors.forename: L David
authors.initials: LD
authors.lastname: Harlow
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003157:Community Pharmacy Services / Q000639:trends*; D005260:Female; D006801:Humans; D000070516:Intersectoral Collaboration; D008297:Male; D054539:Medication Therapy Management / Q000639:trends*; D010348:Patient Care Team / Q000639:trends; D017060:Patient Satisfaction; D018802:Patient-Centered Care / Q000379:methods / Q000639:trends*; D010595:Pharmacists / Q000639:trends*; D012307:Risk Factors; D012424:Rural Population / Q000639:trends*
keywords: ADAPT; chronic disease state management; collaborative care model; comprehensive medication management; patient-centered medical home; pharmacist; transitions of care