March 18, 2021
The US Department of Health and Human Services launched the Million Hearts Initiative 2012 with the goal to reduce tobacco use and sodium consumption and to eliminate artificial trans-fats from the food supply in clinical care. This initiative was led by the Centers for Disease Control and Prevention and the Centers for Medicare and Medicaid Services with federal agencies, state governments, clinical consortia, community and professional organizations, and other partners.1 The first initiative focused on medication use including aspirin use, blood pressure control, cholesterol management, and smoking cessation treatment. This initiative was very successful, estimated to have helped prevent 135,000 cardiovascular events, saved $5.6 billion in averted medical costs from cardiovascular disease.2 In 2022, the Million Hearts phase II aims to reduce tobacco use, sodium intake, and physical inactivity by 20%, achieve performance in the drug-related treatments above, with 70% participation in cardiac rehabilitation, and focus on priority populations.
So, what is the Pharmacy National Initiative? Do we have one? The Rapid Alliance (60 panelists associated with pharmacy practice and research) recently published a report for protecting and improving the US population health and wellbeing through pharmacists and pharmacies working in collaboration with connected stakeholders during and after the COVID-19 pandemic.3 The recommendations of this report are pharmacy-centric, including payments for valuable pharmacy services, reduce practice barriers, and support data sharing. The most important question from this report is: will the health care infrastructure from the Million Hearts campaign support the Rapid Alliance Report recommendations? My answer is no. Not because the recommendations are not worthy or cannot be accomplished, but because the recommendations are not patient-focused.
What Pharmacy National Initiative would engender the health care infrastructure to join pharmacy? A value proposition to improve patient care would be a true North Star. Would the following work for improving health care? The Pharmacy National Initiative: Reduce drug-related hospitalizations and death. This would be a 5-year goal, completed in 2027. The profession could start with implementation of the Pharmacy Quality Solutions Quality (PQA) and Medicaid Part D measures to address high-risk mediation use. This approach fits nicely with the Million Hearts initiative outlined above. It provides the pharmacy profession with a one-size fits all approach to work with providers, health care organizations and government to improve care, improve access for all, and reduce costs. By joining the health care infrastructure, using our knowledge and skills with medications, the pharmacy profession will realize its goals as outlined in the Rapid Alliance Report.
Mark A. Munger, PharmD, FCCP, FACC, is a professor of pharmacotherapy and adjunct professor of internal medicine, at the University of Utah, where he also serves as the associate dean of Academic Affairs for the College of Pharmacy.
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- Frieden TR, Berwick DM. The “Million Hearts” initiative: preventing heart attacks and strokes. N Engl J Med. 2011;365(13):e27.
- Ritchey MD, Wall HK, Hannan J, Sperling LS. Million Hearts 2012-2016 final report addendum [published online June 2020]. Accessed 03/2021.
- The Rapid Alliance Report. Implementation Science-Informed Strategies and Improving US Population Health and Well-Being through Pharmacists and Pharmacies Working in Collaboration with Connected Stakeholders during and after the COVID-19 Pandemic. https://www.rapidalliance.org/