HIV / AIDS Resources

Please take time to familiarize yourself with the HIV and AIDS resources through the NM AIDS Education & Training Center.

• New Mexico AIDS Education and Training Center (Word Doc)
  
• HIV TeleECHO Clinic Curriculum: July 2011-June 2012 (PDF)
• HIV Educational Opportunities sponsored by NM AIDS Education and Training Center (PDF)

Arthritis in New Mexico: Blueprint for Action Available -

Arthritis is a disease that effects 54% of adults aged 65 and over in New Mexico (and twenty-seven percent of all NM adults). These adults in New Mexico with arthritis also often have other existing chronic diseases and co-morbid conditions. For example*:

•    52% do not engage in sufficient activity
•    67% are overweight or obese
•    15% also have diabetes
•    14% also have some form of cardio-vascular disease
•    44% have hypertension
•    49% have high cholesterol levels

The Arthritis Program at the New Mexico Department of Health is funded through a cooperative agreement with the Centers for Disease Control and Prevention. The Arthritis Program has established an Arthritis Advisory Group (AAG) made up of community partners to bring attention to arthritis as a public health issue. (The NMPCA has been actively involved in this group). The AAG worked with the Arthritis Program to develop “Arthritis in New Mexico – Blueprint for Action” (the Blueprint) – this document is described as a roadmap to heighten awareness of arthritis in New Mexico and promote policies that help New Mexicans with arthritis live longer, healthier lives.  The Blueprint has four priority goals –

1.    Access: Increase affordable and appropriate self-management opportunities for people with arthritis

2.    Collaboration: Increase collaboration between agencies and organizations that serve New Mexicans with arthritis and other chronic diseases that have similar disease management approaches.    People with arthritis do not experience their condition in isolation and the self-management practices recommended for people with arthritis can help manage heart disease, diabetes, osteoporosis, obesity and their risk factors

3.    Advocacy: Educate professionals and communities on the prevalence of arthritis in New Mexico, cost-effective self-management strategies and access-to-services barriers facing New Mexicans with arthritis

4.    Evidence based best practices: Healthcare practitioners should have access to evidence-based guidelines for diagnosis, treatment, and self-management referrals for people they treat who may have arthritis.

To see additional information about the Arthritis program visit: http://arthritisnm.org/ - click on Arthritis Advisory Group then choose Strategic Planning Activities from the drop down box and click on Arthritis in New Mexico Blueprint for Action 2009-2012 to download the Blueprint.

* From “Arthritis in New Mexico” a 2010 Fact Sheet developed by the Arthritis Program at New Mexico Department of Health

  

Mobile Mammography Project – a Success! 

For several years the NMPCA has worked with several partners including UNM Cancer Center, UNM College of Nursing, NM Department of Health Comprehensive Cancer Program, NM Breast & Cervical Cancer Early Detection (BCC) Program and the American Cancer Society and others to bring mobile mammography to rural & underserved areas of New Mexico. After some consideration of obtaining a mobile unit the group decided to contract with Assured Imaging Women’s Wellness (AI) from Arizona who was already providing mammography to some places in New Mexico. The first pilot event took place in October 2009 at El Centro Family Health in Las Vegas. The event was a success not only in terms of the number of women that were seen but also in the way the event was coordinated.

Since that pilot event the Mobile Mammography Project Group (the Group) has assisted with coordination of events in:
•    Tierra Amarilla (La Clinica del Pueblo & El Centro Family Health)
•    Penasco (El Centro Family Health)
•    Cuba (Presbyterian Medical Services)
•    Las Vegas (El Centro Family Health & Mora Valley Community Health Services).

The Group set a goal of 50 women for each event. At each of the first three events 47 – 51 women were seen. In Cuba 73 mammograms were done and 19 BCC applications were completed – all in one day! The most recent two day event in Las Vegas was cause for a celebration with 101 women seen!

The event in Tierra Amarilla and the most recent Las Vegas event were tremendous examples of collaboration with community health centers working together to serve women needing mammography. At Tierra Amarilla, La Clinica del Pueblo hosted the event and El Centro Family Health patients from Chama & Coyote also were seen. In Las Vegas, the event was hosted by El Centro Family Health and patients from Mora Valley Community Health Services were also seen.

The Community Health Center hosting the event plays a critical role by determining the women who are eligible for mammography, enrolling women in the BCC program, providing well woman exams the same day and being available to become a medical home to those women who want to have a mammogram but do not have a primary care provider. Women are welcomed into the Health Center waiting area and allowed to complete AI paperwork before being escorted to the mobile unit. After the mammogram is done the women are asked to come back into the clinic and complete a brief UNM College of Nursing survey regarding barriers to mammography. Uninsured and under-insured women who are not eligible for the BCC program are screened using grant funds from the UNM Cancer Center and every woman receives a $10 gift card through those same funds. In addition to employees from the sponsoring Health Center there are a number of volunteers from each organization involved in the Group that assist with registration, translation, escorting women to the mobile unit, etc.

This is a collaborative effort that works! Some of the comments from the women participating include:  “Thanks!” “We hadn’t had this opportunity in a long time!” “I would probably put this off forever if you hadn’t come! THANK YOU!!” “Come more often!”

Medical Home Sweet Home

PSPC Team Name: El Centro and Partners Team (New Mexico), which includes team partners:

•    Albuquerque Health Care for the Homeless
•    El Centro Health Care
•    New Mexico Medical Review Association (NMMRA)
•    New Mexico Primary Care Association
•    University of New Mexico College of Pharmacy

Population of focus: High-risk patients with multiple chronic diseases:

•    Diabetes
•    Hypertension
•    Hyperlipidemia
•    Congestive Heart Failure

It takes a village to manage medication in patients with special high-risk diseases. This village consists of heath care programs from medicine, nursing, pharmacy, and health care organizations. It is important to remember that the patient is also included on that team. This story celebrates the successes seen when the patient is intentionally placed at the center of that team: genuine patient-centered care.

For 12 months, the pharmacist members of the El Centro and Partners Team in New Mexico have been striving to use a holistic approach that includes building rapport to establish trust with their patients, all the way to allowing patients to guide the focus of their clinic visits.  Patients are treated like family, and they trust the pharmacist, asking questions about issues that impact their medical conditions.

In some cases remarkable progress has been made by individual patients. For example, teaching one patient the function of their medications and role of nutrition in diabetes management, including bibliotherapy so the patient could control own learning, guide her own care, thereby decreasing her anxiety over her condition, lowered her blood glucose from an average of over 450mg/dL to 180mg/dL in under two months.  She was able to self-monitor her blood glucose, whereas before she lived by “ignorance is bliss” until her condition deteriorated rapidly.  Realizing the value of being informed allowed her to take charge and control her own care and condition.

Another success concerned a patient’s struggle with depression, which is common in patients with diabetes. During seven months of face-to-face visits, trust was developed and rapport built so that the patient was comfortable revealing symptoms of depression that would have otherwise gone unnoticed and untreated. The pharmacist was able to provide a referral to behavioral health.
In addition, family support of the patient is recognized, along with the value of group visits. The creation of support systems was a very successful component of this intervention, which was critical in establishing self-management goals and providing a forum for patients to share lessons learned.

Clinical outcomes for the El Centro and Partners Team included the following:

•    The percentage of patients with A1C <7 percent increased from 13 percent to 33 percent (exceeding the team’s goal of 25 percent)
•    A1C rates of <9 percent increased from 69 percent to 83 percent (exceeding the team’s goal of 75 percent)
•    LDL of <100mg/dL increased from 52 percent to 75 percent (reaching the team’s goal of 75 percent)
•    Blood pressure under control for the entire population of focus (130mmHg/80mmHg) increased from 45 percent to 67 percent (the team’s goal was 75 percent)

Going forward, the El Centro and Partners Team is planning to work on integrated care delivery for patients with diabetes, including coordinating care transition among providers and patient settings, with medication reconciliation at each transition.

The Diabetes Prevention & Control Program offers online courses to healthcare professional at www.diabetesnm.org. 

Dowlnoad the flier (pdf).

NMPCA Clinical Program and the Diabetes Prevention and Control Program (DPCP) Collaborate

The NMPCA’s Clinical Program is collaborating with the DPCP to initiate a systems intervention in one of our member organizations. This intervention will have an impact on the “ABC” results in diabetic patients. “ABC’s” refer to measuring the Hemoglobin A1c, the Blood Pressure and the LDL-Cholesterol (“bad” cholesterol) in diabetic patients. We expect to improve both the patients’ health and the way the health system is able to track and report the patient outcomes to the medical providers.
This collaboration will continue through June 2011, with the hope of continued collaboration over the next 4 years.

 

NMPCA Tobacco Grant

The NMPCA received a continuation on its HRSA Cancer Grant to focus on tobacco cessation activities for young, low socioeconomic women, their partners and families.  Two of the deliverables were assessing patient tobacco use through a paper survey and assessing provider practice (as it related to tobacco use assessment and providing treatment assistance) through a on-line survey. The results of these two surveys are as follows:

Provider Survey  - April – May 2010

69 surveys returned - about 16% of possible responses
(The expected response rate was 4% – 5%)

73% were Family practice doctors
(50 FP docs out of 91 FTE’s* = 55% off all the FP docs responded)

3% were Internal medicine doctors
(2 IM docs out of 14 FTE’s* = 14% of all the IM docs responded)

7% were Pediatricians
(5 Peds docs out of 8 FTE’s* = 63% of all Peds docs responded)

4% Other (CNP/CNM and Preventive Medicine)
(3 Midlevels out of 86 FTE’s* = 3% response – this survey was targeted to MD/DO’s, Dentists and Licensed Behavioral Health Counselors) 

10% Dentists
(7 out of 53 FTE’s* = 13% of all Dentists responded)

3% Behavioral health counselors
(2 out of 97 FTE’s* = 2% of all counselors responded)

Note: this survey was sent out through the Clinical Performance Improvement Committee members. They may not have forwarded it to all the eligible providers in their organizations.

Assessment of tobacco use @ every visit
    Always =        58%
    Sometimes =   41%
    Never =            1%

Referrals to Quit Line
    Always =         41%
    Sometimes =   48%
    Never =          11%

Use of Brief Interventions during patient visits
    Always =        24%
    Sometimes      63%
    Never =          13%

*data from 2008 UDS
 
NMPCA Tobacco Survey Results

Patient Survey - April 2010

2412 surveys returned out of 2550 surveys sent out

38% have smokers in the household

35% of non-smokers are exposed to secondhand smoke in household

74 % are non-tobacco users

26% are tobacco users (89% of these are cigarette smokers)

75% of the tobacco users have been advised by the clinic staff to quit

75% of the tobacco users have tried to quit in the past

28% of women tobacco users who have been pregnant, used tobacco during their pregnancy