Changes coming to Million Hearts

Pharmacists can accelerate progress in the initiative’s efforts

February is American Heart Month, and changes are afoot at Million Hearts, a public-private health initiative launched in 2011 with the goal of preventing 1 million heart attacks and strokes by 2017. Million Hearts will be updated with a new framework as well as a new set of strategies centered on increasing physical activity. The new version, Million Hearts 2022, will also focus on cardiac rehabilitation. Other key elements of the initiative—the “ABCS” of aspirin, blood pressure control, cholesterol management, and smoking cessation—and the goals of reducing daily sodium intake and tobacco use will remain.

The changes are the result of research, lessons learned, and feedback, said Janet Wright, MD, executive director of Million Hearts. “As a result of extensive modeling exercises, interviews with experts, literature review, and feedback from our partners and others, we have changed the framework to strengthen and focus the community-based and health-system actions that will prevent heart attacks and strokes.”

Wright noted the importance of adding cardiac rehabilitation to Million Hearts 2022. “We have integrated a focus on boosting enrollment and participation in cardiac rehabilitation, a life-saving and life-enhancing set of interventions for those who have had a serious cardiovascular event or procedure.”

Million Hearts 2022 incorporates the following strategies:

  • Health information technology, including clinical decision support, patient portals, and e-referral, with an eye toward finding patients with undiagnosed hypertension, dyslipidemia, or tobacco use
  • Team-based care that includes pharmacists, nurses, community health workers, and cardiac rehabilitation specialists
  • Systems changes, including new or improved treatment protocols and continuous quality improvement
  • Patient supports, such as support for self-measured blood pressure monitoring and medication adherence, behavioral counseling, and referral to community-based physical activity programs

Wright is enthusiastic about the ways pharmacists might contribute to the Million Hearts initiative. “We are eager to learn and highlight how pharmacists are making a difference for people with and at risk for cardiovascular disease, and how these approaches can be scaled and spread across the country. In addition, we ask that wherever possible pharmacists use their skills and experience to help people take their cardiovascular medications regularly, tackle a smoking habit, and learn to self-measure their blood pressure.”

Wright called for APhA to identify how pharmacists can accelerate progress in the initiative’s efforts. “We look forward to working with a wide range of pharmacists and their teams—well-positioned in communities, academia, and healthcare settings across the nation—to prevent cardiovascular disease and improve heart and brain health,” she said.

As an established part of the Million Hearts collaboration, APhA will continue to provide direction and commentary on optimizing the initiative’s target areas, while also reaching out to pharmacists, said Mitchel C. Rothholz, BSPharm, MBA, APhA’s chief strategy officer. “APhA will be educating pharmacists and others within the pharmacy community about the target areas in Million Hearts 2022 and will be looking for opportunities of expanded pharmacist engagement in this important initiative.”