Michelle Chu, PharmD, BCACP, APh

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Biography

Dr. Michelle Chu is Assistant Professor of Clinical Pharmacy at USC School of pharmacy. She went to the University of Illinois at Chicago, School of Pharmacy where she graduated Summa Cum Laude and completed postgraduate residency training in ambulatory care pharmacy practice at the USC School of Pharmacy. Since then, Dr. Chu has worked as one of clinical pharmacists to manage high risk patients with multiple uncontrolled chronic disease states at various safety net clinics, affiliated with the USC School of Pharmacy until her recent appointment. She was the lead pharmacist for projects to integrate clinical pharmacists into primary care clinics.

Since her faculty appointment, she has practiced at the internal medicine department at Keck Medical Center of USC to manage various disease states, including anticoagulation, diabetes, and hypertension, and also has developed telehealth post-discharge pharmacy clinic to improve quality metrics for patients from the hospital. As she became the director of PGY1 pharmacy residency in ambulatory care, she started to practice at the LAC+USC medical center to dedicate majority of her time teaching and training pharmacy residents and to help the medical center to grow in ambulatory care pharmacy services by evaluating the current services and identifying the needs of the future area.

Areas of Expertise (6)

Ambulatory Care Pharmacy

Telehealth

Diabetes

Chronic Disease

Hypertension

Primary Care

Education (2)

University of Illinois at Chicago: Pharm.D., Pharmacy

Rho Chi, Summa Cum Laude

University of Illinois at Urbana-Champaign: B.S., Physiology, Chemistry

Links (1)

• USC School of Pharmacy Profile

Selected Articles (7)

Comprehensive Medication Management Programs: 2015 Status in Southern California

Research in Social and Administrative Pharmacy

Ashley Butler, Patricia Shane, Michelle Chu

2016 Comprehensive medication management (CMM) is an evidence-based, physician approved, pharmacist-led, preventive clinical service ensuring optimal use of medications that is effective at improving health outcomes for high-risk patients while decreasing health care costs. Pharmacist-provided medication management, such as CMM pilot programs have been successfully implemented in six health care systems within Southern California resulting in improvements in clinical, fiscal, and quality measures.

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The Hypothyroid Patient

Rx Consultant Vol 28. No. 10, Nov 2019

Chu M.

2019-11-01

Continuing Education Piece on hypothyroidism

Impact of early initiation of antihypertensive medications for patients with hypertension or elevated blood pressure.

Journal of Hypertension 2019;37:1276-1284

Han X, McCombs J, Chu M, Dougherty S, Fox S.

Objectives: The 2017 American College of Cardiology/ American Heart Association High Blood Pressure Guidelines lowered high blood pressure (BP) threshold, recommending earlier treatment to prevent cardiovascular disease. This study estimated the impact of initiating early antihypertensive medications on the risk of acute myocardial infarction (AMI), stroke, death, and on healthcare costs in patients potentially qualifying for antihypertensive treatment under the 2017 guidelines. Methods: High-risk patients qualifying for antihypertensive medications under the 2017 guidelines were identified using Optum data. Patients with a diagnosis of elevated BP were also assumed eligible for hypertension treatment under the new guidelines. Patients were defined to have initiated early treatment if they initiated treatment before experiencing a cardiovascular event postdiagnosis. Results: A total of 916 633 patients met eligibility requirements and all other study inclusion criteria. Of those, 66% initiated treatment during 2007–2016. Initiating early antihypertensive treatment decreased the likelihood of having AMI by 59%, stroke by 60% and death by 9%. Patients with only an ‘elevated BP’ diagnosis experienced reduced risk of stroke once they initiated medications. Treatment reduced the risk of AMI or stroke for patients with diabetes, chronic renal disease and obesity and also significantly lowered all-cause healthcare costs in the first post index year. Conclusion: Initiating antihypertensive medications before experiencing a cardiovascular disease-related clinical event was associated with reduced risk of AMI, stroke and death for all hypertensive patients identified in the new guidelines. However, early treatment had a significantly smaller effect for patients with only ‘elevated’ BP, who experienced just a lower risk of stroke once treated.

Primary Prevention Using Cholesterol-Lowering Medications in Patients Meeting New Treatment Guidelines: A Retrospective Cohort Analysis

J Manage Care Spec Pharm. 2018;24(11):1087-85

Xue Han, MS; D. Steven Fox, MD, MSc; Michelle Chu, PharmD, CDE, BCACP; J. Samantha Dougherty, PhD; and Jeffrey McCombs, PhD

BACKGROUND: The American College of Cardiology and American Heart Association (ACC/AHA) issued new cholesterol treatment guidelines in 2013. Two of the groups designated for primary prevention were analyzed: patients with a low-density lipoprotein cholesterol (LDL-C) level ≥ 190 mg per dL and diabetic patients aged 40-75 years. OBJECTIVE: To estimate the effects of primary prevention as specified in the 2013 guidelines on cardiovascular event risk and cost. METHODS: Primary prevention patients were identified using laboratory and diagnostic data for Humana members from 2007 to 2013. Potential study patients were classified into 3 risk groups: elevated LDL-C, diabetes, and elevated LDL-C and diabetes. Patients receiving cholesterol-lowering medications before their index date were excluded. Eligible patients were divided into 2 treatment groups: (1) primary prevention patients who initiated treatment before experiencing any cardiovascular disease (CVD)-related event, and (2) patients who either did not initiate treatment until after experiencing a CVD event or never initiated treatment. The associations between initiating cholesterol-lowering medications for primary prevention and the risk for acute myocardial infarction, stroke, coronary angioplasty, or coronary artery bypass graft surgery were estimated using Cox proportional hazards models. The effect of primary prevention on health care costs was estimated using generalized linear models. RESULTS: 91,066 patients met study selection criteria. Primary prevention rates were the lowest in diabetic patients (35%), who were newly designated for treatment in the 2013 guidelines. Primary prevention rates were higher for patients designated for treatment under earlier guidelines: 65% for patients with elevated LDL-C and 78% for the combined LDL-C and diabetes group. Primary prevention treatment was associated with significant reductions in cardiovascular event risk (up to 37%) and lower total all cause costs (by $673) in the first post-index year. CONCLUSIONS: Initiating cholesterol-lowering medications for primary prevention, as specified in the ACC/AHA 2013 guidelines, for patients with high LDL-C and diabetes is associated with reduced CVD event risks and lower health care costs.

Applications in safety net clinics. Chapter in Pharmacy management Essentials for All practice Settings. Fourth Edition

McGraw-Hill Education, New York, NY, Copyright 2016

Chens, Baron M, Chu M, Svadjian R.

Book Chapter on clinical pharmacy services in safety net clinics.

Pharmacists & Test Ordering Roles and Responsibilities

Rx Consultant Vol. 24 No. 5, May 2015

Chen S, Chu ML.

Guide on pharmacists ordering and interpreting diagnostics and laboratory tests related to comprehensive medication management.

HbA1c Change in Patients With and Without Gaps in Pharmacist Visits at a Safety-Net Resident Physician Primary Care Clinic

Journal of Clinical Outcomes Management

Michelle Chu, Brian Ma, Joanne Suh, Mimi Lou

2021-05-31

Objective: The objective of this study is to describe HbA1c changes in patients who maintained continuous pharmacist care vs patients who had a gap in pharmacist care of 3 months or longer. Methods: This retrospective study was conducted from October 1, 2018, to September 30, 2019. Electronic health record data from an academic-affiliated, safety-net resident physician primary care clinic were collected to observe HbA1c changes between patients with continuous pharmacist care and patients who had a gap of 3 months or longer in pharmacist care. A total of 189 patients met the inclusion criteria and were divided into 2 groups: those with continuous care and those with gaps in care. Data were analyzed using the Mann-Whitney test for continuous variables and the χ2 (or Fisher exact) test for categorical variables. The differences-in-differences model was used to compare the changes in HbA1c between the 2 groups. Results: There was no significant difference in changes in HbA1c between the continuous care group and the gaps in care group, although the mean magnitude of HbA1c changes was numerically greater in the continuous care group (-1.48% vs -0.97%). Overall, both groups showed improvement in their HbA1c levels and had similar numbers of primary care physician visits and acute care utilizations, while the gaps in care group had longer duration with pharmacists and between the adjacent pharmacist visits. Conclusion: Maintaining continuous, regular visits with a pharmacist at a safety-net resident physician primary care clinic did not show a significant difference in HbA1c changes compared to having gaps in pharmacist care. Future studies on socioeconomic and behavioral burden on HbA1c improvement and on pharmacist visits in these populations should be explored.