Promoting Healthcare Access for Refugees and the Underserved is a Mission for Tom Buckley

By Loretta Waldman

Tom Buckley, MPH, RPh

Associate Clinical Professor of Pharmacy Practice and InCHIP Principal Investigator (PI) Tom Buckley, MPH, RPh has had a career path that is anything but conventional. Prior to joining the UConn faculty about 10 years ago, Buckley monitored public health outcomes for a major pharmaceutical company. He left that job to return as a volunteer to a refugee camp near the Thailand/Burma border, where he had previously completed a fellowship with the International Refugee Committee – the second of four trips to Southeast Asia to work with refugees.

Dr. Buckley’s prior work with refugees had a profound impact on his research, which focuses predominantly on healthcare equity and health disparities among immigrants/refugees and other underserved populations in the U.S. Approximately half of his research is with Khmer Health Advocates, the only Cambodian-American health organization in the country, and the other half is with community pharmacies in Connecticut, where he has created a community pharmacy practice research network.

At Khmer Health, Buckley is applying what he learned working with Burmese refugees to help the Cambodian immigrant and refugee community in Connecticut and throughout the country, many of whom struggle with the effects of trauma and torture. Located in West Hartford, Khmer Health had never had a pharmacist before Buckley’s arrival, and he quickly saw an opportunity to help clients better manage the many medications they were taking for diabetes, hypertension and other conditions linked to their post-traumatic stress. The prevalence of depression and PTSD (Post-Traumatic Stress Disorder) in the Cambodian-American immigrant/refugee population is more than 10 times the national average, and they experience rates of hypertension, heart disease, diabetes, and stroke and death from diabetic complications at a rate six times greater than the overall population. With the help of grants from the Centers for Disease Control (CDC), National Institutes of Health, Connecticut Department of Public Health (CT DPH), and private foundations, Buckley has expanded his public health work to include a host of initiatives within refugee communities.

One of Dr. Buckley’s initiatives involved creating a clinical rotation for fourth-year pharmacy students at KHA that pairs them with Cambodian-American community health workers for client home visits and to a Buddhist Temple in Bristol to visit with monks. He also was the PI on a study funded through the Center for Technology and Aging that tested the effectiveness of teleconferencing and other technologies in connecting older Cambodian-Americans living in Connecticut, Massachusetts, and California with medication therapy management services at Khmer Health Advocates.

Currently, Dr. Buckley is collaborating with Julie Wagner, Associate Professor of Oral Health and Diagnostic Sciences at UConn Health and an InCHIP PI, on a study aimed at preventing the onset of diabetes in Cambodian Americans with pre-diabetes. Along with intensive medication management, participants in two of the three arms of the so-called DREAM study will be offered a culturally-formulated lifestyle intervention called Eat, Walk, Sleep. They are recruiting adult Cambodian-Americans with major depressive disorder and associated functional impairment at high risk for Type 2 diabetes, from a network of community-based organizations in Connecticut, Rhode Island and Massachusetts. The goal of the study, which will offer some participants home visits and visits via teleconferencing, is to determine if combined strategies reduce the risk for diabetes in a population with numerous diabetes risk factors related to depression.

Dr. Buckley is also working with Megan Berthold, Assistant Professor in the School of Social Work and an InCHIP PI, on a grant project with KHA to specifically identify health equity issues and barriers in Southeast Asian Limited English speaking patients. Using surveys, interviews, and focus groups with community members and healthcare professionals, the goal is to develop policy initiatives to directly address health equity issues in these communities.

As for community pharmacies, Dr. Buckley currently has three projects funded through grants from the CDC and CT DPH. One of the grants will provide the funding for pharmacists to provide comprehensive medication management for patients with complex chronic conditions, including diabetes and hypertension. The pharmacist will spend an hour with the patient and then follow up with him/her.

Another study, conducted in partnership with Optimus Health Care and Bridgeport Pharmacy, focuses on screening African American mostly men, for hypertension. Funded with a grant from the CDC, through the Association of State and Territorial Health Organizations (ASTHO), this study sent trained Community Health Workers (CHWs) into barbershops, car washes, churches, and laundromats to conduct screenings. Armed with tablets and blood pressure cuffs, the CHWs took blood pressure measurements and registered participants with previously undiagnosed high blood pressure to see a doctor at Optimus Health Care. For the vast majority of these individuals, it was the first time they had seen a physician. As part of that study, Dr. Buckley worked with Optimus and the pharmacy to identify individuals already diagnosed and previously treated for high blood pressure but whose blood pressure was currently uncontrolled. “The pharmacist brought those people into the pharmacy, and they were able to get 80% of them to blood pressure goal,” he said.

Buckley often tells his students that pharmacists are the most accessible healthcare professionals but are often underutilized for their professional expertise. “You can walk into one of these pharmacies and theoretically get free medication information,” he said. “Data shows that there are more than 300 million visits to pharmacies in the U.S. every week. So if the pharmacist is truly the most accessible healthcare provider,… how do we get underserved people with the least access to appropriate care – whether it’s culturally or linguistically appropriate care, or just care in general for the English-speaking population – how do we get them linked to that resource which is so accessible and valuable but underutilized?”

Making that happen is Tom Buckley’s mission.