Regional osteoporosis screening, referral, and monitoring program in community pharmacies: findings from Project ImPACT: Osteoporosis.
Regional osteoporosis screening, referral, and monitoring program in community pharmacies: findings from Project ImPACT: Osteoporosis.
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DOI：
10.1331/154434504773062609
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发表时间：
2004-03-01
期刊：
影响因子：
--
通讯作者：
Bluml, Benjamin M
中科院分区：
文献类型：
--
作者：
Goode, Jean-Venable;Swiger, Kim;Bluml, Benjamin M
目的：（1）透过社区药房的骨密度（BMD）筛选，识别有骨质疏松风险的病人，并将有骨质疏松风险的病人转介至基层护理及/或专科医生，以及跟进有骨质疏松风险的病人;（2）治疗及管理转介至药房接受药物治疗管理服务的骨质疏松及骨质疏松病人;和（3）测试支付方法的药剂师谁提供社区健康管理服务的人群在风险或诊断为骨质疏松症。设计：单队列观察研究。杂货店和药房，29家连锁店与22个药店的位置在里士满，Virginia.PARTICIPANTS：消费者与一个或多个已知的风险因素骨质疏松症在Ukrop的客户服务area.INTERVENTION：在该项目的初始阶段（健康促进和疾病预防），药房为基础的骨质疏松症筛查与转诊和随访提供给消费者谁回应Ukrop的筛查促销活动。第二阶段--提供以骨质疏松症监测和管理为重点的协作社区健康管理服务--正在进行中，包括有骨质疏松症风险或被诊断为骨质疏松症的患者，并由区域支付方支付。主要结果指标：筛查结果;患者和医生对通知的反应;以及协作护理期间的长期结果。药剂师筛选了532名患者，并在3至6个月后联系了其中305名患者进行随访。骨折风险分层为37%，高风险; 33%，中度风险; 30%，低风险。共有78%的患者表示，他们事先不知道未来骨折的风险。在中度和高风险类别中，37%的患者安排并完成了医生访视，19%进行了诊断扫描，24%的患者在筛选后开始接受骨质疏松治疗。参与药店获得支付的骨质疏松症筛查和协作健康管理service.CONCLUSION：药店可以发挥有益的作用，在识别，教育和转介的患者在骨质疏松症的风险，通过药店为基础的BMD筛查。患者愿意支付基于药房的骨质疏松症筛查服务。第三方支付者愿意为协作社区健康管理服务的药剂师提供补偿。
OBJECTIVE: (1) To identify patients at risk for osteoporosis through community pharmacy-based bone mineral density (BMD) screening, to refer at-risk patients to primary care and/or specialty practice physicians, and to follow-up with at-risk patients; (2) to treat and manage osteopenic and osteoporotic patients referred to the pharmacy for medication therapy management services; and (3) to test a payment methodology for pharmacists who deliver community health management services to a population at risk for or diagnosed with osteoporosis.DESIGN: Single-cohort observational study.SETTING: Ukrop's Super Markets, Inc. Grocery and Pharmacy, a 29-store chain with 22 pharmacy locations in Richmond, Virginia.PARTICIPANTS: Consumers with one or more known risk factors for osteoporosis in Ukrop's customer service area.INTERVENTION: During the initial phase (health promotion and disease prevention) of the project, pharmacy-based osteoporosis screening with referral and follow-up was provided to consumers who responded to Ukrop's screening promotions. The second phase-provision of collaborative community health management services focused on osteoporosis monitoring and management--is ongoing and includes patients who are at risk for or diagnosed with osteoporosis and are covered by a regional payer.MAIN OUTCOME MEASURES: Results of screenings; responses of patients and physicians to notifications; and long-term results during collaborative care.RESULTS: The pharmacists screened 532 patients and were able to contact 305 of these patients for follow-up interviews 3 to 6 months later. The stratification for risk of fracture was 37%, high risk; 33%, moderate risk; and 30%, low risk. A total of 78% of patients indicated that they had no prior knowledge of their risk for future fracture. In the moderate- and high-risk categories, 37% of patients scheduled and completed a physician visit, 19% had a diagnostic scan, and 24% of those patients were initiated on osteoporosis therapy subsequent to the screening. Participating pharmacies received payment for both the osteoporosis screening and the collaborative health management services.CONCLUSION: Pharmacists can play a useful role in the identification, education, and referral of patients at risk for osteoporosis through pharmacy-based BMD screening. Patients are willing to pay for pharmacy-based osteoporosis screening services. Third-party payers are willing to compensate pharmacists for collaborative community health management services.