Pharmacists providing care in statewide physician organizations: findings from the Michigan Pharmacists Transforming Care and Quality Collaborative.
Pharmacists providing care in statewide physician organizations: findings from the Michigan Pharmacists Transforming Care and Quality Collaborative.
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DOI：
10.18553/jmcp.2020.26.12.1558
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发表时间：
2020-12
影响因子：
2.1
通讯作者：
Farris, Karen B.
中科院分区：
文献类型：
--
作者：
Coe, Antoinette B.;Choe, Hae Mi;Diez, Heidi L.;Rockey, Nicole G.;Ashjian, Emily J.;Dorsch, Michael P.;Kim, Hyungjin Myra;Farris, Karen B.
由药剂师提供的临床服务嵌入在实践中可以改善患者的结果在初级保健设置。很少有人知道医生组织（PO）是否会保留临床药剂师的服务后，外部资金的全州范围内的实施计划结束。为了评估全州范围内的计划，密歇根州药学转型护理和质量（MPTCQ），在17个PO内纳入药剂师。使用2016年6月至2018年9月从参与MPTCQ的PO中的初级保健临床药师接触中收集的数据进行了描述性研究。过程结果包括参与PO的数量、患者就诊次数和每位患者的平均就诊次数。就诊水平的分析按2种就诊类型分层：疾病状态管理（DSM）或综合药物审查（CMR）。分别按就诊类型，通过药物变更的数量、类型和原因以及药物依从性和发现并解决的成本障碍描述药剂师的影响。临床结局包括血红蛋白A1 c和血压变化。报告了提供临床服务的药剂师的可持续性和患者满意度。在17个PO中，27名药剂师参加了MPTCQ计划。药房完成了24，523例DSM患者就诊，其中5，942例患者，平均每位糖尿病患者5次就诊，2次高血压就诊。在糖尿病和高血压的就诊期间，Pharmacopoeia进行了15，153次治疗药物变更，其中约70%与疗效有关。Pharmacology为3，092名患者完成了4，203次CMR访视。在CMR访视期间，建议更换1，296种治疗药物。在13%的CMR访视中发现了药物费用问题。药剂师管理的患者血压和A1 c水平下降。在接受调查的157名患者中，87%的人认为他们的药剂师的护理非常好。16个参与组织在供资结束时保留了药剂师。全州范围内的提供者-付款人伙伴关系成功地整合并保留了PO内的初级保健药剂师。MPTCQ计划中的药剂师通过改变药物来改善患者的临床结局，从而改善了疾病控制。
Clinical services provided by pharmacists embedded in practices can improve patient outcomes within the primary care setting. Little is known about whether physician organizations (POs) will retain the services of clinical pharmacists after outside funding for a statewide implementation program is ended. To evaluate a statewide program, Michigan Pharmacists Transforming Care and Quality (MPTCQ), that incorporated pharmacists within 17 POs. A descriptive study was conducted using data collected from June 2016 to September 2018 from primary care clinical pharmacist encounters in POs participating in MPTCQ. Process outcomes included the number of participating POs, patient encounters, and average visits per patient. Analyses at the encounter level were stratified by 2 encounter types: disease state management (DSM) or comprehensive medication review (CMR). Separately by encounter type, pharmacist effect was described by the number, type, and reasons for medication changes, as well as medication adherence and cost barriers found and addressed. Clinical outcomes included hemoglobin A1c and blood pressure change. Sustainability and patient satisfaction of pharmacists providing clinical services are reported. Across 17 POs, 27 pharmacists participated in the MPTCQ program. Pharmacists completed 24,523 patient encounters for DSM with 5,942 patients, with an average of 5 visits per patient with diabetes and 2 visits for hypertension. Pharmacists made 15,153 therapeutic medication changes during visits for diabetes and hypertension, with approximately 70% related to efficacy. Pharmacists completed 4,203 CMR visits for 3,092 patients. During CMR visits, 1,296 therapeutic medication changes were recommended. Problems with medication cost were identified in 13% of CMR visits. Blood pressure and A1c levels decreased in patients managed by pharmacists. In 157 patients surveyed, 87% rated their pharmacists’ care as excellent. Sixteen POs retained their pharmacists at the end of funding. A statewide provider-payer partnership successfully integrated and retained primary care pharmacists within POs. Pharmacists in the MPTCQ program contributed to improvements in disease control by changing medications to improve patient clinical outcomes.
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影响因子：
1.4
作者：
Edwards, Heather D.;Webb, Ryan D.;Armor, Becky L.
通讯作者：
Armor, Becky L.
影响因子：
2.1
作者：
Benedict, Amanda W.;Spence, Michele M.;Rashid, Nazia
通讯作者：
Rashid, Nazia
DOI：
10.1001/jama.2015.13766
发表时间：
2015-11-03
期刊：
JAMA
影响因子：
--
作者：
Kantor ED;Rehm CD;Haas JS;Chan AT;Giovannucci EL
通讯作者：
Giovannucci EL
影响因子：
9.7
作者：
Bodenheimer, Thomas S.;Smith, Mark D.
通讯作者：
Smith, Mark D.
影响因子：
2.7
作者：
Choe, Hae Mi;Farris, Karen B.;Standiford, Connie J.
通讯作者：
Standiford, Connie J.