An Integrated Pharmacy-Based Program Improved Medication Prescription And Adherence Rates In Diabetes Patients
An Integrated Pharmacy-Based Program Improved Medication Prescription And Adherence Rates In Diabetes Patients
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DOI：
10.1377/hlthaff.2011.0931
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发表时间：
2012-01-01
期刊：
影响因子：
9.7
通讯作者：
Grambley, William
中科院分区：
文献类型：
--
作者：
Brennan, Troyen A.;Dollear, Timothy J.;Grambley, William
对美国公众整体健康的一个重大威胁是不遵守用于治疗糖尿病的药物，以及医生未能开始患者使用这些药物。为了解决这个问题，我们评估了一个综合的，以药房为基础的计划，以提高患者的依从性和医生的启动率。该研究包括干预组的5，123名糖尿病患者和对照组的24，124名糖尿病患者。干预措施包括从邮购和零售药剂师那里获得关于患者坚持用药和使用合并治疗的具体信息。与对照组相比，这些干预措施使患者的药物依从率提高了2.1%，使医生的启动率提高了38%。在零售环境中接受咨询的患者比那些在邮购药店接受药剂师电话咨询的患者获益更大。这表明零售药剂师和患者之间的面对面互动有助于改善行为。这些干预措施具有成本效益，每花费1美元，投资回报率约为3美元。这些发现突出了药师在促进慢性病治疗的适当启动和坚持方面可以发挥的核心作用。
A substantial threat to the overall health of the American public is nonadherence to medications used to treat diabetes, as well as physicians' failure to initiate patients' use of those medications. To address this problem, we evaluated an integrated, pharmacy-based program to improve patients' adherence and physicians' initiation rates. The study included 5,123 patients with diabetes in the intervention group and 24,124 matched patients with diabetes in the control group. The intervention consisted of outreach from both mail-order and retail pharmacists who had specific information from the pharmacy benefit management company on patients' adherence to medications and use of concomitant therapies. The interventions improved patients' medication adherence rates by 2.1 percent and increased physicians' initiation rates by 38 percent, compared to the control group. The benefits were greater in patients who received counseling in the retail setting than in those who received phone calls from pharmacists based in mail-order pharmacies. This suggests that the in-person interaction between the retail pharmacist and patient contributed to improved behavior. The interventions were cost-effective, with a return on investment of approximately $3 for every $1 spent. These findings highlight the central role that pharmacists can play in promoting the appropriate initiation of and adherence to therapy for chronic diseases.