Barriers and facilitators to implementing a Pharmacist, Physician, and Patient Navigator-Collaborative Care Model (PPP-CCM) to treat hepatitis C among people who inject drugs.
Barriers and facilitators to implementing a Pharmacist, Physician, and Patient Navigator-Collaborative Care Model (PPP-CCM) to treat hepatitis C among people who inject drugs.
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在注射吸毒者中实施药剂师、医生和患者导航员协作护理模式 (PPP-CCM) 来治疗丙型肝炎的障碍和促进因素。
DOI：
10.1016/j.drugpo.2022.103924
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发表时间：
2023
期刊：
影响因子：
--
通讯作者：
Deutsch,Sara
中科院分区：
文献类型：
--
作者：
Austin,ElizabethJ;Gojic,AlexanderJ;Bhatraju,ElenoreP;Pierce,KathleenA;Pickering,EleanorI;Tung,ElyseL;Scott,JohnD;Hansen,RyanN;Glick,SaraN;Stekler,JoanneD;Connolly,NancyC;Villafuerte,Sarah;McPadden,Madison;Deutsch,Sara
直接作用抗病毒药物（DAA）为消除丙型肝炎病毒（HCV）感染提供了前所未有的机会，但注射吸毒者（PWID）之间的障碍仍然存在。让药剂师通过合作药物治疗协议（CDTA）提供护理提供了一个有前途的解决方案。我们开发并试行了一种药剂师、医生和患者导航员协作护理模式（PPP-CCM），该模式利用药剂师在为PWID服务的社区组织直接提供HCV护理。我们进行了形成性评价的PPP-CCM试点，以表征实施experiences.MethodsThe PPP-CCM是从2020年11月至2022年7月实施。形成性评价小组成员观察了与执行有关的会议，并进行了多次实地访问，作了详细的实地记录。对实地说明进行了反复审查，以确定实施的障碍和促进因素，并用于在试点结束时与方案工作人员进行的7次关键知情人访谈。所有的数据进行了分析，使用快速评估过程（RAP）的实施研究的综合框架（CFIR）的指导下。形成性评估小组与计划利益相关者（药剂师，医生和其他现场工作人员）分享结果，以验证和扩大学习。结果PPP-CCM的评估揭示了5个主题，包括所有CFIR领域：1）PPP-CCM是可行的，但具有挑战性的有效交付; 2）药剂师的角色和特征（例如，灵活、可用和以患者为中心）是PPP-CCM成功的关键; 3）PPP-CCM团队随着时间的推移遇到了吸引患者的挑战，但一些基于团队的策略有所帮助; 4）社区站点特征（例如，现有的信任关系与PWID和物理空间，使计划的知名度）是重要的贡献者;和5）财政障碍可能会限制PPP-CCM的规模和sustainability.ConclusionPPP-CCM是一种新颖的和有前途的方法，以丙型肝炎病毒的护理提供PWID谁以前可能缺乏参与传统的护理模式，但需要仔细注意支付的财务障碍，以确保可扩展性和可持续性。
BackgroundDirect-acting antivirals (DAAs) offer an unprecedented opportunity to eliminate hepatitis C virus (HCV) infection, yet barriers among people who inject drugs (PWID) remain. Having pharmacists provide care through collaborative drug therapy agreements (CDTAs) offers a promising solution. We developed and piloted a Pharmacist, Physician, and Patient Navigator-Collaborative Care Model (PPP-CCM) which utilized pharmacists to directly deliver HCV care at community organizations serving PWID. We conducted formative evaluation of the PPP-CCM pilot to characterize implementation experiences.MethodsThe PPP-CCM was implemented from November of 2020 through July of 2022. Formative evaluation team members observed implementation-related meetings and conducted multiple site visits, taking detailed fieldnotes. Fieldnotes were iteratively reviewed to identify barriers and facilitators to implementation and used to inform 7 key informant interviews conducted with programmatic staff at the end of the pilot. All data were analyzed using a Rapid Assessment Process (RAP) guided by the Consolidated Framework for Implementation Research (CFIR). The formative evaluation team shared results with program stakeholders (pharmacists, physicians, and other site staff) to verify and expand on learnings.ResultsEvaluation of PPP-CCM revealed 5 themes, encompassing all CFIR domains: 1) PPP-CCM was feasible but challenging to deliver efficiently; 2) the pharmacist role and characteristics (e.g., being flexible, available, and patient-centered) were key to PPP-CCM successes; 3) the PPP-CCM team met challenges engaging patients over time, but some team-based strategies helped; 4) community site characteristics (e.g., existing trusting relationships with PWID and physical space that enabled program visibility) were important contributors; and 5) financial barriers may limit PPP-CCM scale-up and sustainability.ConclusionPPP-CCM is a novel and promising approach to HCV care delivery for PWID who may previously lack engagement in traditional care models, but careful attention needs to be paid to financial barriers to ensure scalability and sustainability.
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社区药剂师可以治疗丙型肝炎病毒吗？
DOI：
10.1016/s2468-1253(20)30184-9
发表时间：
2020
期刊：
The Lancet. Gastroenterology & Hepatology
影响因子：
--
作者：
A. Wade
通讯作者：
A. Wade
DOI：
10.1016/s2214-109x(20)30505-2
发表时间：
2021-04
期刊：
The Lancet. Global health
影响因子：
--
作者：
Oru E;Trickey A;Shirali R;Kanters S;Easterbrook P
通讯作者：
Easterbrook P
影响因子：
4.4
作者：
Broad, Jennifer;Mason, Kate;Powis, Jeff
通讯作者：
Powis, Jeff
影响因子：
3.3
作者：
Hunt, Bijou R.;Ahmed, Christopher;Glick, Nancy R.
通讯作者：
Glick, Nancy R.
影响因子：
2.9
作者：
Adams, Alex J.;Weaver, Krystalyn K.
通讯作者：
Weaver, Krystalyn K.