联合药物治疗管理对患者护理认知及健康相关生活质量的影响。

Effects of collaborative drug therapy management on patients' perceptions of care and health-related quality of life.

作者信息

Isetts Brian J, Schondelmeyer Stephen W, Heaton Alan H, Wadd Wallace B, Hardie Nancy A, Artz Margaret B

机构信息

Department of Pharmaceutical Care & Health Systems at the University of Minnesota College of Pharmacy, Minneapolis, MN 55455, USA.

出版信息

Res Social Adm Pharm. 2006 Mar;2(1):129-42. doi: 10.1016/j.sapharm.2005.12.002.

DOI:10.1016/j.sapharm.2005.12.002

PMID:17138505

Abstract

BACKGROUND

It has been demonstrated that collaborative drug therapy management may result in enhanced medication adherence and improved clinical outcomes. It is not yet known whether CDTM is associated with patients' perceptions of care or self-reports of health-related quality of life.

OBJECTIVES

Examine the impact of collaborative drug therapy management (CDTM) on patients' perceptions of care and health-related quality of life in 15 ambulatory clinics (6 intervention, 9 comparison) in the Fairview system of Minneapolis-St Paul, Minn.

METHODS

The intervention was medication therapy management provided by pharmacists in collaboration with physicians (CDTM) for a 12-month period. Subjects were selected by age, gender, and presence of one of 12 medical conditions in the intervention (n=285) and comparison (n=285) group of patients. Comparison patients received usual care while intervention patients received at least 2 CDTM encounters. The CAHPS (formerly called the Consumer Assessment of Health Plans) 2.0 survey was administered to both the intervention and comparison groups poststudy to analyze patients' perceptions of care. The Short Form-12 (SF-12v2) was administered to intervention group patients pre-CDTM and 6 months post-CDTM to measure health-related quality of life in the intervention group.

RESULTS

Differences in CAHPS scores were not statistically significant (P>.05), although there was a trend toward higher ratings of patients' personal doctor/nurse and doctors' communication in the CDTM intervention group relative to the comparison group. Physical role, social functioning, and physical component summary scales of the SF-12v2 improved significantly (P=.001, P=.014, and P=.024, respectively; P< or =.025 level).

CONCLUSIONS

A trend toward improvements in patient perceptions of effectiveness of care using CAHPS suggests a need for further study. Health-related quality of life improvements in this study meet or exceed previous results incorporating pharmacists into primary care. Intensity and integration of CDTM services may be an explanation; however, prepost study design limits inferences.

摘要

背景

已有研究表明，协作式药物治疗管理可能会提高用药依从性并改善临床结局。目前尚不清楚协作式药物治疗管理（CDTM）是否与患者对护理的认知或健康相关生活质量的自我报告有关。

目的

在明尼苏达州明尼阿波利斯 - 圣保罗市费尔维尤系统的15家门诊诊所（6家干预诊所，9家对照诊所）中，研究协作式药物治疗管理（CDTM）对患者护理认知和健康相关生活质量的影响。

方法

干预措施为药剂师与医生协作提供为期12个月的药物治疗管理（CDTM）。在干预组（n = 285）和对照组（n = 285）患者中，根据年龄、性别以及是否存在12种疾病之一进行受试者选择。对照患者接受常规护理，而干预患者至少接受2次CDTM会诊。研究结束后，对干预组和对照组均进行了CAHPS（原称健康计划消费者评估）2.0调查，以分析患者对护理的认知。对干预组患者在CDTM之前和CDTM之后6个月进行简短健康调查问卷（SF - 12v2）评估，以测量干预组的健康相关生活质量。