Perepelkin Jason, Dobson Roy Thomas
College of Pharmacy & Nutirtion, University of Saskatchewan, Canada.
J Manag Care Pharm. 2007 Sep;13(7):589-97. doi: 10.18553/jmcp.2007.13.7.589.
In 1999, Saskatchewan Health authorized pharmacists to initiate exception drug status (EDS) requests, also known as prior authorization (PA). Before 1999, only those licensed to prescribe medications were authorized to initiate EDS requests. A pharmacist who submits an EDS request must obtain a patient diagnosis from the physician or agent of the physician; a diagnosis presented by the patient is insufficient.
To obtain pharmacists' opinions about the benefits of the PA program of the Saskatchewan drug Plan and to identify factors associated with pharmacist-initiated EDS requests.
A census survey of community pharmacy managers was conducted via a self-administered postal questionnaire in the province of Saskatchewan, Canada, in the fall of 2004. The survey questionnaire was addressed to pharmacy managers, some of whom may have delegated the response to a staff pharmacist. Pharmacy managers or their delegates were asked to respond on behalf of all pharmacists in their pharmacies.
A response rate of 82.6% was achieved (275/333). A majority of respondents agreed that the province's PA program (EDS) benefited patients (87.3%) and the Saskatchewan drug Plan (82.5%), whereas only 33.4% of respondents agreed that the EDS program benefited pharmacists. Pharmacists' ability to obtain the requisite information (87.6%) and to contact the prescribing physician (87.3%), as well as patient-centered concerns such as the patient's ability to pay for the prescription (85.1%), were the most important factors. The time required by the pharmacist to initiate the request was not important relative to other factors. community pharmacies reported receipt of an average of 36.4 prescriptions for restricted and nonformulary drugs per week, of which 22 were submitted for PA coverage, 17 by the pharmacy and 5 by the pharmacy at the request of the physician.
The results of this study indicate that community pharmacists in Saskatchewan acknowledge that the EdS process is beneficial for their patients. However, pharmacists are burdened by an administrative process in which necessary information, particularly the patient diagnosis, is not readily available.
1999年，萨斯喀彻温省卫生部授权药剂师发起特殊药物状态（EDS）申请，即所谓的预先授权（PA）。1999年之前，只有获得药物处方许可的人员才被授权发起EDS申请。提交EDS申请的药剂师必须从医生或医生代理人处获取患者诊断信息；患者提供的诊断信息不足。
了解药剂师对萨斯喀彻温省药物计划预先授权（PA）项目益处的看法，并确定与药剂师发起的EDS申请相关的因素。
2004年秋季，通过在加拿大萨斯喀彻温省自行邮寄问卷调查的方式，对社区药房经理进行普查。调查问卷寄给药房经理，其中一些人可能已将答复委托给药剂师。要求药房经理或其代表代表其药房的所有药剂师进行答复。
答复率为82.6%（275/333）。大多数受访者认为该省的PA项目（EDS）使患者受益（87.3%），也使萨斯喀彻温省药物计划受益（82.5%），而只有33.4%的受访者认为EDS项目使药剂师受益。药剂师获取必要信息的能力（87.6%）、联系开处方医生的能力（87.3%）以及以患者为中心的问题，如患者支付处方费用的能力（85.1%），是最重要的因素。相对于其他因素，药剂师发起申请所需的时间并不重要。社区药房报告称，每周平均收到36.4份受限和非处方药物的处方，其中22份提交PA覆盖，17份由药房提交，5份由药房应医生要求提交。
本研究结果表明，萨斯喀彻温省的社区药剂师承认EDS流程对其患者有益。然而，药剂师因行政流程而负担沉重，在该流程中，必要信息，尤其是患者诊断信息不易获取。
