Department of Pharmaceutical Systems and Policy, School of Pharmacy, West Virginia University, Morgantown, WV 26506, USA.
Ann Pharmacother. 2010 Mar;44(3):424-31. doi: 10.1345/aph.1M386. Epub 2010 Feb 23.
Recently, medication therapy management services (MTMS) has gained significant attention as an important type of pharmaceutical care designed to improve patient outcomes with more appropriate medication usage and monitoring. Although the provision of MTMS is increasing in pharmacies across the nation, and pharmacists are well equipped to administer MTMS, many community pharmacists are not currently providing these services.
To determine barriers to provision of MTMS perceived by pharmacists and factors associated with the likelihood of working in a pharmacy that provides MTMS.
Surveys were mailed to 906 community pharmacists licensed in West Virginia using a stratified random sample. The instrument was constructed and finalized following a review by experts and pilot tested in a convenience sample of pharmacists. Principal components analysis was performed to determine the factors that describe perceived barriers to provision of MTMS. Discriminant analysis using factor scores and other demographic and practice variables was performed to predict respondents' likelihood to work in a pharmacy that provides MTMS.
A 3-factor model was extracted from the responses, which explained 53.3% of the total variance. The factors included perceived ability to respond to patient interest, pharmacy-related factors, and enabling factors. The discriminant function correctly classified 76.2% of cases and included comfort level with provision of services, perceived value of services to patients, perceived ability to respond to patient interest, and whether they currently offer MTMS. These variables were all positively correlated with pharmacists' likelihood of working in a pharmacy that provides MTMS.
Comfort level and ability are important factors that influence pharmacists' likelihood of working in a pharmacy that provides MTMS. These findings highlight the importance of advanced practice experiences, certificate programs, and residencies to build pharmacists' confidence, and the role of targeted recruitment to attract pharmacists to community pharmacies that provide MTMS.
最近，药物治疗管理服务（MTMS）作为一种旨在通过更合理的药物使用和监测来改善患者治疗效果的重要药学服务类型，受到了广泛关注。尽管全国各地的药店都在增加 MTMS 的服务提供，但药剂师具备提供 MTMS 的能力，许多社区药剂师目前并未提供这些服务。
确定药剂师认为提供 MTMS 存在的障碍，以及与在提供 MTMS 的药店工作的可能性相关的因素。
采用分层随机抽样法，向西弗吉尼亚州的 906 名持照社区药剂师邮寄了调查问卷。该工具在专家审查后构建并最终确定，并在药剂师的便利样本中进行了试点测试。采用主成分分析确定描述提供 MTMS 障碍的因素。采用因子得分和其他人口统计学及实践变量的判别分析，预测受访者在提供 MTMS 的药店工作的可能性。
从回复中提取出一个 3 因素模型，该模型解释了 53.3%的总方差。这些因素包括对患者兴趣做出回应的感知能力、与药房相关的因素和促进因素。判别函数正确分类了 76.2%的病例，包括提供服务的舒适度、服务对患者的价值、对患者兴趣做出回应的感知能力，以及他们是否提供 MTMS。这些变量均与药剂师在提供 MTMS 的药店工作的可能性呈正相关。
舒适度和能力是影响药剂师在提供 MTMS 的药店工作可能性的重要因素。这些发现强调了实践经验、证书课程和住院医师培训的重要性，以增强药剂师的信心，以及有针对性招聘的作用，以吸引药剂师到提供 MTMS 的社区药店工作。
