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明尼苏达州农村辅助生活设施中药物治疗管理服务的初步评估。

Preliminary evaluation of medication therapy management services in assisted living facilities in rural Minnesota.

作者信息

Scott David M, Dewey Mark W, Johnson Todd A, Kessler Matthew L, Friesner Daniel L

机构信息

Department of Pharmacy Practice, North Dakota State University College of Pharmacy, Nursing, and Allied Sciences, Fargo, North Dakota 58105-5055, USA.

出版信息

Consult Pharm. 2010 May;25(5):305-19. doi: 10.4140/TCP.n.2010.305.

Abstract

OBJECTIVES

While pharmacists are providing medication therapy management (MTM) services, few programs have been assessed for outcomes, particularly those in rural areas. The objectives are to: 1) categorize the number and type of drug-therapy problems (DTPs) that were identified by consultant pharmacists in assisted living facilities, 2) assess resident and administrator satisfaction of consultant pharmacist MTM services, and 3) assess the direct costs of providing MTM services and make some preliminary inferences about the program's economic viability.

DESIGN

We conducted a cross-sectional, pilot study at 14 assisted living facilities over a 12-month period.

SETTING

14 rural assisted living facilities.

PATIENTS

Assisted living facility residents.

INTERVENTION

MTM visits were performed by a consultant pharmacist based on the MTM model developed by the American Pharmacists Association.

MAIN OUTCOME MEASURES

Patient satisfaction, clinical (DTPs), and economic costs.

RESULTS

130 residents were enrolled with a mean age of 86 years, with 77.7% female. Residents were taking an average of 13 medications (range = 1-29), including prescription and nonprescription drugs. Common medical conditions were hypertension (80.0%), hyperlipidemia (37.7%), and diabetes (20.8%). Residents had an average of 9 comorbidities (range = 2-16) and 304 DTPs (mean 2.3 per resident). Residents reported high mean satisfaction levels with the pharmacist and the services provided. Direct costs of the intervention were $20,372.96, which suggests that only modest gains in overall patient health (or a few major avoided adverse events) caused by the intervention are necessary to ensure the program's economic viability.

CONCLUSION

Through the use of MTM programs to resolve medication problems, pharmacists can improve patient satisfaction with care among assisted living facility residents.

摘要

目的

虽然药剂师正在提供药物治疗管理(MTM)服务,但很少有项目进行过结果评估,尤其是农村地区的项目。目标是:1)对辅助生活设施中顾问药剂师识别出的药物治疗问题(DTP)的数量和类型进行分类,2)评估居民和管理人员对顾问药剂师MTM服务的满意度,3)评估提供MTM服务的直接成本,并对该项目的经济可行性做出一些初步推断。

设计

我们在14个辅助生活设施中进行了为期12个月的横断面试点研究。

地点

14个农村辅助生活设施。

患者

辅助生活设施居民。

干预措施

顾问药剂师根据美国药剂师协会制定的MTM模式进行MTM访视。

主要观察指标

患者满意度、临床(DTP)和经济成本。

结果

共纳入130名居民,平均年龄86岁,女性占77.7%。居民平均服用13种药物(范围为1 - 29种),包括处方药和非处方药。常见医疗状况为高血压(80.0%)、高脂血症(37.7%)和糖尿病(20.8%)。居民平均有9种合并症(范围为2 - 16种)和304个DTP(平均每位居民2.3个)。居民对药剂师及其提供的服务满意度较高。干预的直接成本为20372.96美元,这表明干预措施只需在整体患者健康方面取得适度改善(或避免一些重大不良事件)就能确保该项目的经济可行性。

结论

通过使用MTM项目解决用药问题,药剂师可以提高辅助生活设施居民对护理的满意度。

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