Lauffenburger Julie C, Vu Maihan B, Burkhart Jena Ivey, Weinberger Morris, Roth Mary T
Division of Pharmaceutical Outcomes and Policy, UNC Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
Am J Geriatr Pharmacother. 2012 Apr;10(2):129-38. doi: 10.1016/j.amjopharm.2012.01.002. Epub 2012 Jan 27.
The quality of pharmacologic care provided to older adults is less than optimal. Medication therapy management (MTM) programs delivered to older adults in the ambulatory care setting may improve the quality of medication use for these individuals.
We conducted focus groups with older adults and primary care physicians to explore (1) older adults' experiences working with a clinical pharmacist in managing medications, (2) physician perspectives on the role of clinical pharmacists in facilitating medication management, and (3) key attributes of an effective MTM program and potential barriers from patient and provider perspectives.
Five focus groups (4 with older adults, 1 with physicians) were conducted by a trained moderator using a semistructured interview guide. Each participant completed a demographic questionnaire. Sessions were recorded, transcribed verbatim, and analyzed using qualitative analysis software for theme identification.
Twenty-eight older adults and 8 physicians participated. Older adults valued the professional, trusting nature of their interactions with the pharmacist. They found the clinical pharmacist to be a useful resource, thorough, personable, and a valuable team member. Physicians believe that the clinical pharmacist fills a unique role as a specialized practitioner, contributing meaningfully to patient care. Physicians emphasized the importance of effective communication, pharmacist access to the medical record, and a mutually trusting relationship as key attributes of a program. Potential barriers to an effective program include poor communication and lack of familiarity with the patient's history. The lack of a sustainable reimbursement model was cited as a barrier to widespread implementation of MTM.
This study provides information to assist pharmacists in designing MTM programs in the ambulatory setting. Key attributes of an effective program include being comprehensive and addressing all medication-related needs over time. The clinical pharmacist's ability to build trusting relationships with patients and providers is essential.
为老年人提供的药物治疗护理质量不尽人意。在门诊护理环境中为老年人提供的药物治疗管理（MTM）项目可能会改善这些人的用药质量。
我们与老年人和初级保健医生进行了焦点小组讨论，以探讨：（1）老年人在与临床药剂师合作管理药物方面的经历；（2）医生对临床药剂师在促进药物管理方面作用的看法；（3）有效MTM项目的关键特征以及从患者和提供者角度来看的潜在障碍。
由一名经过培训的主持人使用半结构化访谈指南进行了五个焦点小组讨论（4个针对老年人，1个针对医生）。每位参与者都填写了一份人口统计学调查问卷。会议进行了录音，逐字转录，并使用定性分析软件进行分析以确定主题。
28名老年人和8名医生参与了讨论。老年人重视他们与药剂师互动中专业、值得信赖的性质。他们发现临床药剂师是一个有用的资源，工作 thorough、有亲和力，是团队中有价值的一员。医生认为临床药剂师作为一名专业从业者发挥着独特的作用，对患者护理有重要贡献。医生强调有效沟通、药剂师获取病历的途径以及相互信任的关系是项目的关键特征。有效项目的潜在障碍包括沟通不畅和对患者病史不熟悉。缺乏可持续的报销模式被认为是MTM广泛实施的一个障碍。
本研究提供了信息，以帮助药剂师在门诊环境中设计MTM项目。有效项目的关键特征包括全面且随着时间推移满足所有与药物相关的需求。临床药剂师与患者和提供者建立信任关系的能力至关重要。
