以患者为中心的医疗之家模式下临床药师提供的糖尿病管理服务的患者满意度评估。
Evaluation of patient satisfaction with diabetes management provided by clinical pharmacists in the patient-centered medical home.
作者信息
Shawn McFarland M, Wallace Juliet P, Parra Jessica, Baker Jennifer
机构信息
Pharmacy Service, Department of Veterans Affairs Medical Center, Nashville, TN, USA,
出版信息
Patient. 2014;7(1):115-21. doi: 10.1007/s40271-013-0039-7.
STUDY OBJECTIVE
The patient-centered medical home (PCMH) model is a multidisciplinary, team-based approach to healthcare that focuses on actively involving the patient in clinical decision making. Multiple studies have demonstrated improved clinical outcomes from utilizing clinical pharmacists in the primary care setting, particularly in management of diabetes. No study has evaluated patient satisfaction with pharmacist in the PCMH model. Our objective was to evaluate patient satisfaction of care received in pharmacist-managed primary care clinics among patients with diabetes mellitus within the PCMH.
DESIGN
This study was a single-center, cross-sectional analysis of patients who were seen by a clinical pharmacy specialist (CPS).
SETTING
The setting for this study was eight outpatient primary care clinics within a Veterans Affairs healthcare system where diabetes management services were provided by eight CPSs.
PATIENTS
A total of 1,468 patients with a hemoglobin A1c >7.0 % who were seen in clinic by a CPS at the primary care clinics between 1 October 2008 and 1 April 2012 were mailed the Modified Diabetes Disease State Management Questionnaire (DDSM-QM). The DDSM-QM was a 15-item questionnaire that assessed overall patient satisfaction with pharmacist care, as well as patient satisfaction within three major domains: 'service,' 'self-management,' and 'knowledge'.
MEASUREMENTS AND MAIN RESULTS
A response rate of 42.7 % was attained, with 627 patients consenting to participate by completing and returning the self-administered questionnaire. The mean overall satisfaction score was 90.6 ± 10.6 % (mean ± standard deviation). Mean percentage scores within the 'service,' 'knowledge,' and 'self-management' domains were 92.0 ± 10.8, 89.7 ± 11.3, and 89.2 ± 12.0 %, respectively.
CONCLUSION
Patients with diabetes seen by a CPS within the PCMH model were very satisfied with the care they received overall.
研究目的
以患者为中心的医疗之家（PCMH）模式是一种多学科、基于团队的医疗保健方法，专注于让患者积极参与临床决策。多项研究表明，在初级保健环境中使用临床药剂师可改善临床结果，尤其是在糖尿病管理方面。尚无研究评估患者对PCMH模式中药剂师的满意度。我们的目的是评估PCMH模式下糖尿病患者对药剂师管理的初级保健诊所所接受护理的满意度。
设计
本研究是对临床药学专家（CPS）诊治患者的单中心横断面分析。
背景
本研究的背景是退伍军人事务医疗系统内的八家门诊初级保健诊所，由八名CPS提供糖尿病管理服务。
患者
2008年10月1日至2012年4月1日期间，在初级保健诊所由CPS诊治的1468例糖化血红蛋白>7.0%的患者收到了改良糖尿病疾病状态管理问卷（DDSM-QM）。DDSM-QM是一份包含15个条目的问卷，评估患者对药剂师护理的总体满意度，以及患者在三个主要领域的满意度：“服务”、“自我管理”和“知识”。
测量与主要结果
回复率为42.7%，627例患者通过填写并返还自填问卷同意参与。总体满意度平均得分为90.6±10.6%（平均值±标准差）。“服务”、“知识”和“自我管理”领域的平均百分比得分分别为92.0±10.8%、89.7±11.3%和89.2±12.0%。
结论
在PCMH模式下由CPS诊治的糖尿病患者对他们总体接受的护理非常满意。
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