Bertsch Nathan S, Bindler Ross J, Wilson Poppy L, Kim Anne P, Ward Beverly
Hosp Pharm. 2016 Oct;51(9):721-729. doi: 10.1310/hpj5109-721.
To determine the impact of a pharmacist-driven medication therapy management (MTM) program for patients receiving oral chemotherapy agents. We assessed the impact of MTM consultations with a pharmacist for patients who were receiving a new prescription for an oral chemotherapy agent. Data were assessed for outcomes including (1) number of medication errors identified in electronic medical records (EMRs), (2) number of interventions performed by the pharmacist, (3) time spent on the MTM process, and (4) patient satisfaction. Data were compared between patients who received their oral chemotherapy agents from the onsite specialty pharmacy or from a mail-order pharmacy. The data were also examined for correlations, and logistic regression was utilized to determine the largest variant cofactor to create an equation for estimating the number of errors in a patient's EMR. Fifteen patients received an MTM consultation, and the pharmacists identified an average of 6 medication EMR errors per patient. There was an average of 3 pharmacist-led interventions per patient. Multiple significant correlations were noted between the variables: (1) total number of prescriptions a patient was taking, (2) total number of medication errors identified, (3) time spent on the MTM process, and (4) total number of interventions performed by the pharmacist. Patient satisfaction was favorable for the program. The implementation of a pharmacist-driven MTM program for patients receiving a prescription for an oral chemotherapy agent had a significant impact on patient care by improving medication reconciliation, identifying drug-related problems, and strengthening pharmacist-patient interactions in the oncology clinic.
确定药师主导的药物治疗管理(MTM)计划对接受口服化疗药物患者的影响。我们评估了药师对接受口服化疗新药处方患者进行MTM咨询的影响。评估了包括以下方面的结果数据:(1)电子病历(EMR)中识别出的用药错误数量;(2)药师进行的干预措施数量;(3)MTM过程所花费的时间;(4)患者满意度。对从现场专科药房或邮购药房获取口服化疗药物的患者的数据进行了比较。还对数据进行了相关性检查,并利用逻辑回归确定最大变异协变量,以创建一个估算患者电子病历中错误数量的方程。15名患者接受了MTM咨询,药师平均为每位患者识别出6个用药电子病历错误。每位患者平均有3次由药师主导的干预措施。在以下变量之间发现了多个显著相关性:(1)患者正在服用的处方总数;(2)识别出的用药错误总数;(3)MTM过程所花费的时间;(4)药师进行的干预措施总数。患者对该计划满意度较高。为接受口服化疗药物处方的患者实施药师主导的MTM计划,通过改善用药核对、识别药物相关问题以及加强肿瘤诊所中药师与患者的互动,对患者护理产生了重大影响。