1 Eshelman School of Pharmacy, University of North Carolina, Chapel Hill.
2 Eshelman School of Pharmacy and School of Medicine, University of North Carolina, Chapel Hill.
J Manag Care Spec Pharm. 2017 Nov;23(11):1125-1129. doi: 10.18553/jmcp.2017.23.11.1125.
In accordance with the Patient Protection and Affordable Care Act, Medicare provides coverage for annual wellness visits (AWVs) to eligible beneficiaries, which focus on preventative services, furnish personalized preventative health plans, and direct appropriate referrals. These visits may be conducted by a physician or another licensed practitioner working under the direct supervision of a physician. In North Carolina, pharmacists licensed as clinical pharmacist practitioners (CPPs) may perform and bill for AWVs, but there are limited data on patient satisfaction with pharmacists serving in this advanced role.
To (a) investigate patient satisfaction with and perception of an initial Medicare AWV administered by a CPP in an academic internal medicine clinic and (b) examine the relationship between patient satisfaction and the number of interventions or referrals made during an AWV.
All established patients of an academic internal medicine clinic aged 66 years and older were eligible for AWVs with a CPP, and those completing an AWV with a CPP were eligible for inclusion in this study. Patient satisfaction with the CPP and AWV was assessed by a telephone satisfaction questionnaire administered after the visit by a pharmacy student not affiliated with the clinic.
Forty-six patients were included in this study. Patients rated their satisfaction with the CPP at a mean of 4.7 and with the visit at a mean of 4.6 on a Likert scale ranging from 1 to 5, where 1 was "very dissatisfied" and 5 was "very satisfied." Using a Likert scale of 1 to 5, where 1 was "strongly disagree" and 5 was "strongly agree," patients responded with a mean of 4.4 that they were comfortable discussing their health information with a CPP and a mean of 4.1 that they were just as comfortable discussing their health information for this visit with a CPP as with their primary care physician.
Overall, patients were very satisfied with the CPP and AWVs and felt comfortable with CPPs as the providers of this service. As such, this study demonstrates that through Medicare AWVs, pharmacists can provide direct patient care and contribute to team-based initiatives.
No outside funding supported this study, and the authors have no conflicts of interest to declare. Study concept and design were contributed by Cavanaugh and Shilliday, along with Sherrill. The data were collected by Sherrill and Shilliday and interpreted by Sherrill, Cavanaugh, and Shilliday. The manuscript was written and revised by Sherrill, Cavanaugh, and Shilliday. This work was presented at the ASHP Annual Meeting in Las Vegas, Nevada, on December 3, 2012.
根据《患者保护与平价医疗法案》,医疗保险为符合条件的受益人提供年度健康访视(AWV),重点关注预防服务,提供个性化的预防保健计划,并提供适当的转介。这些访视可以由医生或在医生直接监督下工作的另一名持照执业医师进行。在北卡罗来纳州,注册为临床药师从业者(CPP)的药剂师可以进行并计费 AWV,但关于药师在这一高级角色中的患者满意度的数据有限。
(a)调查在学术内科诊所接受 CPP 管理的初始 Medicare AWV 的患者满意度和认知,以及(b)检查患者满意度与 AWV 期间进行的干预或转介数量之间的关系。
所有年满 66 岁的学术内科诊所的固定患者都有资格接受 CPP 进行 AWV,并且在诊所完成 AWV 的患者有资格参与这项研究。由与诊所没有隶属关系的药学学生在就诊后通过电话满意度问卷评估患者对 CPP 和 AWV 的满意度。
本研究纳入了 46 名患者。患者对 CPP 的满意度评分为 4.7(在 1 到 5 的范围内,1 表示“非常不满意”,5 表示“非常满意”),对就诊的满意度评分为 4.6。患者对 CPP 表示他们愿意在讨论健康信息时愿意回答问题的平均评分为 4.4(在 1 到 5 的范围内,1 表示“强烈不同意”,5 表示“强烈同意”),对在本次就诊中他们愿意与 CPP 而不是与他们的初级保健医生讨论健康信息的平均评分为 4.1。
总体而言,患者对 CPP 和 AWV 非常满意,并且对 CPP 作为该服务的提供者感到满意。因此,这项研究表明,通过 Medicare AWV,药剂师可以提供直接的患者护理,并为团队合作举措做出贡献。
本研究无外部资金支持,作者无利益冲突声明。Cavanaugh 和 Shilliday 共同提出了研究概念和设计,Sherrill 也参与了其中。数据由 Sherrill 和 Shilliday 收集,由 Sherrill、Cavanaugh 和 Shilliday 进行解释。手稿由 Sherrill、Cavanaugh 和 Shilliday 撰写和修订。这项工作于 2012 年 12 月 3 日在拉斯维加斯内华达州举行的 ASHP 年会上进行了展示。