J Am Pharm Assoc (2003). 2019 Mar-Apr;59(2):243-251. doi: 10.1016/j.japh.2018.11.008. Epub 2019 Jan 9.
To describe one independent pharmacy group's experience delivering and being reimbursed for in-home medication coaching, or home visits, to high-risk and high-complexity community-dwelling patients.
A nondispensing clinical division of an independent community pharmacy in Seattle, Washington.
A community pharmacist-led in-home medication coaching program delivered through partnerships with 3 community-based organizations for referrals and payment over a 4.5-year period. Community-based partners included a state comprehensive care management program, a local health system's cardiology clinic, and the local Area Agency on Aging.
A retrospective analysis of patient demographics, drug therapy problems, interventions, and pharmacy and technician time was conducted with the use of the pharmacy's internal patient care documentation and billing systems from January 1, 2012, to June 31, 2016.
A total of 462 home visits (142 initial, 320 follow-up) were conducted with 142 patients. Patients averaged 13 disease states (range 3-31) and 16 medications (range 1-44) at their initial visit. Pharmacists identified an average of 11 drug therapy problems per patient (range 1-36) and performed an average of 13 interventions per patient (range 1-48). The most common drug therapy problem identified was nonadherence, and the most common intervention performed was education. The median pharmacist time in the home was 1.5 hours (range 0.67-2.75) for an initial visit and 1 hour (range 0.08-2.25) for a follow-up visit.
Home visits can be successfully implemented by community pharmacists to provide care to high-risk and high-complexity community-dwelling patients. Our experience may inform other community pharmacy organizations looking to develop similar home visit services.
描述一个独立药房集团提供和报销上门用药指导（即家访）给高风险和高复杂度的社区居住患者的经验。
华盛顿州西雅图的一家独立社区药房的非配药临床部门。
在 4.5 年的时间里，通过与 3 个社区组织的合作，由一名社区药剂师领导的上门用药指导计划，提供转诊和支付服务。社区合作伙伴包括一个州综合护理管理计划、当地卫生系统的心脏病诊所和当地的老龄化区域代理机构。
使用药房内部的患者护理记录和计费系统，对 2012 年 1 月 1 日至 2016 年 6 月 31 日期间的患者人口统计学数据、药物治疗问题、干预措施以及药剂师和技术员时间进行回顾性分析。
共对 142 名患者进行了 462 次家访（142 次初始访问，320 次随访）。患者在初次就诊时平均患有 13 种疾病（范围 3-31）和 16 种药物（范围 1-44）。药剂师平均为每位患者确定了 11 个药物治疗问题（范围 1-36），并为每位患者实施了 13 项干预措施（范围 1-48）。最常见的药物治疗问题是不遵医嘱，最常见的干预措施是教育。初次就诊时，药剂师在家中的平均时间为 1.5 小时（范围 0.67-2.75），随访时为 1 小时（范围 0.08-2.25）。
社区药剂师可以成功实施家访，为高风险和高复杂度的社区居住患者提供护理。我们的经验可能为其他希望开发类似家访服务的社区药房组织提供参考。
