Schumacher Lauren, Coe Antoinette B, Lester Corey A, Rothermal Mary, Dorsch Michael P
J Am Pharm Assoc (2003). 2020 Nov-Dec;60(6):1058-1067.e4. doi: 10.1016/j.japh.2020.08.042. Epub 2020 Sep 19.
Examine the factors that influence a patient's likelihood of participating in clinical pharmacy services so that pharmacists can use this knowledge to effectively expand clinical services.
An online survey was distributed to U.S. citizens 55 years of age or older through a market research company. The survey assessed pharmacy and medication use, general health, interest in clinical pharmacy services, and general demographics. The specific clinical services examined included medication therapy management (MTM) and a collaborative practice agreement (CPA). Logistic regression and best-worst scaling were used to predict the likelihood of participating and determine the motivating factors to participate in clinical pharmacy services, respectively.
Two hundred eight (58.45%) respondents reported being likely to participate in MTM services, and 108 (50.6%) reported being likely to participate in the services offered by a pharmacist with a CPA, if offered. The motivations to participate in MTM were driven by pharmacist management of medication interactions and adverse effects (best-worst scores 0.62 and 0.51, respectively). The primary motivator to participate in a CPA was improved physician-pharmacist coordination (best-worst score 0.80). Those with a personal pharmacist were more likely to participate in MTM (odds ratio [OR] 2.43 [95% CI 1.41-4.22], P = 0.002) and a pharmacist CPA (2.08 [1.26-3.44], P = 0.004). Previous experience with MTM increased the likelihood of participating again in MTM (5.98 [95% CI 2.50-14.35], P < 0.001). Patient satisfaction with the pharmacy increased the likelihood of participating in a pharmacist CPA (1.47 [95% CI 1.01-2.13], P = 0.04).
Patients are interested in clinical pharmacy services for the purposes of medication interaction management, adverse effect management, and improved physician-pharmacist coordination. The factors that influenced the likelihood of participating included having a personal pharmacist, previous experience with MTM, and pharmacy satisfaction. These results suggest a potential impact of the patient-pharmacist relationship on patient participation in clinical services.
研究影响患者参与临床药学服务可能性的因素，以便药剂师能够利用这些知识有效地扩大临床服务。
通过一家市场研究公司向55岁及以上的美国公民发放在线调查问卷。该调查评估了药房和药物使用情况、总体健康状况、对临床药学服务的兴趣以及一般人口统计学信息。所考察的具体临床服务包括药物治疗管理（MTM）和协作实践协议（CPA）。分别使用逻辑回归和最佳-最差尺度法来预测参与的可能性并确定参与临床药学服务的激励因素。
208名（58.45%）受访者表示可能参与MTM服务，108名（50.6%）受访者表示如果有机会，可能参与由具有CPA的药剂师提供的服务。参与MTM的动机是由药剂师对药物相互作用和不良反应的管理驱动的（最佳-最差得分分别为0.62和0.51）。参与CPA的主要动机是改善医生-药剂师的协调（最佳-最差得分0.80）。有私人药剂师的患者更有可能参与MTM（优势比[OR]为2.43[95%置信区间1.41 - 4.22]，P = 0.002）和药剂师CPA（2.08[1.26 - 3.44]，P = 0.004）。之前有MTM经历会增加再次参与MTM的可能性（5.98[95%置信区间2.50 - 14.35]，P < 0.001）。患者对药房的满意度增加了参与药剂师CPA的可能性（1.47[95%置信区间1.01 - 2.13]，P = 0.04）。
患者出于药物相互作用管理、不良反应管理以及改善医生-药剂师协调的目的对临床药学服务感兴趣。影响参与可能性的因素包括有私人药剂师、之前有MTM经历以及对药房的满意度。这些结果表明患者-药剂师关系对患者参与临床服务有潜在影响。
