University of Arizona College of Pharmacy and SinfoniaRx, Tucson, AZ.
University of Arizona College of Pharmacy, Tucson.
J Manag Care Spec Pharm. 2020 Nov;26(11):1390-1397. doi: 10.18553/jmcp.2020.26.11.1390.
The literature is limited concerning the collaboration between pharmacists and promotoras in the delivery of medication therapy management (MTM) services. Yet, this information could help address a practice gap while improving MTM collaborative care approaches. To identify the knowledge, attitudes, and barriers of clinical call center health professionals (pharmacists, nurses, pharmacy interns) and promotoras towards MTM collaborative care in implementing the Rural Arizona Medication Therapy Management (RAzMTM) program. A descriptive, qualitative study using semistructured focus groups was conducted with call center health professionals and promotoras who participated in the RAzMTM program to improve pharmaceutical care for patients with diabetes and/or hypertension in rural Arizona. Recruitment and consent letters, a demographic questionnaire, and a focus group guide were designed specifically for this project. Three facilitators participated in each focus group-one guided the discussion while the others took notes. Focus groups were audio recorded to verify all responses and transcribed verbatim with omission of participant identifiers. Thematic analysis was conducted by 2 independent researchers who reviewed the transcripts to identify codes, seek consensus, and agree on themes, with negotiation from a third independent researcher. Nine participants took part in 2 focus groups. Participants were predominantly female (89%), college graduates and/or had postgraduate/professional degrees (78%), and were Hispanic or Latino (89%). Five themes were identified: (1) roles and responsibilities of RAzMTM participants; (2) benefits unique to the RAzMTM program; (3) interprofessional experience of RAzMTM participants; (4) professional growth for RAzMTM participants; and (5) opportunities for future improvement. Perceptions of the participants in the RAzMTM program were consistent-experiences of health professionals and promotoras were positive; they recognized the benefit of each other's involvement in the program; and they learned how to work together to improve patient care. Future recommended program improvements include improving ease of scheduling (e.g., extending pharmacist availability to provide MTM services). These focus group results suggest that provision of telephonic MTM services, using an academic-community partnership, was positively received by participating pharmacists and promotoras. However, future work is needed for continued improvement of strategies to enhance interprofessional relationships in patient chronic disease management. This project was supported by the Grant or Cooperative Agreement Number DP004793, funded by the Centers for Disease Control and Prevention. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the Centers for Disease Control and Prevention or the Department of Health and Human Services. This work also was supported, in part, by SinfoniaRx. Axon, Taylor, and Warholak received funding from SinfoniaRx. Axon reports grants from Tabula Rasa Op-Co, Merck & Co, Pharmacy Quality Alliance, Arizona Department of Health, and American Association of Colleges of Pharmacy, outside the submitted work. Warholak and Taylor received funding from Arizona Department of Health Services as part of a contract, outside the submitted work. Vaffis reports funding from Merck and Pharmacy Quality Alliance. This study was presented as a poster at the American Society of Health-System Pharmacists Summer Meetings & Exhibition (June 10-12, 2019, Boston, MA) and as a podium presentation at the Arizona Pharmacy Association Southwestern States Residency Conference (June 14, 2019, Phoenix, AZ).
文献资料表明,药剂师和 promotoras 在提供药物治疗管理 (MTM) 服务方面的合作有限。然而,这些信息可以帮助解决实践中的差距,同时改善 MTM 协作护理方法。
确定临床呼叫中心卫生专业人员(药剂师、护士、实习药剂师)和 promotoras 对农村亚利桑那州药物治疗管理 (RAzMTM) 计划中 MTM 协作护理的知识、态度和障碍。
采用半结构式焦点小组的描述性定性研究,对参与 RAzMTM 计划以改善农村亚利桑那州糖尿病和/或高血压患者药物治疗的呼叫中心卫生专业人员和 promotoras 进行研究。专门为本项目设计了招聘和同意信、人口统计问卷和焦点小组指南。每个焦点小组有 3 名主持人-1 名主持人引导讨论,其他 2 名主持人做记录。焦点小组进行了录音,以验证所有回复,并逐字转录,不包括参与者标识符。两名独立研究人员进行了主题分析,他们审查了转录本以识别代码、寻求共识并就主题达成一致意见,并与第三名独立研究人员进行了协商。
共有 9 名参与者参加了 2 个焦点小组。参与者主要为女性(89%)、大学毕业或拥有研究生/专业学位(78%)、西班牙裔或拉丁裔(89%)。确定了 5 个主题:(1)RAzMTM 参与者的角色和责任;(2)RAzMTM 计划独有的优势;(3)RAzMTM 参与者的跨专业经验;(4)RAzMTM 参与者的专业成长;(5)未来改进的机会。RAzMTM 计划参与者的看法是一致的——卫生专业人员和 promotoras 的经验是积极的;他们认识到彼此参与该计划的好处;他们学会了如何共同努力改善患者护理。未来建议的项目改进包括提高预约的便利性(例如,延长药剂师的可用性以提供 MTM 服务)。
使用学术-社区伙伴关系提供电话 MTM 服务得到了参与药剂师和 promotoras 的积极响应。然而,需要进一步开展工作,以持续改进策略,加强慢性病管理中跨专业关系。
本项目得到了赠款或合作协议号 DP004793 的支持,由疾病控制和预防中心资助。其内容完全由作者负责,并不一定代表疾病控制和预防中心或卫生与公众服务部的官方观点。这项工作还得到了 SinfoniaRx 的支持。Axon、Taylor 和 Warholak 从 SinfoniaRx 获得资金。Axon 报告了来自 Tabula Rasa Op-Co、默克公司、药房质量联盟、亚利桑那州卫生部和美国药学院协会的拨款,这些都在提交的工作之外。Warholak 和 Taylor 从亚利桑那州卫生部获得资金,作为合同的一部分,这是提交工作之外的。Vaffis 报告说,他从默克公司和药房质量联盟获得了资金。这项研究以海报的形式在 2019 年 6 月 10 日至 12 日在美国卫生系统药剂师协会暑期会议和展览(波士顿,MA)上展示,并以演讲的形式在 2019 年 6 月 14 日亚利桑那州药剂师协会西南州住院医师会议(凤凰城,AZ)上展示。