Snyder Margie E, Chewning Betty, Kreling David, Perkins Susan M, Knox Lyndee M, Adeoye-Olatunde Omolola A, Jaynes Heather A, Schommer Jon C, Murawski Matthew M, Sangasubana Nisaratana, Hillman Lisa A, Curran Geoffrey M
Purdue University College of Pharmacy, Fifth Third Bank Building, 640 Eskenazi Avenue, Indianapolis, IN, 46202, USA.
University of Wisconsin-Madison School of Pharmacy, 2523 Rennebohm Hall, 777 Highland Ave., Madison, WI, 53705-2222, USA.
Res Social Adm Pharm. 2021 Feb;17(2):466-474. doi: 10.1016/j.sapharm.2020.03.019. Epub 2020 Apr 24.
Medication non-adherence is a problem of critical importance, affecting approximately 50% of all persons taking at least one regularly scheduled prescription medication and costing the United States more than $100 billion annually. Traditional data sources for identifying and resolving medication non-adherence in community pharmacies include prescription fill histories. However, medication possession does not necessarily mean patients are taking their medications as prescribed. Patient-reported outcomes (PROs), measuring adherence challenges pertaining to both remembering and intention to take medication, offer a rich data source for pharmacists and prescribers to use to resolve medication non-adherence. PatientToc™ is a PROs collection software developed to facilitate collection of PROs data from low-literacy and non-English speaking patients in Los Angeles.
This study will evaluate the spread and scale of PatientToc™ from primary care to community pharmacies for the collection and use of PROs data pertaining to medication adherence.
The following implementation and evaluation steps will be conducted: 1) a pre-implementation developmental formative evaluation to determine community pharmacy workflow and current practices for identifying and resolving medication non-adherence, potential barriers and facilitators to PatientToc™ implementation, and to create a draft implementation toolkit, 2) two plan-do-study-act cycles to refine an implementation toolkit for spreading and scaling implementation of PatientToc™ in community pharmacies, and 3) a comprehensive, theory-driven evaluation of the quality of care, implementation, and patient health outcomes of spreading and scaling PatientToc™ to community pharmacies.
This research will inform long-term collection and use of PROs data pertaining to medication adherence in community pharmacies.
药物治疗依从性不佳是一个至关重要的问题，影响着约50%服用至少一种定期处方药的人群，每年给美国造成超过1000亿美元的损失。在社区药房中，用于识别和解决药物治疗依从性不佳问题的传统数据来源包括处方配药记录。然而，拥有药物并不一定意味着患者按规定服药。患者报告结局（PROs）能够衡量与记忆服药及服药意愿相关的依从性挑战，为药剂师和开处方者解决药物治疗依从性不佳问题提供了丰富的数据源。PatientToc™是一款PROs收集软件，旨在促进从洛杉矶低识字率和非英语患者中收集PROs数据。
本研究将评估PatientToc™从初级保健机构推广至社区药房以收集和使用与药物治疗依从性相关的PROs数据的范围和规模。
将开展以下实施和评估步骤：1）实施前的发展性形成性评估，以确定社区药房识别和解决药物治疗依从性不佳问题的工作流程及当前做法、PatientToc™实施的潜在障碍和促进因素，并创建实施工具包草案；2）两个计划-实施-研究-改进循环，以完善在社区药房推广和扩大PatientToc™实施范围的实施工具包；3）对将PatientToc™推广至社区药房的护理质量、实施情况和患者健康结局进行全面的、基于理论的评估。
本研究将为社区药房长期收集和使用与药物治疗依从性相关的PROs数据提供信息。
