J Am Pharm Assoc (2003). 2021 Mar-Apr;61(2):e171-e175. doi: 10.1016/j.japh.2020.11.021. Epub 2020 Dec 24.
Patient engagement is an important aspect in improving patient outcomes. However, there is a paucity of literature regarding patient engagement in a nonresearch health care setting and the impacts of ambulatory clinical pharmacist interventions. Patient engagement has several definitions making it challenging to assess, but attendance to initial primary care provider (PCP) visits is an important aspect of patient engagement.
The study objective was to assess if improved patient engagement, defined as attendance to an initial PCP visit, was associated with differences in services provided or pharmacist participation during postdischarge clinic appointments.
The site of this study was the Johns Hopkins After Care Clinic (JHACC), an interdisciplinary postdischarge, safety net clinic in Baltimore, MD.
Through an interdisciplinary health care team including pharmacists, patients received comprehensive care to assist with postacute disease-state management and transitions of care.
Initial PCP visit attendance after a postacute visit in a high-risk population was evaluated for differing service delivery factors between groups who attended and did not attend their initial PCP visit. Descriptive statistics and chi-square tests were used for analysis.
Patients were statistically significantly more likely to engage in primary care when clinical pharmacy specialists participated in their JHACC appointment (P = 0.02). Medication education and disease-state counseling improved initial PCP visit attendance, both of which are key pharmacist activities.
This study suggests ambulatory clinical pharmacy specialists' roles in an interdisciplinary clinic model correlates with increased attendance to initial PCP visits, a surrogate for patient engagement. Disease-state education and medication education are both important activities in improving this measure; however, additional research is necessary to determine specific pharmacist interventions associated with patient engagement. As research in patient engagement continues, the positive effects of pharmacist involvement in this area could support their value in ambulatory care services.
患者参与是改善患者预后的一个重要方面。然而，关于非研究性医疗保健环境中的患者参与以及门诊临床药师干预的影响，文献却很少。患者参与有几个定义，这使得评估变得具有挑战性，但参加初始初级保健提供者（PCP）就诊是患者参与的一个重要方面。
本研究的目的是评估是否改善患者参与度（定义为参加初始 PCP 就诊）与在出院后诊所预约期间提供的服务或药剂师参与度的差异相关。
本研究的地点是约翰霍普金斯后续护理诊所（JHACC），这是马里兰州巴尔的摩的一个跨学科出院后、保障网诊所。
通过包括药剂师在内的跨学科医疗保健团队，患者接受全面的护理，以帮助管理急性后疾病状态并过渡到护理。
在高风险人群中，对急性后就诊后参加和未参加初始 PCP 就诊的患者进行不同服务提供因素的初始 PCP 就诊出勤率评估。使用描述性统计和卡方检验进行分析。
当临床药学专家参与他们的 JHACC 预约时，患者参加初级保健的可能性具有统计学意义（P=0.02）。药物教育和疾病状态咨询改善了初始 PCP 就诊出勤率，这两者都是药剂师的关键活动。
本研究表明，门诊临床药学专家在跨学科诊所模式中的角色与增加初始 PCP 就诊出勤率相关，这是患者参与的替代指标。疾病教育和药物教育都是改善这一指标的重要活动；然而，需要进一步的研究来确定与患者参与相关的具体药剂师干预措施。随着患者参与研究的继续，药剂师在这一领域的积极参与可能支持他们在门诊护理服务中的价值。
