Hu Qinyuan, Hu Haiyao, Hu Ming, Yang Yumei, Wu Zhiang, Zhou Naitong
West China School of Pharmacy, Sichuan University, Chengdu, Sichuan, China.
West China School of Medicine, Sichuan University, Chengdu, Sichuan, China.
Front Public Health. 2020 Dec 9;8:597389. doi: 10.3389/fpubh.2020.597389. eCollection 2020.
To survey, analyze, and ascertain the preferences for specialty pharmacy services among patients requiring complex care and to provide evidence to support specialty pharmacy service decision-making in China. To identify essential service attributes and levels, a review of the literature, discussions with specialty pharmacy managers and a pilot questionnaire were conducted. A D-efficient fractional factorial design was used to generate the discrete-choice experiment (DCE) questionnaire. A face-to-face survey of patients with chronic illness and their families or friends was conducted at three specialty pharmacies in Chengdu and Qingdao, China. A mixed logit model was used for estimation. Six relevant attributes were identified and incorporated into the DCE questionnaire. A total of 417 participants completed the survey (mean age 43 years, 45.1% males), and 32.1% had lung cancer. The conditional relative importance showed that the most critical attribute was "frequency of telephone follow-up to monitor adverse drug reactions (ADRs), "followed by "mode of drug delivery," "provider of medication guidance services," and "availability of medical insurance consultation"; the least important attribute was "business hours." A 1 min increase in time spent led to a 0.73% decrease in the probability that a service profile would be chosen. Negative preferences were noted for ADR monitoring by telephone follow-up once a year (β = -0.23, < 0.001) and business hours [8:30-20:00 (Monday to Friday), 8:30-17:30 (weekend)] (β = -0.12, < 0.001). Compared with women, men had a higher preference for service monitoring ADRs once every 3 months. Preference measurements showed that "frequency of telephone follow-up to monitor ADRs" had the most critical impact on decisions, followed by "mode of drug delivery." Specialty pharmacies in China need to take these findings into account to improve their design to increase uptake and patient loyalty.
调查、分析并确定需要复杂护理的患者对专科药房服务的偏好，并为中国专科药房服务决策提供证据支持。为确定基本服务属性和水平，进行了文献综述、与专科药房经理的讨论以及初步问卷调查。采用D - 最优分数析因设计生成离散选择实验（DCE）问卷。在中国成都和青岛的三家专科药房对慢性病患者及其家人或朋友进行了面对面调查。使用混合逻辑模型进行估计。确定了六个相关属性并纳入DCE问卷。共有417名参与者完成了调查（平均年龄43岁，男性占45.1%），32.1%患有肺癌。条件相对重要性表明，最关键的属性是“监测药物不良反应（ADR）的电话随访频率”，其次是“药物配送方式”“用药指导服务提供者”和“医疗保险咨询的可获得性”；最不重要的属性是“营业时间”。时间花费每增加1分钟，服务配置文件被选择的概率就降低0.73%。对于每年通过电话随访监测一次ADR（β = -0.23，<0.001）和营业时间[8:30 - 20:00（周一至周五），8:30 - 17:30（周末）]（β = -0.12，<0.001）存在负面偏好。与女性相比，男性对每三个月监测一次ADR的服务偏好更高。偏好测量表明，“监测ADR的电话随访频率”对决策的影响最为关键，其次是“药物配送方式”。中国的专科药房需要考虑这些结果来改进其设计，以提高使用率和患者忠诚度。
