Nduaguba Sabina, Barner Jamie C, Makhinova Tatiana, Roberson Kim
Department of Pharmaceutical Outcomes and Policy, University of Florida College of Pharmacy, Gainesville, FL, USA.
Health Outcomes Division, The University of Texas at Austin College of Pharmacy, Austin, TX, USA.
J Pharm Pract. 2022 Aug;35(4):528-535. doi: 10.1177/0897190021997032. Epub 2021 Mar 2.
Pharmacists can play an important role in providing medication therapy management (MTM) services, which focus on appropriate medication use. This pilot study aimed to describe pharmacists' MTM service provision, results/outcomes of pharmacists' recommendations and resolution/acceptance rate among patients with high-risk asthma and/or chronic obstructive pulmonary disease (COPD).
This was a prospective descriptive study of MTM services provided by community pharmacists to Texas Medicaid patients (5-63 years) with "high risk" asthma or COPD. Patients received in-person and telephone consultations that included medication review, asthma control test assessment, and education on adherence and proper medication/device use. Data extracted from MTM software was used to describe: reasons for MTM services, type of pharmacists' interventions, outcomes of pharmacists' recommendations and acceptance rate.
Twenty-eight pharmacists provided 139 MTM interventions with 63 patients (2.2 interventions per patient). The most frequent intervention reason was complex drug therapy (53.2%), underuse of medication (8.6%), need for drug therapy (8.6%), new or changed prescription therapy (6.5%), and administration technique (5.0%). The resolution rate was 77.7%. Patient and prescriber, respectively, refused recommendation in 12% and 6% of the interventions. Outcomes included comprehensive medication review (46.7%), improved adherence (6.5%), therapeutic success (6.5%), improved administration technique (5.0%), and initiation of new therapy (5.0%).
Through the provision of MTM, pharmacists were able to identify and intervene with medication-related problems. These interventions are instrumental in helping patients better manage their asthma/COPD. The high resolution rate was encouraging. Larger scale studies are needed to assess clinical and economic outcomes.
药剂师在提供药物治疗管理(MTM)服务方面可发挥重要作用,该服务专注于合理用药。这项试点研究旨在描述药剂师为高危哮喘和/或慢性阻塞性肺疾病(COPD)患者提供的MTM服务、药剂师建议的结果/成效以及患者中的解决/接受率。
这是一项对社区药剂师为德克萨斯州医疗补助患者(5至63岁)提供的针对“高危”哮喘或COPD的MTM服务的前瞻性描述性研究。患者接受了面对面和电话咨询,包括用药评估、哮喘控制测试评估以及关于依从性和正确用药/设备使用的教育。从MTM软件中提取的数据用于描述:MTM服务的原因、药剂师干预的类型、药剂师建议的结果和接受率。
28名药剂师对63名患者进行了139次MTM干预(每位患者2.2次干预)。最常见的干预原因是复杂药物治疗(53.2%)、用药不足(8.6%)、需要药物治疗(8.6%)、新的或更改的处方治疗(6.5%)以及给药技术(5.0%)。解决率为77.7%。在12%和6%的干预中,患者和开处方者分别拒绝了建议。结果包括全面用药评估(46.7%)、依从性提高(6.5%)、治疗成功(6.5%)、给药技术改善(5.0%)以及开始新治疗(5.0%)。
通过提供MTM,药剂师能够识别并干预与药物相关的问题。这些干预有助于患者更好地管理其哮喘/COPD。高解决率令人鼓舞。需要进行更大规模的研究来评估临床和经济结果。