Department of Pharmacy, Spectrum Health, Holland, MI, USA.
Department of Pharmacy, University of North Carolina Medical Center, Chapel Hill, NC, USA.
J Pharm Pract. 2022 Aug;35(4):551-558. doi: 10.1177/0897190021997007. Epub 2021 Mar 2.
The purpose of this study is to assess the impact of a clinic embedded Medication Assistance Program (MAP) specialist on the prescription benefit prior authorization (PA) process and provider satisfaction in an adult pulmonary clinic.
In this mixed methods study, a retrospective cohort analysis was done to determine the turnaround time for the PA process from initial referral to approval or final denial in an adult pulmonary clinic. Additionally, a pre- and post-implementation survey to providers was conducted to assess provider satisfaction and perceptions around the prescription benefit PA process. The first study aim assessed PA efficiency by summarizing PA approval rate and PA turnaround time using descriptive statistics. Any prescriptions written by a clinic provider requiring a PA during the timeframe of June 2018 through August 2018 were included. The second study aim assessed change in provider satisfaction, analyzed via the Mann-Whitney U test.
The MAP specialist completed 110 PAs over 3 months for 110 unique patients. Median turnaround time was 3 hours, with 76% of PAs approved in less than 24 hours. Initial approval rate was 82.7%, and overall approval rate following the appeals process was 87.3%. A significant difference between the pre- and post-survey responses were identified in 2 of the 17 questions.
Implementation of a clinic embedded MAP specialist to complete PAs demonstrated an efficient process while also improving provider satisfaction.
本研究旨在评估在成人肺科诊所中，一个嵌入诊所的药物辅助计划（MAP）专家对处方福利预授权（PA）流程和医生满意度的影响。
在这项混合方法研究中，我们进行了回顾性队列分析，以确定成人肺科诊所中从初始转介到批准或最终拒绝的 PA 流程的周转时间。此外，我们还对医生进行了实施前后的调查，以评估医生对处方福利 PA 流程的满意度和看法。第一项研究目的通过总结 PA 批准率和 PA 周转时间来评估 PA 的效率，使用描述性统计。在 2018 年 6 月至 8 月期间，任何由诊所医生开具且需要 PA 的处方都包括在内。第二项研究目的通过 Mann-Whitney U 检验分析评估医生满意度的变化。
MAP 专家在 3 个月内为 110 名患者完成了 110 次 PA。中位数周转时间为 3 小时，76%的 PA 在 24 小时内获得批准。初始批准率为 82.7%，在上诉流程后整体批准率为 87.3%。在 17 个问题中的 2 个问题中，发现预调查和后调查的回答有显著差异。
实施嵌入诊所的 MAP 专家来完成 PA 证明了一个高效的流程，同时也提高了医生的满意度。
