Department of Pharmaceutical Care & Health Systems, College of Pharmacy, University of Minnesota, Minneapolis.
Center for Medication Optimization, UNC Eshelman School of Pharmacy, University of North Carolina at Chapel Hill.
J Manag Care Spec Pharm. 2021 Jul;27(7):865-872. doi: 10.18553/jmcp.2021.27.7.865.
HealthPartners is an integrated health plan offering comprehensive medication management (CMM) under a value-based care model called Partners in Excellence (PIE). In PIE, participating organizations are incentivized to conduct CMM visits and are eligible for bonus payments if they achieve quality and engagement metrics. Engagement in PIE from community pharmacies has been lacking. Implementation science, specifically the assessment of implementation outcomes, provides key insights into the uptake of patient care services, such as CMM, into practice. To evaluate the acceptability, appropriateness, and feasibility of the PIE program from the perspective of community pharmacists and pharmacy managers. Semi-structured, one-on-one qualitative interviews were conducted with a group of 14 pharmacists and pharmacy managers participating in the PIE program. Interviews were coded inductively, and then codes were mapped to the implementation outcomes of acceptability, appropriateness, and feasibility. Twelve codes emerged from the interviews. Four codes (targeted conditions of PIE, achieving PIE metrics, comprehensiveness of PIE, and confusion and barriers) were mapped to acceptability; 3 codes (CMM documentation and billing, fitting CMM into limited time with patients, and community pharmacy's role in patient care) were mapped to appropriateness; and 1 code (collecting clinical patient information) was mapped to feasibility. Four codes (CMM payment model, targeting patients for CMM, personnel for CMM, and patient/provider buy-in of CMM) were considered a combination of more than 1 outcome. Although the acceptability, appropriateness, and feasibility of the PIE program was generally positive, participants cited a number of implementation challenges related to documentation and billing and producing a sustainable CMM model. The results shed light on how a value-based care model for CMM is perceived within community pharmacies and could inform the development and implementation of similar quality-based CMM programs. This study was funded by the National Association of Chain Drug Stores (NACDS) Foundation and the UNC Eshelman Institute for Innovation. Pestka is affiliated with the University of Minnesota College of Pharmacy and reports grants from NACDS Foundation and UNC Eshelman Institute for Innovation for the conduct of the study; she has also received grants from UNC Eshelman Institute for Innovation and NACDS Foundation outside the submitted work. Stoa and Sorensen are also affiliated with the University of Minnesota College of Pharmacy. Blanchard is employed at the UNC Eshelman School of Pharmacy, University of North Carolina at Chapel Hill. This work was presented as a virtual poster at the 2020 American College of Clinical Pharmacy Annual Meeting, October 19-30, 2020.
健康伙伴是一个综合性的医疗计划，提供基于价值的医疗模式下的综合药物管理（CMM），该模式称为卓越合作伙伴（PIE）。在 PIE 中，参与组织有动力进行 CMM 访问，如果他们达到质量和参与度指标，就有资格获得奖金。社区药店参与 PIE 的积极性一直不高。实施科学，特别是对实施结果的评估，为患者护理服务（如 CMM）的实施提供了关键见解。从社区药剂师和药剂经理的角度评估 PIE 计划的可接受性、适当性和可行性。 对参与 PIE 计划的一组 14 名药剂师和药剂经理进行了半结构化的一对一定性访谈。访谈内容采用归纳法进行编码，然后将代码映射到可接受性、适当性和可行性的实施结果上。 访谈中出现了 12 个代码。其中 4 个代码（PIE 的目标条件、实现 PIE 指标、PIE 的全面性以及困惑和障碍）被映射到可接受性上；3 个代码（CMM 文档和计费、在有限的时间内为患者安排 CMM 以及社区药店在患者护理中的作用）被映射到适当性；1 个代码（收集临床患者信息）被映射到可行性。4 个代码（CMM 支付模式、针对 CMM 的患者、CMM 人员以及患者/提供者对 CMM 的认可）被认为是超过 1 个结果的组合。 尽管 PIE 计划的可接受性、适当性和可行性总体上是积极的，但参与者提到了与文档编制和计费以及创建可持续 CMM 模式相关的一些实施挑战。研究结果揭示了社区药店如何看待 CMM 的基于价值的护理模式，并为类似的基于质量的 CMM 计划的制定和实施提供了参考。 这项研究由全国连锁药店协会基金会（NACDS）和北卡罗来纳大学教堂山分校埃舍尔曼创新研究所资助。Pestka 隶属于明尼苏达大学药学院，报告了 NACDS 基金会和 UNC Eshelman 创新研究所为进行该研究提供的赠款；她还获得了 UNC Eshelman 创新研究所和 NACDS 基金会在提交工作之外的赠款。Stoa 和 Sorensen 也隶属于明尼苏达大学药学院。Blanchard 受雇于北卡罗来纳大学教堂山分校埃舍尔曼药学院。这项工作作为虚拟海报在 2020 年美国临床药学学院年度会议上展示，2020 年 10 月 19 日至 30 日。
