Department of Pharmacy Practice, University of Illinois Chicago College of Pharmacy, Chicago, IL, USA.
Virginia Mason Medical Center, Seattle, WA.
Am J Health Syst Pharm. 2021 Sep 22;78(19):1765-1791. doi: 10.1093/ajhp/zxab277.
Results of the first ASHP National Survey of Health-System Specialty Pharmacy Practice are presented.
A sample of 230 leaders in health-system specialty pharmacies were contacted by email and invited to participate in a survey hosted using an online survey application. The survey sample was compiled from ASHP member lists, through review of data from other ASHP surveys indicating the presence of specialty pharmacies, and by outreach to ASHP member organizational leaders.
The response rate was 53.0%. Most health-system specialty pharmacies dispense 30,000 or fewer specialty prescriptions per year, have an annual revenue of $100 million or less, are part of an entity eligible to participate in the 340B Drug Pricing Program, operate 1 specialty pharmacy location, have at least 1 specialty pharmacy accreditation, dispense nonspecialty medications in addition to specialty medications, and employ an average of 13 pharmacists and 15 technicians. More than two-thirds of health-system specialty pharmacies (68.8%) dispense no more than half of the prescriptions written by their providers due to payer network restrictions or limited distribution drugs. The health-system specialty pharmacy practice model includes access to the electronic health record (100% of respondents), pharmacists and technicians dedicated to specific clinics (64.9% and 57.7%, respectively), specialty pharmacist involvement in treatment decisions and drug therapy selection prior to the prescription being written (64.9%), and documenting recommendations and progress notes in patients' electronic health record (93.4%). Most health-system specialty pharmacies (83.3%) offer experiential or formal education in specialty pharmacy. Top challenges that survey respondents expected to face in the next year included restricted access to payer networks and limited distribution drugs, 340B Drug Pricing Program changes, and shrinking reimbursement from payers.
The health-system specialty pharmacy represents an integrated advanced practice model that incorporates specialty medication-use management across the continuum of care.
介绍首次 ASHP 全美卫生系统专科药房实践调查结果。
通过电子邮件联系了 230 名卫生系统专科药房的领导，并邀请他们参与使用在线调查应用程序托管的调查。调查样本是从 ASHP 会员名单中编制的，通过审查表明存在专科药房的其他 ASHP 调查数据，并通过与 ASHP 会员组织领导联系。
回复率为 53.0%。大多数卫生系统专科药房每年分发的专科处方少于 30,000 张，年收入低于 1 亿美元，是有资格参加 340B 药品定价计划的实体的一部分，经营 1 个专科药房地点，至少有 1 个专科药房认证，除了专科药物外，还分发非专科药物，平均雇用 13 名药剂师和 15 名技术员。由于支付者网络限制或有限分发药物，超过三分之二的卫生系统专科药房（68.8%）分发的处方不超过其提供者开具的处方的一半。卫生系统专科药房的实践模式包括访问电子健康记录（100%的受访者），药剂师和技术人员专门为特定诊所服务（分别为 64.9%和 57.7%），专科药剂师在处方开具前参与治疗决策和药物治疗选择（64.9%），并在患者的电子健康记录中记录建议和进展说明（93.4%）。大多数卫生系统专科药房（83.3%）提供专科药房方面的经验或正式教育。调查受访者预计在未来一年面临的主要挑战包括支付者网络访问受限和有限分发药物、340B 药品定价计划变化以及支付者报销减少。
卫生系统专科药房代表了一种综合的高级实践模式，将专科药物使用管理纳入整个护理连续体。
