Necyk Candace, Johnson Jeffrey A, Tsuyuki Ross T, Eurich Dean T
School of Public Health, University of Alberta, Edmonton, Alberta.
Faculty of Pharmacy and Pharmaceutical Sciences, University of Alberta, Edmonton, Alberta.
Can Pharm J (Ott). 2021 Jul 5;154(5):331-341. doi: 10.1177/17151635211020340. eCollection 2021 Sep-Oct.
In 2012, the Government of Alberta introduced a funding program to remunerate pharmacists to develop a comprehensive annual care plan (CACP) for patients with complex needs. The objective of this study is to explore patients' perceptions of the care they received through the pharmacist CACP program in Alberta.
We invited 3442 patients who received a pharmacist-billed CACP within the previous 3 months and 6888 matched controls across Alberta to complete an online questionnaire. The questionnaire consisted of the short version Patient Assessment of Chronic Illness Care (PACIC-11), with 3 additional pharmacy-specific assessment questions added. Additional questions related to health status and demographics were also included.
Overall, most patients indicated a low level of chronic illness care by pharmacists, with few differences noted between CACP patients and non-CACP controls. Of note, controls reported higher quality of care for 5 domains within the adapted PACIC-like tool compared with CACP patients ( < 0.05 for all). Interestingly, only 79 (44%) of CACP patients reported that they had received a CACP, whereas only 192 (66%) of control patients reported that they did not receive a care plan. In a sensitivity analysis including only these respondents, individuals who received a CACP perceived a significantly higher quality of chronic illness care across all PACIC domains.
Overall, chronic illness care incentivized by the pharmacist CACP program in Alberta is perceived to be moderate to low. When limited to respondents who explicitly recognized receiving the service or not, the perceptions of quality of care were more positive. This suggests that better implementation of CACP by pharmacists may be associated with improved quality of care and that some redesign is needed to engage patients more. 2021;154:xx-xx.
2012年，艾伯塔省政府推出了一项资助计划，向药剂师支付报酬，以便为有复杂需求的患者制定全面的年度护理计划（CACP）。本研究的目的是探讨患者对通过艾伯塔省药剂师CACP计划所接受护理的看法。
我们邀请了在过去3个月内接受过药剂师计费CACP的3442名患者以及艾伯塔省6888名匹配的对照者完成一份在线问卷。问卷包括慢性病护理患者评估简版（PACIC - 11），并额外增加了3个针对药房的评估问题。还包括了与健康状况和人口统计学相关的其他问题。
总体而言，大多数患者表示药剂师提供的慢性病护理水平较低，CACP患者与非CACP对照者之间差异不大。值得注意的是，与CACP患者相比，对照者在改编后的类似PACIC工具中的5个领域报告了更高的护理质量（所有领域均P<0.05）。有趣的是，只有79名（44%）CACP患者报告他们收到了CACP，而只有192名（66%）对照患者报告他们没有收到护理计划。在仅包括这些受访者的敏感性分析中，接受CACP的个体在所有PACIC领域中都认为慢性病护理质量显著更高。
总体而言，艾伯塔省药剂师CACP计划所激励的慢性病护理被认为是中等偏低水平。当仅限于明确承认接受或未接受该服务的受访者时，对护理质量的看法更为积极。这表明药剂师更好地实施CACP可能与改善护理质量相关，并且需要进行一些重新设计以更好地让患者参与进来。2021；154：xx - xx。
