Division of Epidemiology, Department of Internal Medicine, University of Utah, Salt Lake City, UT, USA.
George E. Wahlen Department of Veterans Affairs Medical Center, Salt Lake City, UT, USA.
Am J Health Syst Pharm. 2022 May 24;79(11):835-843. doi: 10.1093/ajhp/zxac023.
Veterans prescribed oral antineoplastic therapies (OATs) by community providers outside the Veterans Health Administration (VA) may lack access to comprehensive medication management. To address this, our multidisciplinary team developed and implemented a pharmacist-led telehealth medication management program for veterans prescribed OATs by community providers.
The program exclusively uses telehealth to connect veterans with a dedicated board-certified clinical oncology pharmacist who provides comprehensive medication management. The program is based on established pharmacy models found in the research literature. We developed a standard operating procedure, communication templates, patient education materials, and a suite of health information technology tools to help streamline pharmacy processes. The Consolidated Framework for Implementation Research was used to design implementation strategies to promote the adoption of the program. In the first year, 64 veterans from 3 VA medical centers were enrolled in the program. The oncology clinical pharmacist performed 342 encounters and 101 interventions. The program saved an estimated $200,724 in medication-related costs. The veterans we surveyed reported high levels of satisfaction with the pharmacy services provided by the program.
The delivery of comprehensive medication management through telehealth is feasible from a healthcare system perspective and beneficial for patients. The board-certified oncology clinical pharmacist provided remote pharmacy services to Veterans across three sites in a large and rural service area for the VA. The program realized several benefits, including positive clinical outcomes, high levels of patient satisfaction, and cost savings on medication-related costs.
退伍军人在退伍军人健康管理局 (VA) 以外的社区医疗机构接受口服抗肿瘤治疗 (OAT) 时,可能无法获得全面的药物管理。为了解决这个问题,我们的多学科团队为退伍军人开发并实施了一项由社区供应商开具的 OAT 的药剂师主导的远程医疗药物管理计划。
该计划完全使用远程医疗将退伍军人与专门的认证临床肿瘤药剂师联系起来,为他们提供全面的药物管理。该计划基于研究文献中发现的已建立的药房模式。我们制定了一项标准操作程序、沟通模板、患者教育材料以及一套健康信息技术工具,以帮助简化药房流程。采用实施研究综合框架来设计实施策略,以促进该计划的采用。在第一年,来自 3 个 VA 医疗中心的 64 名退伍军人参加了该计划。肿瘤临床药剂师进行了 342 次就诊和 101 次干预。该计划估计节省了 200,724 美元的药物相关费用。我们调查的退伍军人报告说对该计划提供的药房服务非常满意。
从医疗保健系统的角度来看,通过远程医疗提供全面的药物管理是可行的,对患者有益。认证的肿瘤临床药剂师为 VA 位于一个大而农村的服务区域的三个地点的退伍军人提供远程药房服务。该计划实现了多个效益,包括积极的临床结果、患者满意度高和药物相关费用的节省。