Centre for Health Evaluation & Research/Infosaúde, National Association of Pharmacies, Lisbon, Portugal.
Infosaúde, National Association of Pharmacies, Lisbon, Portugal.
Value Health. 2022 Aug;25(8):1321-1327. doi: 10.1016/j.jval.2022.03.004. Epub 2022 Apr 12.
In Portugal, the dispensing of most outpatient specialty medicines is performed exclusively through hospital pharmacies and totally financed by the National Health Service. During the COVID-19 first wave, the government allowed the transfer of the dispensing of hospital-only medicines (HOMs) to community pharmacies (CPs). This study aimed to measure the value generated by the intervention of CP in the dispensing of HOM.
A single-arm, before-and-after study with 3-month follow-up was conducted enrolling a randomly selected sample of patients or caregivers with at least 1 dispensation of HOM through CP. Data were collected by telephone interview. Main outcomes were patients' self-reported adherence (Measure Treatment Adherence), health-related quality of life (EQ-5D 3-Level), satisfaction with the service, and costs related to HOM access.
Overall 603 subjects were recruited to participate in the study (males 50.6%) with mean 55 years old (SD = 16). The already high mean adherence score to therapy improved significantly (P < .0001), and no statistically significant change (P > .5757) was found in the mean EQ-5D score between baseline (0.7 ± 0.3) and 3-month follow-up (0.8 ± 0.3). Annual savings account for €262.1/person, arising from travel expenses and absenteeism reduction. Participants reported a significant increase in satisfaction levels in all evaluated domains-pharmacist's availability, opening hours, waiting time, privacy conditions, and overall experience.
Changing the dispense setting to CP may promote better access and satisfaction. Moreover, it ensures the persistence of treatments, promotes savings for citizens, and reduces the burden of healthcare services, representing a crucial public health measure.
在葡萄牙,大多数专科门诊药品的配药工作仅由医院药房完成,并由国家卫生服务系统完全资助。在 COVID-19 第一波期间,政府允许将仅限医院使用的药品(HOM)的配药转移到社区药房(CP)。本研究旨在衡量 CP 在 HOM 配药方面的干预所产生的价值。
这是一项单臂、前后对照研究,随访 3 个月,纳入了至少通过 CP 配药 1 次 HOM 的随机选择的患者或护理人员样本。通过电话访谈收集数据。主要结局是患者自我报告的依从性(测量治疗依从性)、健康相关生活质量(EQ-5D 3 级)、对服务的满意度以及与 HOM 获得相关的成本。
共有 603 名受试者参与了这项研究(男性占 50.6%),平均年龄为 55 岁(SD=16)。已经很高的治疗依从性评分显著提高(P<0.0001),而基线时(0.7±0.3)和 3 个月随访时(0.8±0.3)的平均 EQ-5D 评分没有统计学上的显著变化(P>.5757)。由于旅行费用和缺勤减少,每人每年节省 262.1 欧元。参与者报告在所有评估领域的满意度都显著提高——药剂师的可用性、营业时间、等待时间、隐私条件和整体体验。
将配药地点改为 CP 可能会促进更好的获取和满意度。此外,它确保了治疗的持续进行,为公民节省了开支,并减轻了医疗服务的负担,这是一项至关重要的公共卫生措施。