Livet Melanie, Levitt Jordana M, Lee Alyssa, Easter Jon
Center for Medication Optimization (CMO), Division of Practice Advancement and Clinical Education, UNC Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, USA.
Explor Res Clin Soc Pharm. 2021 Jun 5;2:100032. doi: 10.1016/j.rcsop.2021.100032. eCollection 2021 Jun.
The advent of COVID-19 exacerbated the impact of social determinants of health (SDOH) on patients' ability to manage their health, especially those with chronic conditions. Clinical pharmacists are well positioned to expand the patient care services they already provide to address patients' basic social needs, which may otherwise impede medication access and adherence.
The purpose of this exploratory study was to evaluate the feasibility of expanding a comprehensive medication management (CMM) telepharmacy service to include SDOH support. This service was offered as part of four primary care clinics in rural and underserved North Carolina communities. More specifically, the study aimed to describe the expanded service, evaluate stakeholders' experience with the service, and assess short-term impact on patients with diabetes.
Data collected over the first 4 months of implementation included administrative data used to describe the expanded service; a clinic survey and interviews to assess clinic team members' experience with the service; and patient surveys to evaluate patient satisfaction, as well as impact on SDOH self-efficacy and diabetes quality of life.
Through SDOH screening, the pharmacist identified 26 unresolved COVID-prompted SDOH concerns across 66 patients. These concerns were addressed by the pharmacist through three types of brief interventions, including information provision/education (71%), access to resources (21%), and additional care coordination (7%). Clinic team members perceived the expanded service as highly satisfactory and beneficial Patients also reported high levels of satisfaction and significantly increased their SDOH self-efficacy and diabetes quality of life as a result of the service.
These data provide preliminary insights into the expanded role that pharmacists can play to address current population health gaps that can directly impact patients' engagement with their medication regimen and overall health status.
2019年冠状病毒病（COVID-19）的出现加剧了健康的社会决定因素（SDOH）对患者管理自身健康能力的影响，尤其是对患有慢性病的患者。临床药师完全有能力扩大他们已经提供的患者护理服务，以满足患者的基本社会需求，否则这些需求可能会妨碍药物的获取和依从性。
本探索性研究的目的是评估将综合药物管理（CMM）远程药房服务扩展为包括SDOH支持的可行性。这项服务是北卡罗来纳州农村和服务不足社区的四个初级保健诊所提供的服务的一部分。更具体地说，该研究旨在描述扩展后的服务，评估利益相关者对该服务的体验，并评估对糖尿病患者的短期影响。
在实施的前4个月收集的数据包括用于描述扩展服务的管理数据；一项诊所调查和访谈，以评估诊所团队成员对该服务的体验；以及患者调查，以评估患者满意度，以及对SDOH自我效能和糖尿病生活质量的影响。
通过SDOH筛查，药剂师在66名患者中识别出26个未解决的由COVID引发的SDOH问题。药剂师通过三种类型的简短干预解决了这些问题，包括提供信息/教育（71%）、获取资源（21%）和额外的护理协调（7%）。诊所团队成员认为扩展后的服务非常令人满意且有益。患者也报告了很高的满意度，并由于该服务显著提高了他们的SDOH自我效能和糖尿病生活质量。
这些数据为药剂师可以发挥的扩展作用提供了初步见解，以解决当前可能直接影响患者药物治疗方案参与度和整体健康状况的人群健康差距。
