Vanderbilt University Medical Center, Nashville, TN, USA.
Shields Health Solutions, Stoughton, MA, USA.
Am J Health Syst Pharm. 2022 Oct 21;79(21):1906-1918. doi: 10.1093/ajhp/zxac212.
Specialty medications can have life-altering outcomes for patients with complex diseases. However, their benefit relies on appropriate treatment selection, patients' ability to afford and initiate treatment, and ongoing treatment optimization based on patient response to therapy. Mounting research demonstrates the benefits of the health-system specialty pharmacies (HSSPs) in improving specialty medication access, affordability, and outcomes. The purpose of this rapid review is to describe the currently reported role and function of HSSP pharmacists and outcomes reported with use of the HSSP model, and to identify gaps in the literature where more information is needed to better understand the HSSP model and outcomes.
Current literature describes the role of HSSP pharmacists in facilitating patient access, affordability, and initiation and maintenance of specialty medications. Though it is clear HSSP pharmacists are involved in treatment monitoring, often through utilizing the electronic health record, more information is needed to elucidate the frequency, method, and extent of monitoring. Despite several valuable continuity of care services reported to be provided by HSSPs, the breadth and degree of standardization of these services remains unclear. There is minimal literature describing HSSP education and research involvement. HSSPs have reported significant benefits of this patient care model, as demonstrated by higher adherence and persistence; better clinical outcomes; financial benefits to patients, payers, and the health system; better quality of care; higher patient and provider satisfaction with services, and highly efficient specialty pharmacy services. More literature comparing clinical and diagnosis-related outcomes in HSSP versus non-HSSP patients is needed.
HSSPs provide comprehensive, patient-centered specialty medication management that result in improved care across the continuum of the specialty patient journey and act as a valuable resource for specialty clinics and patients beyond medication management. Future research should build on the current description of HSSP services, how services affect patient outcomes, and the impact HSSP network restrictions.
对于患有复杂疾病的患者来说，专科药物可能会改变他们的生活。然而，它们的益处依赖于适当的治疗选择、患者的支付能力和启动治疗的能力，以及根据患者对治疗的反应进行持续的治疗优化。越来越多的研究表明，医疗系统专科药房（HSSP）在改善专科药物的可及性、可负担性和治疗效果方面具有优势。本快速综述的目的是描述 HSSP 药剂师目前报告的作用和功能，以及使用 HSSP 模型报告的结果，并确定文献中的空白点，需要更多信息来更好地了解 HSSP 模型和结果。
目前的文献描述了 HSSP 药剂师在促进患者获得、负担得起和启动和维持专科药物方面的作用。尽管 HSSP 药剂师参与治疗监测是明确的，通常是通过利用电子健康记录，但需要更多的信息来阐明监测的频率、方法和程度。尽管 HSSP 报告了许多有价值的连续性护理服务，但这些服务的广度和标准化程度仍不清楚。关于 HSSP 教育和研究参与的文献很少。HSSP 报告了这种患者护理模式的显著益处，表现为更高的依从性和持久性；更好的临床结果；对患者、支付者和医疗系统的经济利益；更好的护理质量；患者和服务提供者对服务的满意度更高，以及高效的专科药房服务。需要更多的文献比较 HSSP 患者和非 HSSP 患者的临床和诊断相关结果。
HSSP 提供全面的、以患者为中心的专科药物管理，在专科患者治疗旅程的整个过程中改善护理，并作为专科诊所和患者的宝贵资源，超越药物管理。未来的研究应该建立在 HSSP 服务的当前描述、服务如何影响患者的结果以及 HSSP 网络限制的影响的基础上。
