Department of Pharmaceutical Services, Vanderbilt University Medical Center, Nashville, Tennessee, United States of America.
Department of Psychology, Vanderbilt University, Nashville, Tennessee, United States of America.
PLoS One. 2022 Aug 15;17(8):e0273040. doi: 10.1371/journal.pone.0273040. eCollection 2022.
Integrated health-system specialty pharmacies (IHSSP) have shown high medication access, adherence, and provider satisfaction. The goal of this study was to explore healthcare providers' experiences with specialty medications distributed via Limited Distribution Networks (LDN) that do not include IHSSPs. We investigated healthcare providers' perceived impact of LDNs on clinic workflow, clinical practice, and patient outcomes. Interviews and focus groups were conducted with fourteen healthcare providers from four outpatient specialty clinics at an academic health system with an IHSSP. Qualitative analysis using an iterative inductive/deductive approach of coded transcripts was used to identify themes. Participants discussed requirements and barriers to communicating with insurance providers, drug manufacturers, and external pharmacies; time and effort required to navigate LDNs and impact on workload and clinic workflow; financial awareness of medication costs and methods for communication about financial information with patients; and advocating for patients to ensure access to necessary therapy and avoid missed doses or treatment lapse. Participants reported barriers to navigating LDNs that can interfere with clinic workflow and patient care. IHSSPs may reduce clinic burden by helping patients access, afford, and remain on therapy.
综合医疗系统专科药房 (IHSSP) 已显示出较高的药物可及性、依从性和提供者满意度。本研究的目的是探讨医疗保健提供者在不包括 IHSSP 的有限分销网络 (LDN) 分发专科药物方面的经验。我们调查了医疗保健提供者认为 LDN 对诊所工作流程、临床实践和患者结果的影响。在一家拥有 IHSSP 的学术医疗系统的四个门诊专科诊所，对十四名医疗保健提供者进行了访谈和焦点小组讨论。使用迭代归纳/演绎方法对转录本进行定性分析，以确定主题。参与者讨论了与保险公司、药品制造商和外部药房沟通的要求和障碍；浏览 LDN 所需的时间和精力以及对工作量和诊所工作流程的影响；对药物成本的财务认识以及与患者沟通财务信息的方法；以及为患者争取必要治疗的机会，以避免漏服或治疗中断。参与者报告了在浏览 LDN 时遇到的障碍，这些障碍可能会干扰诊所工作流程和患者护理。IHSSP 通过帮助患者获得、负担得起并继续治疗，可能会减轻诊所的负担。
