Nova Southeastern University College of Pharmacy, Davie, FL, USA.
Pharmacy Practice, Nova Southeastern University West Palm Beach Student Educational Center, Palm Beach Gardens, FL, USA.
J Pharm Pract. 2024 Feb;37(1):27-34. doi: 10.1177/08971900221111144. Epub 2022 Aug 18.
Medication nonadherence is the leading cause of poor health outcomes and increased risk of hospitalizations. Previous studies have shown that pharmacist interventions can help improve medication adherence and CMS quality measures. The purpose of this study was to examine the impact of clinical pharmacists' interventions on medication adherence and PDC scores for ACEi/ARBs, statins, and noninsulin antidiabetic medications in the primary care setting. This observational study was conducted at four primary care clinics to evaluate PDC scores pre- and post-pharmacist interventions from April 2020 to December 2020. Eligible patients were Humana Part D beneficiaries with a baseline PDC score <85%. The primary outcome of this study was to evaluate the average change in final PDC scores, and 1-month change in PDC scores following a pharmacist intervention. Secondary outcomes were number and types of adherence barriers identified, interventions provided by the pharmacist, and barriers and interventions category (pharmacy, patient or physician-related). A total of 89 barriers were identified and 208 interventions were completed. A statistically significant difference in the average change of final PDC score from baseline was seen among those on ACEi/ARBs (72.5 to 78.0, = 0.004) and statins (73.3 to 76.6, < 0.001). Similarly, a statistically significant change was observed from baseline to 1-month PDC among those on ACEi/ARBS (72.5 to 75.4, = 0.001) and statins (73.3 to 74.9, < 0.001). Conclusion: Pharmacists located in a primary care setting improved medication adherence and PDC score for patients on ACEIs/ARBs and statins.
药物依从性差是导致健康状况不佳和住院风险增加的主要原因。先前的研究表明，药剂师的干预可以帮助提高药物依从性和 CMS 质量指标。本研究的目的是探讨临床药师干预对初级保健环境中 ACEi/ARB、他汀类药物和非胰岛素类抗糖尿病药物的药物依从性和 PDC 评分的影响。这项观察性研究在四家初级保健诊所进行，以评估 2020 年 4 月至 2020 年 12 月期间药剂师干预前后的 PDC 评分。合格患者为基线 PDC 评分<85%的 Humana Part D 受益人的患者。本研究的主要结果是评估最终 PDC 评分的平均变化，以及药剂师干预后 1 个月 PDC 评分的变化。次要结果是确定的药物依从性障碍的数量和类型、药剂师提供的干预措施以及障碍和干预措施类别（药房、患者或医生相关）。共确定了 89 个障碍，并完成了 208 次干预。在 ACEi/ARB（从 72.5 到 78.0， = 0.004）和他汀类药物（从 73.3 到 76.6， < 0.001）中，最终 PDC 评分的平均变化从基线开始有统计学意义的差异。同样，在 ACEi/ARB（从 72.5 到 75.4， = 0.001）和他汀类药物（从 73.3 到 74.9， < 0.001）中，从基线到 1 个月 PDC 的变化也有统计学意义。结论：在初级保健环境中，药剂师提高了 ACEIs/ARBs 和他汀类药物患者的药物依从性和 PDC 评分。
