Morillo-Verdugo Ramón, Lazaro-Lopez Alicia, Alonso-Grandes Elena, Martin-Conde Maria Teresa, Diaz-Ruiz Pilar, Molina-Cuadrado Emilio, Huertas-Fernandez María José, Navarro-Aznares Herminia, Areas Del Aguila Vera, Gimeno-Gracia Mercedes, Margusino-Framiñán Luis, Martínez-Sesmero Jose Manuel
Pharmacy Hospital Service, Hospital Valme, Área de Gestión Sanitaria Sur de Sevilla, Sevilla, Spain.
Pharmacy Hospital Service, Hospital Universitario de Guadalajara, Guadalajara, Spain.
J Multidiscip Healthc. 2022 Dec 29;15:2991-3003. doi: 10.2147/JMDH.S392398. eCollection 2022.
To compare patient experience in a real-life population of people living with HIV (PLWH) who received pharmaceutical care (PC) based on the Capacity-Motivation-Opportunity (CMO) model versus the traditional model.
Prospective cohort study in PLWH receiving either CMO-based PC or traditional PC in Spain between October 2019 and June 2021 (24 weeks), performed by the pharmacy department of 14 Spanish hospitals. Participants were adult patients with a clinical diagnosis of HIV treated with antiretrovirals who had been monitored in the participating hospital pharmacies for >1 year. Patient experience (IEXPAC questionnaire), clinical outcomes (cholesterol, triglycerides, HDL, glycated haemoglobin, and blood pressure), adherence to treatment, virologic control and patient satisfaction were determined.
Patient experience in the CMO group at week 24 was significantly better (7.6 vs 6.9) than in the traditional group, with a higher mean improvement. Adherence was better in the CMO group, particularly with regard to concomitant medications (53.2% to 91.7%, <0.001); no changes were observed in the traditional group. Patient satisfaction improved in the CMO group vs the traditional group (48 vs 44, <0.001).
To our knowledge, this is the first study to compare CMO vs traditional methodology. The CMO model showed an overall improvement in real-life patient experience, satisfaction, and adherence to treatment compared to the traditional methodology.
比较接受基于能力-动机-机会（CMO）模型的药学服务（PC）的真实生活中的艾滋病毒感染者（PLWH）与接受传统模型的患者的体验。
2019年10月至2021年6月（24周）期间，在西班牙接受基于CMO的PC或传统PC的PLWH中进行前瞻性队列研究，由14家西班牙医院的药房部门开展。参与者为临床诊断为艾滋病毒且接受抗逆转录病毒治疗的成年患者，他们在参与研究的医院药房接受监测超过1年。测定患者体验（IEXPAC问卷）、临床结局（胆固醇、甘油三酯、高密度脂蛋白、糖化血红蛋白和血压）、治疗依从性、病毒学控制和患者满意度。
CMO组在第24周时的患者体验显著优于传统组（7.6对6.9），平均改善程度更高。CMO组的依从性更好，尤其是在使用伴随药物方面（从53.2%提高到91.7%，<0.001）；传统组未观察到变化。与传统组相比，CMO组的患者满意度有所提高（48对44，<0.001）。
据我们所知，这是第一项比较CMO与传统方法的研究。与传统方法相比，CMO模型在真实生活中的患者体验、满意度和治疗依从性方面总体有所改善。
