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在远程医疗药物治疗管理计划中,药物治疗不依从的双重参保医疗保险-医疗补助患者的社会需求。

Social needs of dual-enrolled Medicare-Medicaid patients with medication nonadherence in a telehealth medication therapy management program.

机构信息

Institute of Therapeutic Innovations and Outcomes, Colleges of Pharmacy, Columbus, OH.

El Rio Community Health Center, Tucson, AZ.

出版信息

J Manag Care Spec Pharm. 2023 Feb;29(2):210-215. doi: 10.18553/jmcp.2023.29.2.210.

Abstract

Telehealth services that identify and address the social needs of patients can improve access to health care and social services. The social needs of medication therapy management (MTM)-eligible Medicare-Medicaid dual-enrolled patients are unknown. To describe the social needs of Medicare-Medicaid dual-enrolled patients participating in a telephonic MTM program. This study evaluated the findings of a social needs survey implemented within a telehealth MTM program. Surveys were offered telephonically to eligible Medicare-Medicaid patients of one insurance plan who were identified with medication nonadherence between July 13, 2020, and December 31, 2020. This study described patients who completed the survey during provision of a comprehensive medication review (CMR). Questions screened for social needs in the following social determinant of health domains: community and social context, economic stability, and neighborhood and physical environment. Descriptive statistics were used to describe results. Among 461 patients who completed CMRs, 358 completed the social needs survey. The most prevalent needs and concerns identified included lacking support to perform daily activities (165 [47%]), lacking companionship (81 [23%]), feeling left out (71 [20%]), feeling isolated (81 [23%]), not having enough money to pay bills (177 [49%]), worrying about running out of food (77 [22%]), or having run out of food within the last 12 months (81 [23%]). In this sample, 54 (15%) patients reported avoiding a provider visit because of transportation barriers. Certain individuals were without a steady place to live or were worried about losing their home (40 [11%]) and 35 (10%) reported struggling to keep a job. The identification of social needs among patient populations is necessary to reduce barriers to medication adherence and optimize health care utilization. This study described important social needs identified during the provision of a telehealth CMR among MTM-eligible Medicare-Medicaid dual-enrolled patients. Dr Nahata was supported in part by the Avatar Foundation. Dr Silva Almodóvar works as a research pharmacist within a medication management program, which provides medication therapy management services.

摘要

远程医疗服务可以识别和满足患者的社会需求,从而改善医疗保健和社会服务的可及性。药物治疗管理(MTM)合格的医疗保险-医疗补助双重参保患者的社会需求尚不清楚。本研究旨在描述参与远程电话 MTM 项目的医疗保险-医疗补助双重参保患者的社会需求。

这项研究评估了一项社会需求调查的结果,该调查是在一项远程医疗 MTM 项目中实施的。调查通过电话向 2020 年 7 月 13 日至 2020 年 12 月 31 日期间被确定为药物不依从的符合条件的医疗保险-医疗补助患者提供。本研究描述了在进行全面药物审查(CMR)期间完成调查的患者。调查问卷在以下健康社会决定因素领域筛选社会需求:社区和社会环境、经济稳定性以及邻里和物理环境。使用描述性统计数据描述结果。

在完成 CMR 的 461 名患者中,有 358 名完成了社会需求调查。确定的最常见需求和关注点包括缺乏完成日常活动的支持(165[47%])、缺乏陪伴(81[23%])、感觉被冷落(71[20%])、感觉孤立(81[23%])、没有足够的钱付账单(177[49%])、担心食物不够(77[22%])或在过去 12 个月内食物耗尽(81[23%])。在这个样本中,有 54 名(15%)患者因交通障碍而避免就诊。某些人没有稳定的住所或担心失去家园(40[11%]),35 名(10%)报告难以保住工作。

确定患者群体的社会需求对于减少药物依从性障碍和优化医疗保健利用至关重要。本研究描述了在医疗保险-医疗补助双重参保患者的远程 CMR 提供过程中发现的重要社会需求。

纳哈塔博士部分得到了阿凡达基金会的支持。席尔瓦·阿尔莫多瓦尔博士作为一名研究药剂师,在一个药物管理项目中工作,该项目提供药物治疗管理服务。

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