针对联邦合格健康中心与责任医疗组织中临床药师在初级保健中的作用的提供者调查。
Provider survey of the roles of clinical pharmacists in primary care in a Federally Qualified Health Center versus an Accountable Care Organization.
作者信息
Amin Pranav, Jones Sara, Selby Courtney, McCarty Journey, Smith Forrest, Douglass Gabriella
机构信息
ARcare PGY2 Ambulatory Care Pharmacy Resident, ARcare 1241 W. Beebe Capps Exp., Searcy, AR 72143, United States of America.
ARcare Clinical Pharmacy, ARcare 1241 W. Beebe Capps Exp., Searcy, AR 72143, United States of America.
出版信息
Explor Res Clin Soc Pharm. 2023 Mar 21;9:100242. doi: 10.1016/j.rcsop.2023.100242. eCollection 2023 Mar.
BACKGROUND
Healthcare providers at primary care Federally Qualified Healthcare Centers (FQHC) and an Accountable Care Organizations (ACO) collaborated with clinical pharmacists in providing patient care utilizing the comprehensive medication management (CMM) framework. The intention of CMM was to generate more time for providers to see patients, and to improve overall patient quality of life.
OBJECTIVES
The purpose of this study was to survey the providers' views of clinical pharmacy services, and to compare and contrast the shared-visit model in rural FQHCs and an ACO collaborative practice agreement model in a mid-sized metropolitan area.
METHODS
Primary care providers completed a five-domain 22-item survey of provider patient care, provider pharmacy consults, provider ranking of pharmacy-services, disease treatment and provider views on the value of clinical pharmacists.
RESULTS
FQHC pharmacists were available one day per week (75%), while 69% of ACO pharmacists were available five days per week. FQHC providers requested <5 pharmacist consults per week (46%), while ACO requested >10 consults per week (44%). Both organizations had nearly identical provider rankings and impact on patient care for clinical pharmacy services and disease-focused pharmacy services. The provider survey of satisfaction with pharmacy consultations were highly positive and scored as strongly agree with FQHC and ACO, with the exception of three items with the FQHC. Overall providers at both organizations report highly effective medication-related improvements, disease outcomes and also recommend clinical pharmacists to other providers and primary care teams. Regression analysis revealed relevant clinical associations between survey statements not seen with individual survey items alone.
CONCLUSION
Primary care providers report high satisfaction with, and benefits of, clinical pharmacy services. Drug information resource and disease-focused management were documented by providers as valuable pharmacy services. Providers promoted expanding the role of clinical pharmacists with providers, and integration into primary care teams.
背景
联邦合格医疗中心（FQHC）的基层医疗服务提供者以及一个责任医疗组织（ACO）与临床药剂师合作，利用综合药物管理（CMM）框架提供患者护理。CMM的目的是为医疗服务提供者腾出更多时间看诊患者，并提高患者的整体生活质量。
目的
本研究的目的是调查医疗服务提供者对临床药学服务的看法，并比较和对比农村FQHC的共享就诊模式和中型都市地区的ACO合作实践协议模式。
方法
基层医疗服务提供者完成了一项关于医疗服务提供者患者护理、医疗服务提供者药学咨询、医疗服务提供者对药学服务的排名、疾病治疗以及医疗服务提供者对临床药剂师价值看法的五领域22项调查。
结果
FQHC的药剂师每周有一天提供服务（75%），而69%的ACO药剂师每周有五天提供服务。FQHC的医疗服务提供者每周请求的药剂师咨询少于5次（46%），而ACO每周请求的咨询多于10次（44%）。两个组织在临床药学服务和以疾病为重点的药学服务的医疗服务提供者排名以及对患者护理的影响方面几乎相同。医疗服务提供者对药学咨询满意度的调查非常积极，在FQHC和ACO中得分均为强烈同意，但FQHC有三项除外。两个组织的医疗服务提供者总体上都报告了与药物相关的改进、疾病治疗效果非常有效，并且还向其他医疗服务提供者和基层医疗团队推荐临床药剂师。回归分析揭示了单个调查项目未发现的调查陈述之间的相关临床关联。
结论
基层医疗服务提供者对临床药学服务表示高度满意并认为其有益。医疗服务提供者将药物信息资源和以疾病为重点的管理记录为有价值的药学服务。医疗服务提供者主张扩大临床药剂师与医疗服务提供者的合作，并将其纳入基层医疗团队。
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