J Am Pharm Assoc (2003). 2024 Nov-Dec;64(6):102210. doi: 10.1016/j.japh.2024.102210. Epub 2024 Aug 23.
Tobacco-focused medication therapy management (MTM) interventions executed in pharmacies located in Federally Qualified Health Centers (FQHC) may provide an innovative means to reach smokers with low incomes and reduce health disparities. However, greater understanding of the intervention's potential feasibility in this setting is needed.
To inform the feasibility of implementing an MTM program to address tobacco and nicotine dependence in the FQHC setting by assessing the experience and perceptions of pharmacists working in pharmacies associated with FQHCs.
A convergent mixed methods approach was used to assess indicators associated with the domains of the Consolidated Framework for Implementation Research (CFIR). Pharmacists from FQHC-based pharmacies in the Southeast United States completed surveys (n = 24) and interviews (n = 15). Quantitative data were summarized descriptively. Qualitative data were content coded.
Quantitative and qualitative data were mapped across all 5 CFIR domains. Pharmacists report high rates of tobacco and nicotine use among their patients and that addressing their use is important. A total of 62.5% of pharmacists had some or a great deal of experience with tobacco and nicotine dependence. Quantitative and qualitative data demonstrate that the pharmacists and their FQHCs would support MTM efforts focused on tobacco and nicotine dependence. Qualitative findings highlight that pharmacists view an MTM intervention as aligning with their current workflow. Quantitative and qualitative data highlight how factors related to pharmacists' engagement in introducing tobacco and nicotine dependence treatment programs to patients, the electronic medical record, time, staffing, and patient-level barriers could impact the feasibility of an MTM intervention focused on tobacco and nicotine dependence.
Findings suggest an MTM intervention focused on tobacco and nicotine dependence has the potential to be feasible within FQHC-based pharmacies. Considerations related to training, staffing, time, identifying participants, and supporting participant engagement must be taken into account to support its implementation.
在联邦合格健康中心 (FQHC) 开设的药房中实施以烟草为重点的药物治疗管理 (MTM) 干预措施，可能为低收入吸烟者提供一种创新的方法，以减少健康差距。然而，需要更多地了解该干预措施在这种环境下的潜在可行性。
通过评估在 FQHC 附属药房工作的药剂师的经验和看法，了解在 FQHC 环境中实施 MTM 计划以解决烟草和尼古丁依赖问题的可行性。
采用收敛混合方法评估与实施研究综合框架 (CFIR) 五个领域相关的指标。美国东南部 FQHC 药房的药剂师完成了调查 (n=24) 和访谈 (n=15)。定量数据以描述性方式总结。定性数据进行内容编码。
将定量和定性数据映射到所有五个 CFIR 领域。药剂师报告其患者中有很高的烟草和尼古丁使用率，并且解决他们的使用问题很重要。共有 62.5%的药剂师在某种程度上或很大程度上有烟草和尼古丁依赖的经验。定量和定性数据表明，药剂师及其 FQHC 支持专注于烟草和尼古丁依赖的 MTM 工作。定性研究结果表明，药剂师认为 MTM 干预符合他们当前的工作流程。定量和定性数据突出了与药剂师参与向患者引入烟草和尼古丁依赖治疗方案、电子病历、时间、人员配备和患者层面障碍相关的因素，这些因素可能会影响专注于烟草和尼古丁依赖的 MTM 干预的可行性。
研究结果表明，专注于烟草和尼古丁依赖的 MTM 干预措施在 FQHC 药房中具有可行性。在实施过程中，必须考虑到培训、人员配备、时间、确定参与者和支持参与者参与的相关问题。
