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将安德森行为模型应用于药物治疗管理项目:一种提高老年人用药安全性的方法。

Applying the Andersen behavioral model to the medication therapy management program: an approach for improving medication safety in older adults.

作者信息

Fu Yu-Hua, Castora-Binkley Melissa, Coe Antoinette B, Snyder Margie E, Cooke Catherine E, Vogel Carlyn E, Hines Lisa, Lyles Alan, Brandt Nicole

机构信息

Department of Practice, Sciences and Health Outcomes Research, University of Maryland Baltimore School of Pharmacy, Baltimore, MD, United States.

Peter Lamy Center on Drug Therapy and Aging, University of Maryland Baltimore, School of Pharmacy, Baltimore, MD, United States.

出版信息

Front Public Health. 2024 Nov 21;12:1499362. doi: 10.3389/fpubh.2024.1499362. eCollection 2024.

Abstract

Medication therapy problems (MTPs) are common among older adults and are associated with considerable morbidity, mortality, and healthcare costs. The Medicare Part D Medication Therapy Management (MTM) program, which includes Comprehensive Medication Reviews (CMRs), Targeted Medication Reviews (TMRs), and guidance on safe medication disposal, is designed to optimize therapeutic outcomes and reduce adverse events by addressing MTPs. Although this program has demonstrated success in reducing MTPs, its utilization remains low, with ongoing concerns about service access disparities, patient satisfaction, and long-term health outcomes. This perspective paper applies the Andersen Behavioral Model (ABM) to the Medicare Part D MTM program to enhance understanding of factors influencing service utilization and impact among older adults. The ABM provides a structured framework to examine how macro-and micro-level factors shape health behaviors and outcomes. By applying ABM framework to MTM, this paper highlights essential research directions to generate rigorous evidence for program evaluation, inform policy adjustments, and make targeted recommendations for improving MTM within the U.S. healthcare system. Furthermore, this work has potential implications for global programs aimed at enhancing medication safety by addressing MTPs and optimizing medication use.

摘要

药物治疗问题(MTPs)在老年人中很常见,并且与相当高的发病率、死亡率及医疗成本相关。医疗保险D部分药物治疗管理(MTM)项目,包括全面药物评估(CMRs)、针对性药物评估(TMRs)以及安全用药处置指南,旨在通过解决药物治疗问题来优化治疗效果并减少不良事件。尽管该项目已证明在减少药物治疗问题方面取得了成功,但其利用率仍然很低,人们持续关注服务获取差距、患者满意度和长期健康结果。这篇观点论文将安德森行为模型(ABM)应用于医疗保险D部分的MTM项目,以加深对影响老年人服务利用和影响因素的理解。ABM提供了一个结构化框架,用于研究宏观和微观层面的因素如何塑造健康行为和结果。通过将ABM框架应用于MTM,本文突出了重要的研究方向,以产生严格的项目评估证据、为政策调整提供信息,并为改善美国医疗系统内的MTM提出有针对性的建议。此外,这项工作对旨在通过解决药物治疗问题和优化药物使用来提高用药安全性的全球项目具有潜在影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/da7d/11619275/6eaa2a138782/fpubh-12-1499362-g001.jpg

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