RESUMO
BACKGROUND AND OBJECTIVES: Pharmacist inclusion in patient-centered medical home (PCMH) teams has been shown to benefit both patients and practices. However, pharmacists' inclusion on these teams is not widespread, partly because the work they do is not well known. The Successful Collaborative Relationships to Improve PatienT care (SCRIPT) project was started in August 2009 to understand the clinical and economic impact of pharmacists providing direct patient care. The objective of this study was to describe the work of pharmacists practicing as integrated members of the patient care team within PCMHs through retrospective analysis of their patient care documentation over a 4-year time frame. Two pharmacists were placed into four suburban medical home practices in Pittsburgh, Pennsylvania to perform comprehensive medication management (CMM). These pharmacists documented their CMM encounters in an electronic health record and a database for reporting purposes. METHODS: This study is a retrospective, descriptive analysis of pharmacist-documented CMM encounters from February 2010 through February 2014. Pharmacists' work-including patient demographics, disease states, and medication therapy problems-was recorded in a Microsoft Access database and tabulated. RESULTS: The pharmacists conducted 11,206 CMM encounters with 3,777 unique patients during the study period. The pharmacists identified 9,375 medication therapy problems (MTPs) and performed 14,092 interventions. Pharmacists most commonly worked with patients with diabetes, hypertension, pain, and hyperlipidemia. Physician and patient acceptance of the pharmacists' work was high. CONCLUSIONS: Pharmacists working in family medicine offices contribute to patient care through identification and resolution of MTPs and also by collaborating with PCMH teams.
Assuntos
Prestação Integrada de Cuidados de Saúde/organização & administração , Medicina de Família e Comunidade/organização & administração , Conduta do Tratamento Medicamentoso/organização & administração , Farmacêuticos , Papel Profissional , Feminino , Humanos , Masculino , Conduta do Tratamento Medicamentoso/tendências , Pessoa de Meia-Idade , Equipe de Assistência ao Paciente/organização & administração , Assistência Centrada no Paciente/organização & administração , Estudos RetrospectivosRESUMO
OBJECTIVES: This study tested screening feasibility and described the behavioral, mental, and physical health of patients filling prescriptions for opioid medications in the community pharmacy setting. METHODS: We conducted a cross-sectional survey in rural/urban community pharmacies with adult noncancer patients. The survey included validated measures for opioid medication misuse risk, drug and alcohol use, and physical and mental health problems. Descriptive statistics were calculated, and bivariate and multivariable logistic regression evaluated relationships between opioid medication misuse risk and patient demographics, behavioral, mental, and physical health. RESULTS: A total of 164 patients completed the survey (87% response rate), revealing positive screens for prescription opioid misuse risk (14.3%), illicit drug use (7.3%), hazardous alcohol use (21.4%), depression (25.8%), and posttraumatic stress disorder (PTSD; 17.1%). Bivariate analyses revealed increased odds of a positive opioid medication misuse risk score with a positive screen for illicit drug use in the previous year (odds ratioâ=â3.91; 95% confidence interval [CI], 1.05-14.63) and PTSD (odds ratioâ=â6.7; 95% CI, 2.54-17.69). In adjusted multivariable analyses, these relationships strengthened such that a positive screen for illicit drug use (adjusted odds ratioâ=â12.96; 95% CI, 2.18-76.9) and PTSD (adjusted odds ratioâ=â13.3; 95% CI, 3.48-50.66) increased odds for a positive opioid medication misuse risk score. CONCLUSIONS: Findings confirmed the feasibility of screening risk factors and positive opioid medication misuse risk among community pharmacy patients. Future research should validate these findings as a foundation to intervention development.