药剂师对药物治疗调整的认证:佐治亚州药剂师报告的实践、促进因素和障碍调查

IF 1.3 Q4 PHARMACOLOGY & PHARMACY Journal of the American College of Clinical Pharmacy : JACCP Pub Date : 2024-03-03 DOI:10.1002/jac5.1938
Rebecca H. Stone Pharm.D., FCCP, Blake R. Johnson Pharm.D., MPH, Devin L. Lavender Pharm.D., Beth Bryles Phillips Pharm.D., FCCP, Chelsea A. Keedy Pharm.D., Russ Palmer Ph.D., Henry N. Young Ph.D., Sharmon P. Osae Pharm.D.
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引用次数: 0

摘要

协作药物治疗管理 (CDTM) 允许药剂师评估患者、用药、管理和调整用药方案,并在规定的方案内开具化验单。主要目标是确定佐治亚州药剂师提供的 CDTM 服务,研究提供 CDTM 服务的相关因素,并确定提供 CDTM 服务的障碍和促进因素。次要目标是评估完成注册药剂师(R.Ph.)/药学博士(Pharm.D.)、研究生一年级(PGY1)或研究生二年级(PGY2)住院实习的药剂师在 CDTM 实践中的差异。这项横断面研究采用 Dilman 方法,邀请佐治亚州所有 134 名 CDTM 执业药剂师完成 30 分钟的电子调查。数据包括人口统计学、培训、提供的服务、管理的疾病状态以及对 CDTM 实施的看法。共有 36 名药剂师(26.9%)完成了调查。参与调查者提供的 CDTM 服务中位数为 3 项。大多数人提供药物治疗管理(86.1%)和慢性病护理管理(66.7%)。大多数人提供糖尿病(58.3%)、高脂血症(55.6%)和高血压(55.6%)服务。在博士/药学博士和 PGY2 组之间,所提供 CDTM 服务的平均数量排名存在差异(-11.667,p = 0.019),在博士/药学博士和 PGY1 组之间,所涵盖疾病状态的平均数量排名存在差异(-10.990,p = 0.029),在博士/药学博士和 PGY2 组之间,所涵盖疾病状态的平均数量排名存在差异(-12.640,p = 0.010,调整后的 p 值)。所报告的 CDTM 促进因素包括工作要求、扩大患者护理、工作满意度/个人发展以及扩大专业实践。据报告,面临的挑战包括继续教育、临床/专业间问题、药事委员会或个人执业地点的管理问题以及与其他州不同的法规。研究生培训可帮助药剂师为从事 CDTM 服务做好准备。
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Pharmacist certification of drug therapy modification: A survey of pharmacist-reported practices, facilitators, and barriers in Georgia

Introduction

Collaborative drug therapy management (CDTM) allows pharmacists to assess patients, administer medications, manage and adjust medication regimens, and order laboratory tests within a defined protocol. Pharmacist CDTM may aid in preventative care and chronic condition management.

Objectives

The primary objectives were to identify CDTM services provided by pharmacists in the state of Georgia, examine factors associated with the provision of CDTM services, and identify barriers and facilitators to CDTM service provision. The secondary objective was to assess differences in CDTM practice between pharmacists who completed a Registered Pharmacist (R.Ph.)/Doctor of Pharmacy (Pharm.D.), postgraduate year one (PGY1), or postgraduate year two (PGY2) residency.

Methods

Using the Dilman method, this cross-sectional study invited all 134 CDTM-licensed pharmacists in Georgia to complete a 30-min electronic survey. Data included demographics, training, services offered, disease states managed, and perceptions regarding CDTM implementation. Descriptive statistics, Welchs analysis of variance (ANOVA), and chi-square were conducted using SPSS v28.

Results

A total of 36 (26.9%) pharmacists completed the survey. Participants offered a median of three CDTM services. A majority offered medication therapy management (86.1%) and chronic care management (66.7%). A majority offered services for diabetes (58.3%), hyperlipidemia (55.6%), and hypertension (55.6%). There were differences in the mean ranked number of CDTM services offered between R.Ph./Pharm.D. and PGY2 groups (−11.667, p = 0.019), and the mean ranked number of disease states covered between R.Ph./Pharm.D. and PGY1 (−10.990, p = 0.029) and R.Ph./Pharm.D. and PGY2 (−12.640, p = 0.010, adjusted p-value) groups. Reported CDTM facilitators were job requirements, expanding patient care, job satisfaction/personal advancement, and expanding professional practice. Reported challenges were continuing education, clinical/interprofessional concerns, administration issues with the board of pharmacy or individual practice site, and regulations differing from other states.

Conclusion

Of those with CDTM licensure, a majority offer medication therapy management and chronic care management services covering diabetes, hypertension, and hyperlipidemia. Postgraduate training may help prepare pharmacists to engage in CDTM services.

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