社区药房的预约模式:安大略省的患者人口统计和可报销临床服务的使用情况

T. Tilli, A. Mathers, Qiqi Lin, Saleema Bhaidani, Jen Baker, Louis Wei, Paul Grootendorst, S. Cadarette, Lisa Dolovich
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摘要

社区药房通常要求患者申请续药。预约模式 (ABM) 是一种积极主动的方法,可同步续药并安排患者与药剂师的预约。这些预约为药物回顾、药物优化和健康促进服务提供了机会。本研究的主要目的是描述 2017 年在安大略省一家社区药房接受 ABM 服务的患者类型。次要目的是描述可报销临床服务的使用情况。2017 年 9 月,加拿大药房旗下的 3 家安大略社区药房实施了 ABM。至少服用过一种慢性口服药物并同意注册的患者均符合条件。2018 年 12 月,使用药房管理软件从 3 家药房的样本中提取了数据。生成了描述性统计和频率。对131名患者(51.1%为女性;平均(±SD)年龄为70.8±10.5岁)的分析表明,患者平均(±SD)配发了5.1±2.7种药物,其中73人(55.7%)服用多种药物。高血压(87.8%)和血脂异常(68.7%)是最常见的病症。有 74 名(56.5%)患者接受了≥1 次药物审查服务(MedsCheck)。在发现的 79 个独特药物治疗问题 (DTP) 中,最常见的类别与患者需要额外药物治疗和药物不良反应有关。参与 ABM 的患者一般都是使用多种药物治疗的老年人。ABM 为 DTP 识别和提供有偿服务提供了机会。研究结果支持继续探索 ABM,以支持在社区实践中整合临床服务。
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The appointment-based model in community pharmacies: Patient demographics and reimbursable clinical services uptake in Ontario
Community pharmacies typically require patients to request medication refills. The appointment-based model (ABM) is a proactive approach that synchronizes refills and schedules patient–pharmacist appointments. These appointments provide opportunities for medication reviews, medication optimization and health promotion services. The primary aim of this study was to describe the types of patients who received an ABM service in a community pharmacy in Ontario in 2017. The secondary aim was to describe reimbursable clinical service uptake. In September 2017, the ABM was implemented across 3 Ontario community pharmacies within a Canadian pharmacy banner. Patients who filled at least 1 chronic oral medication and consented to enrolment were eligible. In December 2018, data were extracted from a sample of 3 pharmacies using pharmacy management software. Descriptive statistics and frequencies were generated. Analysis of 131 patients (51.1% female; mean ± SD age 70.8 ± 10.5 years) revealed patients were dispensed a mean ± SD of 5.1 ± 2.7 medications, and 73 (55.7%) experienced polypharmacy. Hypertension (87.8%) and dyslipidemia (68.7%) were the most common medical conditions. There were 74 (56.5%) patients who received ≥1 medication review service (MedsCheck). Of 79 unique drug therapy problems (DTPs) identified, the most common categories related to patients needing additional drug therapy and adverse drug reactions. Patients enrolled in the ABM were generally older adults experiencing polypharmacy. The ABM presented opportunities for DTP identification and delivery of reimbursed services. Findings support continued exploration of the ABM to support integration of clinical services within community practice.
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