一个专业药房健康指导项目的评估

D. Simonson, Marj Wittenborg, M. Snyder, H. Wiest, A. Mcnamara
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Aims: Goals of this study were to determine the impact of a health coach in patients who receive specialty pharmacy services as measured by number of referrals to this program, patient satisfaction and perceived impact on health, and impact on patient depression scores. Methods: Health coaching services were offered to patients during initial TM call or when a trigger was identified, such as emotional distress, new chronic illness diagnosis, life transition, coping issues, stress management, end of life, advanced care planning, or family concerns. Initial outreach health coach call to the patient provided program overview, confirmed interest, determined focus area (emotional/spiritual needs, loss/grief, lifestyle changes, or stress management), encouraged goal setting, and documented baseline depression score using the Patient Health Questionnaire (PHQ-9). 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引用次数: 0

摘要

摘要背景:Fairview Specialty Pharmacy为患者提供全面的治疗管理(TM),但一些患者需要额外的社会、身体和心理支持,而药剂师或护士可能无法满足这些支持。为了解决复杂的患者需求并远程改善健康的社会决定因素,我们聘请了一名健康教练。健康指导计划对患者的预期好处包括为健康和心理健康提供全面支持,识别和克服健康应对的障碍,以及确定额外的支持资源。目的:本研究的目的是确定健康教练对接受专科药房服务的患者的影响,通过转诊该项目的次数、患者满意度和对健康的感知影响以及对患者抑郁评分的影响来衡量。方法:在首次TM呼叫期间或确定触发因素时,为患者提供健康指导服务,如情绪困扰、新的慢性病诊断、生活过渡、应对问题、压力管理、生命终结、高级护理计划或家庭问题。对患者的初步外展健康教练电话提供了项目概述、确认的兴趣、确定的重点领域(情感/精神需求、损失/悲伤、生活方式改变或压力管理)、鼓励的目标设定以及使用患者健康问卷(PHQ-9)记录的基线抑郁评分。患者和健康教练之间的随访电话主要针对患者目标;提供额外服务的转介记录在案。在第三次通话结束时,给了患者PHQ-9,并向患者邮寄了满意度调查。项目影响是根据满意度调查、推荐和第三次通话后PHQ-9的变化来确定的。结果:82名患者完成了623项健康指导评估(2016年4月至2019年1月)。最常见的辅导重点(46%的患者)是情感/精神和损失/悲伤的结合。在基线和第3阶段对54名患者进行PHQ-9评估;54例患者中有30例(56%)病情好转。在基线为中度至重度抑郁症的患者中,70%的患者的抑郁症减轻。匿名患者体验调查(n = 21)显示,该项目中86%的患者强烈同意或同意他们的身体健康,95%的患者强烈赞同或同意与健康教练合作对他们的心理健康产生了积极影响。所有患者(100%)强烈同意或同意他们对Fairview Specialty Pharmacy健康指导计划感到满意。健康教练将37名患者转介至其他服务,包括支持小组、社会工作者、病例管理人员、医生、精神科医生、临终关怀或预先护理计划。结论:专科药房健康指导计划是有影响力的,其衡量标准是患者满意度高,患者对该计划对身心健康的影响有积极的感知,患者抑郁评分提高,以及转诊到其他资源。
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Evaluation of a specialty pharmacy health coaching program
Abstract Background: Fairview Specialty Pharmacy provides comprehensive therapy management (TM) for patients, yet some patients require additional social, physical, and psychological support that may be unmet by a pharmacist or nurse. To address complex patient needs and remotely improve social determinants of health, a health coach is employed. The projected benefits of a health coaching program for patients include providing holistic support for health and mental well-being, identifying and overcoming barriers to healthy coping, and identifying additional resources for support. Aims: Goals of this study were to determine the impact of a health coach in patients who receive specialty pharmacy services as measured by number of referrals to this program, patient satisfaction and perceived impact on health, and impact on patient depression scores. Methods: Health coaching services were offered to patients during initial TM call or when a trigger was identified, such as emotional distress, new chronic illness diagnosis, life transition, coping issues, stress management, end of life, advanced care planning, or family concerns. Initial outreach health coach call to the patient provided program overview, confirmed interest, determined focus area (emotional/spiritual needs, loss/grief, lifestyle changes, or stress management), encouraged goal setting, and documented baseline depression score using the Patient Health Questionnaire (PHQ-9). Follow-up calls between the patient and health coach were focused on patient goals; referrals to additional services were documented. At the end of the third call, the PHQ-9 was given and a satisfaction survey was mailed to the patient. Program impact was determined based on satisfaction surveys, referrals, and the change in PHQ-9 after the third call. Results: 623 health coaching assessments were completed in 82 patients (April 2016-January 2019). The most common coaching focus (46% of patients) was combined emotional/spiritual and loss/grief. PHQ-9 was assessed in 54 patients at baseline and session 3; improvement occurred in 30 of the 54 patients (56%). In patients with baseline moderate to severe depression, 70% of patients experienced decreased depression. Anonymous patient experience survey (n = 21) revealed that 86% of patients in this program strongly agreed or agreed that their physical health and 95% strongly agreed or agreed that their mental health was positively impacted by working with the health coach. All patients (100%) strongly agreed or agreed that they were satisfied with the Fairview Specialty Pharmacy health coaching program. The health coach referred 37 patients to additional services, including support groups, social workers, case managers, physicians, psychiatrists, and hospice or advance care planning. Conclusions: The specialty pharmacy health coaching program was impactful, as measured by high patient satisfaction, positive patient perception of program impact on physical and mental health, improved patient depression scores, and referrals to other resources.
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Journal of Drug Assessment
Journal of Drug Assessment PHARMACOLOGY & PHARMACY-
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