PHARMACY-BASED PATIENT MONITORING IN AN IPA HMO

IPA HMO 中基于药房的患者监测

• 批准号: 2236627
• 负责人: L DOUGLAS RIED
• 金额: $ 6.07万
• 依托单位: UNIVERSITY OF FLORIDA
• 依托单位国家: 美国
• 财政年份: 1995
• 资助国家: 美国
• 起止时间: 1995-04-01 至 1997-10-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/2236627
• 关键词: PHARMACY; BASED; PATIENT; MONITORING; IPA

This project will evaluate the pilot test of a pharmacy-based patient monitoring (PPM) protocol. The PPM protocol is designed to modify the relationship between the provision of pharmaceutical care and drug utilization outcomes among patients of community pharmacy practitioners. Staff model HMOs have significant organizational advantages that enhance the management of care. However, not all managed care programs that are likely to compete are staff model HMOs. The care of medically indigent and Medicaid patients in rural areas most likely will be provided by health care practitioners associated with one or more IPAs. Unfortunately, IPA HMOs do not have the same degree of control over the practice of the medical and pharmacy providers because they are not HMO employees. It is important to IPA HMO drug benefit administrators to determine whether they can manage the cost and care of their patients in ways similar to staff model HMOs. The experimental design is a pretest-posttest control group experimental trial. Randomly selected moderate-to-severe asthmatics from a north- central Florida IPA HMO will be monitored by pharmacists using the experimental PPM protocol and their outcomes will be compared with an age- sex matched control group's outcomes. The control level of pharmaceutical care is the usual prescribing and dispensing process of community practice. The pharmacy-based patient monitoring (PPM) protocol includes: (a) drug therapy review and assessment based upon asthma treatment guidelines, (b) recommendations and form for collecting relevant patient information, (c) strategies to influence the appropriateness of physician prescribing, (d) guidelines for monitoring patients' clinical and quality-of-life outcomes, and (e) forms for providing feedback to patients and their physicians. The protocol differs from normal community-based pharmacy services because of its added emphasis on monitoring patient outcomes and providing patient-specific advice and feedback to patients and physicians. Experimental and control groups will be compared on a process of care and patient outcome measure, namely drug utilization and quality of life. The primary sources of data are the IPA HMOs automated prescription dispensing data base and surveys of patient's asthma-specific quality of life. Pharmaceutical care in the context of community, ambulatory care has major policy implications and has rarely been explicitly addressed by prior research or health policy analysts as a variable that influences clinical and quality-of-life outcomes.

该项目将评估基于药房的患者的试点测试 监控（PPM）协议。 PPM协议旨在修改 提供药学服务与药物之间的关系 社区药房从业者患者的使用结果。 员工模式 HMO 具有显着的组织优势，可以增强 护理管理。 然而，并非所有管理式医疗计划都 可能参与竞争的是员工模范 HMO。 医疗贫困者的护理 农村地区的医疗补助患者很可能将由 与一种或多种 IPA 相关的医疗保健从业者。 不幸的是，IPA HMO 对药物没有同等程度的控制。 医疗和药房提供者的做法，因为他们不是 HMO 雇员。 对于 IPA HMO 药物福利管理者来说，重要的是 确定他们是否能够管理患者的费用和护理 方式类似于员工模型 HMO。 实验设计为前测后测对照组实验 审判。 随机选择来自北方的中度至重度哮喘患者 佛罗里达州中部 IPA HMO 将由药剂师使用 实验性 PPM 协议及其结果将与年龄进行比较 性别匹配对照组的结果。 药学服务的控制水平是通常的处方和 社区实践的配发过程。 以药房为基础的患者 监测 (PPM) 方案包括： (a) 药物治疗审查和评估 根据哮喘治疗指南，(b) 的建议和表格 收集相关患者信息，(c) 影响患者的策略 医生处方的适当性，(d) 监测指南 患者的临床和生活质量结果，以及 (e) 表格 向患者及其医生提供反馈。 协议不同 来自正常的社区药房服务，因为它添加了 强调监测患者的治疗结果并提供针对患者的具体情况 向患者和医生提供建议和反馈。 将比较实验组和对照组的护理过程和 患者结果衡量标准，即药物利用率和生活质量。 这 主要数据来源是 IPA HMO 自动处方配药 患者哮喘特定生活质量的数据库和调查。 社区背景下的药学服务、门诊护理具有重要意义 政策影响，并且之前很少明确解决 研究或卫生政策分析师作为影响临床的变量 和生活质量结果。