亚利桑那州农村病人的药物治疗管理、生活方式和健康计划。

IF 2.5 4区医学 Q3 PHARMACOLOGY & PHARMACY

Journal of the American Pharmacists Association Pub Date : 2025-03-01 DOI:10.1016/j.japh.2025.102324

David R. Axon, Becka Eckert, Terra Leon, Sonia Morales, John Ehiri, Aminata Kilungo, Thelma Okotie, Tenneh Turner-Warren

{"title":"亚利桑那州农村病人的药物治疗管理、生活方式和健康计划。","authors":"David R. Axon, Becka Eckert, Terra Leon, Sonia Morales, John Ehiri, Aminata Kilungo, Thelma Okotie, Tenneh Turner-Warren","doi":"10.1016/j.japh.2025.102324","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>Pharmacist-provided medication therapy management (MTM) services have demonstrated improved clinical outcomes for patients. MTM services could incorporate additional lifestyle and wellness counseling to potentially enhance health care for underserved patients.</div></div><div><h3>Objective</h3><div>To report the outcomes of a new pharmacist-provided MTM lifestyle and wellness counseling program for underserved rural Arizonans with diabetes and/or hypertension.</div></div><div><h3>Methods</h3><div>A community health center referred rural Arizonans with type 2 diabetes and/or hypertension to the MTM pharmacist for telephonic MTM lifestyle and wellness counseling between July 2020 and June 2023. Data were collected on clinical characteristics, adherence issues, and pharmacist recommendations. A nurse reviewed the patients' electronic health record to determine which recommendations had been accepted by the primary care provider after 90 days. Summary statistics were computed.</div></div><div><h3>Results</h3><div>For 93 patients in the program, pharmacists identified many drug-drug interactions, adverse drug reactions, utilization/cost concerns, and recommended preventative vaccines. Pharmacists provided counseling for exercise, nutrition, laboratory values, and disease state education. Twenty-nine patients reported missing any doses of their medications in the past 2 weeks. Patients used a variety of methods to remind them to take their medications. A total of 309 recommendations were made by the pharmacist averaging 3.3 ± 1.4 per patient. Of these, 113 (36.6%) were accepted within 90 days. The most common recommendations made were screening needed (n = 77) and vaccination due (n = 70). The most frequently accepted recommendations by the patients' provider were reinforcing lifestyle/disease self-management strategies (61.7%) and decreasing medication dose (60.0%).</div></div><div><h3>Conclusion</h3><div>This novel MTM lifestyle and wellness counseling program demonstrated some success for underserved Arizonans with diabetes and/or hypertension. Over one-third of recommendations made by the pharmacist to the patients' primary care provider were accepted, which is encouraging in showing the value of this program but suggests further work is needed to act upon them or understand why they are not implemented.</div></div>","PeriodicalId":50015,"journal":{"name":"Journal of the American Pharmacists Association","volume":"65 2","pages":"Article 102324"},"PeriodicalIF":2.5000,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Medication therapy management lifestyle and wellness program for patients in rural Arizona\",\"authors\":\"David R. Axon, Becka Eckert, Terra Leon, Sonia Morales, John Ehiri, Aminata Kilungo, Thelma Okotie, Tenneh Turner-Warren\",\"doi\":\"10.1016/j.japh.2025.102324\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><div>Pharmacist-provided medication therapy management (MTM) services have demonstrated improved clinical outcomes for patients. MTM services could incorporate additional lifestyle and wellness counseling to potentially enhance health care for underserved patients.</div></div><div><h3>Objective</h3><div>To report the outcomes of a new pharmacist-provided MTM lifestyle and wellness counseling program for underserved rural Arizonans with diabetes and/or hypertension.</div></div><div><h3>Methods</h3><div>A community health center referred rural Arizonans with type 2 diabetes and/or hypertension to the MTM pharmacist for telephonic MTM lifestyle and wellness counseling between July 2020 and June 2023. Data were collected on clinical characteristics, adherence issues, and pharmacist recommendations. A nurse reviewed the patients' electronic health record to determine which recommendations had been accepted by the primary care provider after 90 days. Summary statistics were computed.</div></div><div><h3>Results</h3><div>For 93 patients in the program, pharmacists identified many drug-drug interactions, adverse drug reactions, utilization/cost concerns, and recommended preventative vaccines. Pharmacists provided counseling for exercise, nutrition, laboratory values, and disease state education. Twenty-nine patients reported missing any doses of their medications in the past 2 weeks. Patients used a variety of methods to remind them to take their medications. A total of 309 recommendations were made by the pharmacist averaging 3.3 ± 1.4 per patient. Of these, 113 (36.6%) were accepted within 90 days. The most common recommendations made were screening needed (n = 77) and vaccination due (n = 70). The most frequently accepted recommendations by the patients' provider were reinforcing lifestyle/disease self-management strategies (61.7%) and decreasing medication dose (60.0%).</div></div><div><h3>Conclusion</h3><div>This novel MTM lifestyle and wellness counseling program demonstrated some success for underserved Arizonans with diabetes and/or hypertension. Over one-third of recommendations made by the pharmacist to the patients' primary care provider were accepted, which is encouraging in showing the value of this program but suggests further work is needed to act upon them or understand why they are not implemented.</div></div>\",\"PeriodicalId\":50015,\"journal\":{\"name\":\"Journal of the American Pharmacists Association\",\"volume\":\"65 2\",\"pages\":\"Article 102324\"},\"PeriodicalIF\":2.5000,\"publicationDate\":\"2025-03-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of the American Pharmacists Association\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S1544319125000032\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"PHARMACOLOGY & PHARMACY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of the American Pharmacists Association","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1544319125000032","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"PHARMACOLOGY & PHARMACY","Score":null,"Total":0}

引用次数: 0

摘要

背景：药剂师提供的药物治疗管理（MTM）服务已经证明可以改善患者的临床结果。MTM服务可以纳入额外的生活方式和健康咨询，以潜在地加强对服务不足的患者的卫生保健。目的：报告一种新的药剂师提供的MTM生活方式和健康咨询项目的结果，该项目适用于服务不足的亚利桑那州农村糖尿病和/或高血压患者。方法：2020年7月至2023年6月，社区卫生中心将亚利桑那州农村2型糖尿病和/或高血压患者转介给MTM药剂师，进行MTM生活方式和健康电话咨询。收集临床特征、依从性问题和药剂师建议的数据。一名护士审查了患者的电子健康记录，以确定90天后初级保健提供者接受了哪些建议。计算汇总统计数据。结果：在该项目的93名患者中，药剂师确定了许多药物-药物相互作用，药物不良反应，利用/成本问题，并推荐了预防性疫苗。药剂师提供运动、营养、化验值和疾病状态教育方面的咨询。29名患者报告在过去两周内没有服用任何剂量的药物。病人用各种方法提醒自己吃药。药师共提出309条建议，平均每位患者3.3±1.4条。其中，113份（36.6%）在90天内被接受。最常见的建议是需要筛查（n = 77）和应接种疫苗（n = 70）。患者提供者最常接受的建议是加强生活方式/疾病自我管理策略（61.7%）和减少药物剂量（60.0%）。结论：这种新颖的MTM生活方式和健康咨询项目对亚利桑那州患有糖尿病和/或高血压的人来说取得了一些成功。药剂师向患者的初级保健提供者提出的建议中有超过三分之一被接受，这在显示该计划的价值方面是令人鼓舞的，但也表明需要进一步的工作来采取行动，或者理解为什么这些建议没有得到实施。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

查看原文本刊更多论文

Medication therapy management lifestyle and wellness program for patients in rural Arizona

Background

Pharmacist-provided medication therapy management (MTM) services have demonstrated improved clinical outcomes for patients. MTM services could incorporate additional lifestyle and wellness counseling to potentially enhance health care for underserved patients.

Objective

To report the outcomes of a new pharmacist-provided MTM lifestyle and wellness counseling program for underserved rural Arizonans with diabetes and/or hypertension.

Methods

A community health center referred rural Arizonans with type 2 diabetes and/or hypertension to the MTM pharmacist for telephonic MTM lifestyle and wellness counseling between July 2020 and June 2023. Data were collected on clinical characteristics, adherence issues, and pharmacist recommendations. A nurse reviewed the patients' electronic health record to determine which recommendations had been accepted by the primary care provider after 90 days. Summary statistics were computed.

Results

For 93 patients in the program, pharmacists identified many drug-drug interactions, adverse drug reactions, utilization/cost concerns, and recommended preventative vaccines. Pharmacists provided counseling for exercise, nutrition, laboratory values, and disease state education. Twenty-nine patients reported missing any doses of their medications in the past 2 weeks. Patients used a variety of methods to remind them to take their medications. A total of 309 recommendations were made by the pharmacist averaging 3.3 ± 1.4 per patient. Of these, 113 (36.6%) were accepted within 90 days. The most common recommendations made were screening needed (n = 77) and vaccination due (n = 70). The most frequently accepted recommendations by the patients' provider were reinforcing lifestyle/disease self-management strategies (61.7%) and decreasing medication dose (60.0%).

Conclusion

This novel MTM lifestyle and wellness counseling program demonstrated some success for underserved Arizonans with diabetes and/or hypertension. Over one-third of recommendations made by the pharmacist to the patients' primary care provider were accepted, which is encouraging in showing the value of this program but suggests further work is needed to act upon them or understand why they are not implemented.

求助全文

通过发布文献求助，成功后即可免费获取论文全文。去求助

来源期刊

Journal of the American Pharmacists Association 医学-药学

CiteScore

3.30

自引率

14.30%

发文量

336

审稿时长

46 days

期刊介绍： The Journal of the American Pharmacists Association is the official peer-reviewed journal of the American Pharmacists Association (APhA), providing information on pharmaceutical care, drug therapy, diseases and other health issues, trends in pharmacy practice and therapeutics, informed opinion, and original research. JAPhA publishes original research, reviews, experiences, and opinion articles that link science to contemporary pharmacy practice to improve patient care.