Effects of collaborative drug therapy management on patients' perceptions of care and health-related quality of life☆
Abstract
Background
It has been demonstrated that collaborative drug therapy management may result in enhanced medication adherence and improved clinical outcomes. It is not yet known whether CDTM is associated with patients' perceptions of care or self-reports of health-related quality of life.
Objectives
Examine the impact of collaborative drug therapy management (CDTM) on patients' perceptions of care and health-related quality of life in 15 ambulatory clinics (6 intervention, 9 comparison) in the Fairview system of Minneapolis–St Paul, Minn.
Methods
The intervention was medication therapy management provided by pharmacists in collaboration with physicians (CDTM) for a 12-month period. Subjects were selected by age, gender, and presence of one of 12 medical conditions in the intervention (n=285) and comparison (n=285) group of patients. Comparison patients received usual care while intervention patients received at least 2 CDTM encounters. The CAHPS® (formerly called the Consumer Assessment of Health Plans) 2.0 survey was administered to both the intervention and comparison groups poststudy to analyze patients' perceptions of care.
The Short Form-12 (SF-12v2) was administered to intervention group patients pre-CDTM and 6 months post-CDTM to measure health-related quality of life in the intervention group.
Results
Differences in CAHPS® scores were not statistically significant (P>.05), although there was a trend toward higher ratings of patients' personal doctor/nurse and doctors' communication in the CDTM intervention group relative to the comparison group. Physical role, social functioning, and physical component summary scales of the SF-12v2 improved significantly (P=.001, P=.014, and P=.024, respectively; P≤.025 level).
Conclusions
A trend toward improvements in patient perceptions of effectiveness of care using CAHPS® suggests a need for further study. Health-related quality of life improvements in this study meet or exceed previous results incorporating pharmacists into primary care. Intensity and integration of CDTM services may be an explanation; however, prepost study design limits inferences.
dUniversity of Minnesota College of Pharmacy, Minneapolis, MN 55455, USA
Corresponding author. University of Minnesota College of Pharmacy, Weaver Densford Hall, Room 7-175, 308 Harvard Street, SE, Minneapolis, MN 55455, USA. Tel.: +1 612 624 2140; Fax: 612-625-9931.
☆ This project was supported by a grant from the University of Minnesota, Academic Health Center/Fairview Health System, Joint Funding Program.
Preliminary project results were presented at the Blue Cross Blue Shield Association, Best Practices in Medical and Pharmacy Management meeting, Chicago, Ill, October 9, 2003. Wadd WB, Heaton AH, Isetts BJ. Measuring the Impact of Collaborative Pharmaceutical Care, BCBSA—Best Practices in Medical and Pharmacy Management.
1 Dr Artz was supported by the VFW Endowed Chair in Pharmacotherapy for the Elderly, College of Pharmacy, University of Minnesota.
ABSTRACT