Evaluation of Patient Experience With A Model of Coordinated Telematic Pharmaceutical Care Between Hospital and Rural Pharmacies in Spain: A Proof of Concept.

Purpose: To determine the usefulness of a coordinated pharmaceutical care model between the specialized hospital setting and the rural community care setting, based on the incorporation of telepharmacy based on Capacity-Motivation-Opportunity (CMO) methodology to improve patient experience with hospital medication prescriptions. Patients and Methods: Prospective cohort study in outpatients receiving telepharmacy based on CMO-based pharmaceutical care in rural areas in Spain between January and November 2021, conducted by the pharmacy department of four hospitals and 29 rural communities' pharmacy. Each patient was followed for 48 weeks on both face-to-face and telematic visits, scheduled and unscheduled at the patients' request. Patient experience (IEXPAC questionnaire), and satisfaction (EVASAF) were determined. Secondary variables included pharmaceutical care interventions, care coordination and clinical variables (compliance with pharmacotherapeutic objectives according to the clinical conditions of each patient), additionally measurement of individual holistic results (EQ5D-5L score) was evaluated. Results: A new telepharmacy tool (called Telemaco) was developed for a multidisciplinary healthcare team (available at: https://inteligeniapps.com/telemaco/) that includes seven different functionalities. We evaluated the first 20 patients (50% women) were included. Their median age was 66.0 years (IQR=14). A total of 215 visits were made (adding 150 video calls). A total of 64 visits were unscheduled (29.7%). The patient´s experience showed improvement (7.4 vs 9.5, p<0.005). The results of the EVASAF questionnaire were also higher (44 vs 48, p<0.001). Overall, 573 pharmaceutical interventions were performed. A difference was observed in patients who achieved the intended pharmacotherapeutic objectives: 48.5 vs 88.2 (p< 0.001). The mean EQ-5D-5L score was 74.7 ± 3.3 at baseline and 80.6 ± 3.6 points at the end (p>0.05). Conclusion: Telepharmacy based on the CMO-PC model, using the "Telemaco" tool, has improved the patient experience, satisfaction, and offered other advantages over the traditional model, including more pharmaceutical interventions adapted to the needs of each patient.

Assessing patient experience with a Telepharmacy model coordinated in the hospital and rural pharmacy setting: The TELEMACO project.

OBJECTIVE: To determine variation in patient experience with a model of Telepharmacy coordinated in the specialist hospital and rural pharmacy setting. METHOD: A pre-post experimental analytical study. A set of common essential  pharmacy tasks based on the capacity-motivation-opportunity method will be  performed in each participating site. A a Telepharmacy software will be  designed to include the following functionalities: history of patient  pharmaceutical profiling and prioritization; scheduled appointment book;  unscheduled visit record; generic participant communication wall; patient- professional instantaneous messaging chat; video calls; monitoring of  treatment adherence; and evaluation of patient-reported outcomes. Inclusion  criteria: age older than 18 years; being on regular hospital pharmacy follow-up for the last 6 months; using a stable drug therapy (without treatment changes  in the last 6 months); using a chronic hospital outpatient prescription (any  prescription valid for at least 6 months); living in any of the municipalities  served by the participating pharmacies or using the services of a participating  pharmacy located near the usual place of residence; granting informed consent prior to inclusion in the study. A 48-week follow-up will be performed of each  patient. The primary endpoint will be variation in patient experience, as  assessed using the "Instrumento de Evaluación de la eXperiencia del PAciente  Crónico" scale at baseline and at the end of the follow-up period. CONCLUSIONS: The incorporation, development and implementation of a  coordinated Telepharmacy care model will help us determine whether this  model is useful in improving patient follow-up and communication with pharmacy professionals at different levels of healthcare.

OBJETIVO: Determinar la variación en la experiencia del paciente con un modelo de atención farmacéutica coordinada entre farmacia hospitalaria y  farmacia rural especializado y el rural de atención comunitaria, basado en la  incorporación de la Telefarmacia.Método: Estudio analítico experimental de intervención antes-después. Para desarrollar el proyecto se realizarán una serie de procedimientos comunes e indispensables, basados en la metodología capacidad-motivación- oportunidad, en cada uno de los centros. Se diseñará una aplicacion  informática de Telefarmacia que contemplará, entre otras, las siguientes  funcionalidades: historial de caracterización y priorización farmacoterapéutica  de los pacientes; agenda de visitas programadas y registro de visitas no  programadas; muro de comunicación genérica entre participantes; chat de  mensajería instantánea entre pacientes y profesionales; videollamadas;  onitorización de la adherencia a la medicación y valoración de cuestionarios de  resultados reportados por pacientes. Se incluirán: pacientes mayores de 18  años; en seguimiento habitual en consultas externas de farmacia hospitalaria  durante más de 6 meses previo al inicio del estudio; que se encuentren en  situación estable desde el punto de vista farmacoterapéutico (sin cambios de  tratamientos en los últimos 6 meses); que tengan prescrito, al menos, un  tratamiento crónico de dispensación en oficina de farmacia (prescripción con  una vigencia de más de 6 meses de cualquier fármaco); que residan  habitualmente en las localidades de las oficinas de farmacia participantes en el  estudio o que acudan a las mismas por cercanía a su lugar de residencia  habitual; y que otorguen su consentimiento informado de participación. Cada  paciente tendrá un seguimiento de 48 semanas. La variable principal será la  diferencia en la experiencia del paciente, valorada mediante la escala  Instrumento de Evaluación de la eXperiencia del PAciente Crónico", desde el  inicio hasta el final de seguimiento. CONCLUSIONES: La puesta en marcha, desarrollo e implementación de la metodología de atención farmacéutica coordinada, basada en la  Telefarmacia, permitirá identificar, a partir de su medición, si esta metodología consigue llevar a cabo un seguimiento más oportuno de los  pacientes incluidos, y si proporciona una mejor experiencia de los mismos en  su relación con los profesionales farmacéuticos que les atienden en los  diferentes niveles de atención sanitaria.