BACKGROUND Persons with spinal cord injury/dysfunction (SCI/D) often take multiple medications to treat their secondary complications and chronic conditions (multimorbidity). Multiple healthcare and service providers are often involved in care, which can result in increased risk of fragmentation of care. Optimal medication therapy management (MTM) is essential to ensure therapeutic benefit from medication regimens. However, little is known about the experiences of providers in supporting persons with SCI/D with MTM. METHODS Telephone interviews were conducted to explore healthcare and service providers' experiences with MTM for persons with SCI/D. Participants were recruited through clinical organizations and researchers' personal contacts. Participants were purposefully selected for diversity in profession and were required to be English speaking and to have provided care to at least one person with SCI/D. The qualitative interviews followed a semi-structured interview guide. Data display matrices were used in a constant comparative process for descriptive and interpretive analysis. RESULTS Thirty-two interviews were conducted from April to December 2018. Each profession had distinct views on their roles in facilitating MTM for persons with SCI/D, which aligned with their respective scopes of practice. Shared provider tasks included tailoring medications, providing education, and exploring medication alternatives. Most participants felt that the care they provided for persons with SCI/D was similar to the care that they provided to other patients, with some differences relating to the physical limitations and medical complexity associated with SCI/D. Five factors were identified that impacted participants' abilities to provide MTM for persons with SCI/D: patient self-management skills, provider knowledge and confidence, provider-patient relationships, interprofessional collaboration, and provider funding models including the use of technology-supported consultations. CONCLUSION While participants described commonalities in the barriers and enablers associated with providing MTM to persons with SCI/D and other populations, there were unique considerations identified. These SCI/D-specific considerations resulted in recommendations for improvements in MTM for this population. Future research should include perspectives from persons with SCI/D.

中文翻译：

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“策略相同，问题可能有所不同”：一项定性研究，探索了针对脊髓损伤/功能障碍患者进行药物治疗的医疗保健和服务提供者的经验。

背景技术患有脊髓损伤/功能障碍（SCI / D）的人经常服用多种药物来治疗其继发性并发症和慢性病（多发病）。多个医疗保健和服务提供商经常参与护理，这可能导致护理分散的风险增加。最佳药物治疗管理（MTM）对于确保药物治疗方案的治疗效益至关重要。但是，对于提供者在MTM上支持SCI / D人员的经验知之甚少。方法进行电话采访以探讨医疗保健和服务提供商对SCI / D患者使用MTM的经验。通过临床组织和研究人员的个人联系招募了参与者。参与者是有针对性地被选择的，因为他们的专业是多样化的，并且要求他们会说英语，并至少为一名SCI / D患者提供了护理。定性访谈遵循半结构化访谈指南。数据显示矩阵用于不断的比较过程中，以进行描述性和解释性分析。结果2018年4月至2018年12月进行了32次面试。每个行业对他们在促进SCI / D人士进行MTM方面的作用有不同的看法，这与各自的业务范围相吻合。提供者共享的任务包括定制药物，提供教育和探索药物替代方案。大多数参与者认为，他们为SCI / D患者提供的护理与他们为其他患者提供的护理相似，在与SCI / D相关的身体限制和医疗复杂性方面存在一些差异。确定了五个影响参与者为SCI / D患者提供MTM的能力的因素：患者的自我管理技能，提供者的知识和信心，提供者与患者的关系，专业间的合作以及提供者的资助模式，包括使用技术支持的咨询。结论尽管参与者描述了向SCI / D患者和其他人群提供MTM的障碍和促成因素的共性，但仍存在一些独特的考虑因素。这些针对SCI / D的考虑因素提出了针对该人群改善MTM的建议。未来的研究应包括SCI / D患者的观点。