Background

Patient-Centered Care (PCC) resides in the center of the Joint Commission of Pharmacy Practitioners' “Pharmacists’ Patient Care Process” (PPCP) and is essential to successful management of chronic disease. However, the widely recognized importance and relevance of PCC contrasts with the limited number of studies in the pharmacist literature investigating patient preferences and expectations that inform PCC. Filling this gap is vital for improving pharmacist PCC at the micro-level (i.e., within and adjacent to patient-pharmacist encounters), meso-level (i.e., healthcare systems), and macro-level (i.e., legislation, payment, workforce dynamics).

Objective

The study's objective was to describe, interpret, and compare patient preferences and expectations of Patient-Centeredness in pharmacist outpatient care.

Methods

This mixed methods study used semi-structured, in-depth phone interviews among a purposive national sample of US adult patients with multiple chronic conditions and the experienced outpatient pharmacists caring for them. Interviews aimed to elicit conceptual definitions and concrete experiences of Patient-Centeredness in pharmacist care, were analyzed following Bengtsson's Content Analysis procedures, and assessed for reliability using Perrault and Leigh's Reliability Index. Data trustworthiness was interpreted using processes outlined by Guba & Krefting.

Results

Data analysis revealed a three-archetype heuristic of preferences and expectations for pharmacist care: ‘Partner,’ ‘Client,’ and ‘Customer.’ Each respective archetype is described and distinguished from the others across five common factors: Nature of the Relationship & Locus of Control; Care Customization; Encounter Duration & Care Longevity; Intent of Communication; and Source of Value. Exemplar excerpts from study participants also illuminate the meaning and distinctiveness of each respective archetype across the five factors.

Conclusions

Findings suggest a novel approach for exploring pharmacist PCC quality, design, evaluation, and value-based payment at the micro-, meso-, and macro-levels of care. Future research should include operational field testing to investigate the model's validity, applicability, and consistency in pharmacist PCC.

中文翻译：

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门诊药剂师实践中以患者为中心的护理偏好和期望：三个原型启发式

背景

以患者为中心的护理 (PCC) 位于药学从业者联合委员会“药剂师患者护理流程”(PPCP) 的中心，对于成功管理慢性病至关重要。然而，广泛认可的 PCC 的重要性和相关性与药师文献中有限数量的研究形成对比，这些研究调查了 PCC 的患者偏好和期望。填补这一空白对于改善微观层面（即患者与药剂师会面内部和附近）、中观层面（即医疗保健系统）和宏观层面（即立法、支付、劳动力动态）的药剂师 PCC 至关重要）。

客观的

该研究的目的是描述、解释和比较药剂师门诊护理中患者的偏好和以患者为中心的期望。

方法

这项混合方法研究使用半结构化、深入的电话访谈，对患有多种慢性病的美国成年患者和照顾他们的经验丰富的门诊药剂师进行了有目的的全国样本调查。访谈旨在引出药剂师护理中以患者为中心的概念定义和具体经验，按照 Bengtsson 的内容分析程序进行分析，并使用 Perrault 和 Leigh 的可靠性指数评估可靠性。使用 Guba & Krefting 概述的流程来解释数据可信度。

结果

数据分析揭示了对药剂师护理的偏好和期望的三个原型启发式：“合作伙伴”、“客户”和“客户”。每个各自的原型都被描述并通过五个共同因素与其他原型区分开来： 关系的性质和控制点；护理定制；遭遇持续时间和护理寿命；沟通的意图；和价值来源。研究参与者的示例摘录还阐明了五个因素中每个原型的含义和独特性。

结论

研究结果提出了一种在微观、中观和宏观护理水平上探索药剂师 PCC 质量、设计、评估和基于价值的支付的新方法。未来的研究应包括操作现场测试，以调查该模型在药剂师 PCC 中的有效性、适用性和一致性。