(1) To develop an adaptation framework for MTM delivery for pharmacists (the MTM Adaptability Framework), (2) to examine the impact of an educational intervention informed by the MTM Adaptability Framework on MTM completion rates over a 2-year period, and (3) to explore pharmacists’ perceptions regarding knowledge and beliefs about MTM and MTM implementation self-efficacy pre- and post-intervention. This study is a prospective, mixed-methods research study including a quasi-experimental, one-group pretest-posttest quantitative study with a sequential explanatory qualitative study arm featuring semi-structured key informant interviews. US supermarket pharmacy chain setting included 93 community pharmacy sites located in Tennessee, Kentucky, and Alabama. MTM completion rates are reported as percentage of completed comprehensive medication reviews (CMRs) and targeted medication reviews (TMRs) and pharmacist perceptions. An 11.4% absolute increase in MTM completion rates was seen after the educational intervention targeting adaptation of MTM in the community pharmacy setting. This was found to be significant (46.92% vs. 58.3%; p < 0.001). Responses to the semi-structured interviews were mapped against CFIR and included themes: “knowledge and beliefs about MTM (pre-intervention),” “self-efficacy for MTM implementation (pre-intervention),” “knowledge and beliefs about MTM (post-intervention),” and “self-efficacy for MTM implementation (post-intervention).” Data convergence was found across these methodologies and suggested that targeting adaptability of MTM delivery increases MTM completion rates (quantitative data) and positively changes perceptions of MTM feasibility and self-efficacy (interviews). The use of an educational intervention about adaptation of MTM to influence adaptation of MTM to a chain community pharmacy setting part of an implementation strategy improved MTM completion rates significantly. Future research should investigate combined implementation strategies and their impact on MTM implementation success.

中文翻译：

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以适应性为目标，以改善社区药房的药物治疗管理（MTM）实施。

（1）为药剂师制定MTM交付适应框架（MTM适应性框架），（2）研究MTM适应性框架提供的教育干预对两年内MTM完成率的影响，以及（ 3）探索药剂师对MTM和MTM实施干预前后自我效能的知识和信念的看法。这项研究是一项前瞻性，混合方法的研究，其中包括一项准实验性，单组前测后测定量研究，以及一个以半结构性关键知情人访谈为特色的顺序说明性定性研究机构。美国超市药房连锁店的设置包括位于田纳西州，肯塔基州和阿拉巴马州的93个社区药房站点。MTM完成率报告为已完成的综合药物评论（CMR）和目标药物评论（TMR）和药剂师看法的百分比。在社区药房进行针对MTM适应性的教育干预后，MTM完成率绝对提高了11.4％。发现这是显着的（46.92％对58.3％； p <0.001）。对半结构式访谈的回应是针对CFIR进行映射的，包括以下主题：“关于MTM的知识和信念（干预前），“关于MTM实施的自我效能（干预前）”，“关于MTM的知识和信念（发布后） -干预）和“ MTM实施的自我效能感（干预后）。通过这些方法发现了数据融合，这表明针对MTM交付的适应性提高了MTM完成率（定量数据），并积极改变了对MTM可行性和自我效能感的看法（访谈）。使用有关MTM适应性的教育干预措施来影响MTM对链社区药房的适应性，这是实施策略的一部分，这极大地提高了MTM的完成率。未来的研究应研究组合的实施策略及其对MTM实施成功的影响。使用有关MTM适应性的教育干预措施来影响MTM对链社区药房的适应性，这是实施策略的一部分，这极大地提高了MTM的完成率。未来的研究应研究组合的实施策略及其对MTM实施成功的影响。使用有关MTM适应性的教育干预措施来影响MTM对链社区药房的适应性，这是实施策略的一部分，这极大地提高了MTM的完成率。未来的研究应研究组合的实施策略及其对MTM实施成功的影响。