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

Abstract

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.

Keywords:

• telepharmacy
• pharmaceutical care
• patient satisfaction
• outcome assessment

Acknowledgments

To all participant in the project:

Alicia Lazaro Lopez, Maria Blanco Crespo, Ana Maria Horta Fernandez (Hospital de Guadalajara), Luis Ortega Valín (Complejo Hospitalario de León), Jose Sebastian Roldan Gonzalez, Jose Jimenez Casaus, Sonia Fernandez Cañabate (Complejo Hospitalario de Zamora), Transito Salvador Gomez, Mercedes Gimeno Gracia, Lucia Sopena Carrera, Raquel Fresquet, Arantxa Magallón (Hospital Lozano Blesa, Zaragoza).

M Pilar Fabian Sanz, Azucena Ojeda Saez, Francisco Aceituno Romero, Raquel Avila Torvisco, Lucila Menendez Bueno, Bernardina Moro Mediano, Mª Lourdes Sanchez-Seco Fraile, Isabel Calvo Ruiz, Amor Lopez Gonzalez, Clara Eugenia Navarro Castro, Nuria Muñoz Muñoz, Elena Amaro Lopez, Patricia Redondo Lajas, Begoña Gonzalez Paramino, Ana Belen Prieto Nieto, Cristina Lobato Valencia, Alvaro Perez Asensio, Ana de Paula Blanco, Isabel Garcia Garcia, Patricia Molina Lomba, Enrique Eguizabal Martinez, Antonio Ramos, Juan Jimenez, Andrea Martinez Seguer, Ana Maria Azagra Saez, Mª Pilar Baras Bandrés (Oficinas de Farmacia, Sociedad Española de Farmacia Rural)

Alvaro Serrano, Ricardo Serrano y Daniel Ruiz (4Clavis Consulting S.L).

Enrique Contreras Macias for his support at statistical level.

Disclosure

The authors report no conflicts of interest in this work.