Telephone versus In-Person Pharmacist-Led Medication Reviews in Home Dialysis Patients: Evaluating Quality of Care and Patient Satisfaction
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design
2.2. Participants
2.3. Pharmacist Medication Reviews
2.4. Data Collection
2.4.1. Quantitative Data
2.4.2. Qualitative Data
2.5. Data Analysis
2.5.1. Quantitative Data
Sample Size Estimation
2.5.2. Qualitative Data
3. Results
3.1. Demographics
3.2. Pharmacist-Led Medication Review Outcomes
3.3. Patient Satisfaction Survey Outcomes
3.3.1. Quantitative Data
3.3.2. Qualitative Data
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
Appendix A. Patient Survey
- (1)
- Have you had an in-person medication review with a pharmacist in the dialysis clinic?
Yes No - (2)
- Have you had a telephone medication review with a pharmacist from the dialysis clinic?
Please check the box that corresponds with your level of agreement to each of the following statements about medication reviews with the dialysis pharmacist completed over the telephone.Yes No - (3)
- I am satisfied with the care that I received from the dialysis pharmacist over the telephone.
Strongly disagree Disagree Neither agree or disagree Agree Strongly Agree - (4)
- I am able to communicate effectively with the pharmacist on the telephone.
Strongly disagree Disagree Neither agree or disagree Agree Strongly Agree - (5)
- My privacy and confidentiality were respected and protected during the medication review on the telephone.
Strongly disagree Disagree Neither agree or disagree Agree Strongly Agree - (6)
- The telephone medication reviews are just as good as in-person medication reviews.
Strongly disagree Disagree Neither agree or disagree Agree Strongly Agree - (7)
- How would you prefer to review your medications with the pharmacist in the future?
- I would prefer to review my medications with the pharmacist in person.
- I would prefer to review my medications with the pharmacist over the telephone.
- I would prefer to review my medications with the pharmacist in person once a year, and over the phone the rest of the time
- I don’t have a preference
- (8)
- What would you change about the telephone medication reviews with the pharmacist?_________________________________________________________________
- (9)
- What do you like best about the telephone medication reviews with the pharmacist?_________________________________________________________________
- (10)
- Please provide any additional comments:_________________________________________________________________
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Characteristic | Outcome |
---|---|
Demographics | |
Male, N (%) | 20 (43.5) |
Female, N (%) | 26 (56.5) |
Age, years, mean (SD) | 59.3 (12.5) |
Time on dialysis, years, mean (SD) | 3.6 (2.4) |
Number of medications, mean (SD) | 11.3 (3.7) |
Number of comorbidities, mean (SD) | 5.9 (2.3) |
Comorbidities, N (%) | |
Hypertension | 39 (84.8) |
Diabetes | 25 (54.3) |
Dyslipidemia | 16 (34.8) |
Osteoarthritis | 8 (17.4) |
Gout | 6 (13.0) |
Atrial Fibrillation | 5 (10.9) |
Polycystic Kidney Disease | 5 (10.9) |
GERD | 4 (8.7) |
COPD | 4 (8.7) |
Peripheral Vascular Disease | 4 (8.7) |
Measure | Median (IQR) | p-Value | ES |
---|---|---|---|
Number of recommendations, per visit | 0.200 | −0.13 | |
In-person | 1.0 (0.5–1.5) | ||
Telephone | 1.0 (0.38–1.5) | ||
Acceptance of pharmacist intervention | 0.009 | −0.27 | |
In-person | 1.0 (1.0–2.0) | ||
Telephone | 0.0 (0.0–2.0) | ||
No acceptance of pharmacist intervention | 0.057 | 0.20 | |
In-person | 0.0 (0.0–1.0) | ||
Telephone | 0.0 (0.0–1.0) | ||
Acceptance of pharmacist intervention with change | 0.564 | −0.06 | |
In-person | 0.0 (0.0–0.0) | ||
Telephone | 0.0 (0.0–0.0) | ||
Total drug therapy problems (DTPs) | 0.431 | −0.08 | |
In-person | 2.0 (1.0–4.0) | ||
Telephone | 2.0 (1.0–3.0) | ||
Unnecessary drug therapy | 0.415 | −0.09 | |
In-person | 0.0 (0.0–0.25) | ||
Telephone | 0.0 (0.0–0.0) | ||
Needed additional drug therapy | 0.094 | −0.17 | |
In-person | 1.0 (0.0–1.0) | ||
Telephone | 0.0 (0.0–1.0) | ||
Ineffective drug therapy | 0.083 | 0.18 | |
In-person | 0.0 (0.0–0.0) | ||
Telephone | 0.0 (0.0–0.0) | ||
Dosage too high | 0.089 | −0.18 | |
In-person | 0.0 (0.0–1.0) | ||
Telephone | 0.0 (0.0–0.0) | ||
Dosage too low | 0.968 | −0.004 | |
In-person | 0.0 (0.0–1.0) | ||
Telephone | 0.0 (0.0–1.0) | ||
Adverse drug reaction | 0.909 | 0.01 | |
In-person | 0.0 (0.0–0.25) | ||
Telephone | 0.0 (0.0–1.0) | ||
Non-adherence | 0.186 | 0.14 | |
In-person | 0.0 (0.0–0.0) | ||
Telephone | 0.0 (0.0–1.0) |
What Would You Change about the Telephone Medication Reviews with the Pharmacist? | ||
---|---|---|
Theme | # of Statements | Quotes |
In-person visits only | 1 | “I don’t like virtual care” |
Schedule appointment times in advance | 1 | “The one thing I would prefer would be a designated time and date, as opposed to getting an unexpected call. I like to have my med list in front of me, and have any questions I may have, prepared.” |
Speak Louder | 1 | “If the pharmacist spoke a little louder.” |
Change Nothing | 16 | “I wouldn’t change anything” |
What do you Like Best about the Telephone Medication Reviews with the Pharmacist? | ||
Theme | # of Statements | Quotes |
Similar quality of care | 3 | “There is no difference between in person and telephone visits” |
No travel required | 7 | “I live out of town, saves having to go for in person visit” “I don’t have to go to the hospital” |
Efficient and patient-centered care | 5 | “The pharmacists are open and personable, effective and efficient during every visit.” “The professional yet personal experience” |
Convenient for patient | 7 | “Quick, easy, and it saves time” “More convenient, I don’t have to be there” “It doesn’t take as much time” |
Enjoy all of it | 1 | “All of it” |
Please Provide any Additional Comments | ||
Theme | # of Statements | Quotes |
Patients are satisfied with the care they receive from pharmacists | 5 | “I am satisfied with the care I receive from the pharmacists” “I find the pharmacists to be very thorough, professional and informative.” |
Better care is perceived to be obtained through in-person visits | 3 | “I feel if they see me they will do better, but you can’t do that on the phone. If you don’t tell them everything that’s going on they won’t know.” “I feel a disconnect with COVID and telephone visits.” |
No issues | 2 | “No issues with pharmacy” |
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Allen, K.; Flewelling, A.J.; Munro, L.; Naylor, H. Telephone versus In-Person Pharmacist-Led Medication Reviews in Home Dialysis Patients: Evaluating Quality of Care and Patient Satisfaction. Pharmacy 2023, 11, 1. https://doi.org/10.3390/pharmacy11010001
Allen K, Flewelling AJ, Munro L, Naylor H. Telephone versus In-Person Pharmacist-Led Medication Reviews in Home Dialysis Patients: Evaluating Quality of Care and Patient Satisfaction. Pharmacy. 2023; 11(1):1. https://doi.org/10.3390/pharmacy11010001
Chicago/Turabian StyleAllen, Kelsey, Andrew J. Flewelling, Lauren Munro, and Heather Naylor. 2023. "Telephone versus In-Person Pharmacist-Led Medication Reviews in Home Dialysis Patients: Evaluating Quality of Care and Patient Satisfaction" Pharmacy 11, no. 1: 1. https://doi.org/10.3390/pharmacy11010001