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- Title
Patient-reported outcomes and pharmacist actions in patients with multiple sclerosis managed by health-system specialty pharmacies.
- Authors
Zuckerman, Autumn D; Banks, Aimee M; Wawrzyniak, Julie; Rightmier, Elizabeth; Simonson, Dana; Zagel, Alicia L; Turco, Evan; Blevins, Abbi; DeClercq, Josh; Choi, Leena
- Abstract
Purpose This study evaluated patient-reported outcomes (PROs) and pharmacist actions for patients on disease-modifying therapies (DMTs) for multiple sclerosis (MS) through health-system specialty pharmacies (HSSPs). Methods A multisite, prospective cohort study of patients utilizing an HSSP for DMT fulfillment was performed. Primary outcomes were affirmative answers to PRO questions regarding impacted productivity, hospitalization, and relapse and pharmacist actions. Rates of pharmacist actions were reported as the number of person-years of treatment per action. Univariate and multivariate logistic regression were used to evaluate the association between each PRO and covariates, including the number of pharmacist actions performed, age, sex, insurance, site, and route of administration. Results The 968 patients included had 10,562 fills and 6,946 PRO assessments. The most common affirmative PRO was impacted productivity (14.6%). Pharmacists performed 3,683 actions, most commonly general medication education (42.6%) and safety (33.3%). Rates of general medication education and nonfinancial coordination of care actions were similar across medication classes; other pharmacist actions varied by medication class. Insurance type was significantly associated with reporting impacted productivity; patients with Medicare and Medicaid were 2.2 and 3.1 times more likely to have reported impacted productivity, respectively (P < 0.001) than commercially insured patients. Patients who reported impacted productivity had more pharmacist actions (P < 0.001). Conclusion Patients on DMTs through an HSSP reported low rates of impacted productivity, relapse, and hospitalization due to MS, although patients with noncommercial insurance were more likely to have impacted productivity. Patients reporting impacted productivity and those taking certain DMTs may require more frequent pharmacist actions.
- Subjects
UNITED States; MULTIPLE sclerosis; OCCUPATIONAL roles; RESEARCH; DRUG administration routes; LABOR productivity; AGE distribution; HEALTH outcome assessment; HOSPITAL pharmacies; DISEASE relapse; SEX distribution; DRUGS; HOSPITAL care; HEALTH insurance; PATIENT compliance; LOGISTIC regression analysis; LONGITUDINAL method; EVALUATION
- Publication
American Journal of Health-System Pharmacy, 2023, Vol 80, Issue 22, p1650
- ISSN
1079-2082
- Publication type
Article
- DOI
10.1093/ajhp/zxad180