Patient Experience Evaluation of the CMO-Based Pharmaceutical Care Model vs Usual Care in People Living with HIV

Morillo-Verdugo, Ramón; Lázaro-López, Alicia; Alonso-Grandes, Elena; Martin-Conde, Maite; Diaz-Ruiz, Pilar; Molina-Cuadrado, Emilio; Huertas-Fernández, M.J.; Navarro-Aznares, Herminia; Águila, Vera Áreas del; Gimeno-Gracia, Mercedes; Margusino‐Framiñán, Luis; Martínez-Sesmero, José Manuel

doi:10.2147/jmdh.s392398

Cited by 10 publications

(6 citation statements)

References 30 publications

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“…This study is the first work to evaluate how individual characteristics may have influenced the pharmaceutical interventions proposed, in addition to determining the pharmaceutical interventions carried out in a PC clinic for PLWHIV, using the CMO methodology. The distribution of the patients included coincides with the theoretical distribution of the stratification models published, which would indicate an ideal and reproducible scenario for the implementation of this methodology in other settings 7 8 15…”

Section: Discussionsupporting

confidence: 60%

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Influence of baseline characteristics and stratification level of patients living with HIV on pharmaceutical interventions developed according to the Capacity-Motivation-Opportunity methodology

et al. 2023

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ObjectiveIn recent years the therapeutic approach to patients with HIV has gone from being multidisciplinary to multidimensional, being vital to know the different aspects that define patients in order to outline the best care interventions for each patient. The aim of this study was to determine the influence of the individual characteristics (demographic and clinical, pharmacotherapeutic and HIV infection control data) of patients with HIV being followed up using the Capacity-Motivation-Opportunity methodology on the pharmaceutical interventions performed.MethodsA single-centre prospective observational study was conducted between February 2019 and January 2020. Patients with HIV aged ≥18 years on antiretroviral treatment and who were receiving pharmaceutical care based on the Capacity-Motivation-Opportunity methodology were included. Demographic, clinical and pharmaceutical variables and HIV infection control data were registered at baseline. To identify the independent variables associated with pharmaceutical interventions, a univariate logistic regression was performed.ResultsSixty-five patients were included in the study. A total of 129 pharmaceutical care consultations were performed and 909 pharmaceutical interventions were carried out: 503/909 (55.3%) capacity interventions, 381/909 (41.9%) motivation interventions, 25/909 (2.8%) opportunity interventions. The educational level had a significant influence on the opportunity (p=0.025) and transversal training interventions performed (p=0.001). A relationship was found between the antiretroviral therapy received and the development of safety interventions (p=0.037). The presence of polypharmacy significantly influenced concomitant review and validation (p=0.030) and motivation interventions (p=0.041). Adherence of ≥95% had a significant influence on the motivation interventions carried out (p=0.038). Stratification significantly influenced adherence interventions (p=0.033). The sex and age of the patients, as well as their toxic habits, presence of comorbidities, CD4+ cell count and HIV viral load, did not significantly influence the pharmaceutical interventions performed (p>0.05).ConclusionsOur study has elucidated the pharmaceutical interventions carried out in a pharmaceutical care consultation for patients with HIV based on the Capacity-Motivation-Opportunity model and ascertained the individual characteristics (demographic and clinical, pharmacotherapeutic and HIV infection control data) that may have conditioned them.

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Section: Discussionsupporting

confidence: 60%

“…The CMO model is of particular interest in the management of HIV-infected patients, as it allows for targeted pharmaceutical interventions to reach the pharmacotherapeutic goals proposed for each individual patient in order to achieve the best health outcomes 6 7…”

Section: Introductionmentioning

confidence: 99%

Influence of baseline characteristics and stratification level of patients living with HIV on pharmaceutical interventions developed according to the Capacity-Motivation-Opportunity methodology

et al. 2023

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“…Our results corroborated that the coordinated, patient-centred model is superior to traditional care and improves this problem. 35 However, obviously, given the characteristics of the population analysed, this result should be considered with caution, as some variables may have a confounding influence.…”

Section: Discussionmentioning

confidence: 98%

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

Morillo-Verdugo¹,

Morillo-Lisa²,

Espolita-Suarez³

et al. 2023

JMDH

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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.

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“…However, the development of multidimensional intervention strategies as allowed by the Capacity-Motivation-Opportunity Pharmaceutical Care model allows us to identify those most at risk and develop interventions and preventive strategies to avoid these problems with negative consequences. In addition, improvements have already been described both in the patients’ experience and in their clinical results when applying these strategies 30…”

Section: Discussionmentioning

confidence: 99%

Comparative analysis of the prevalence 3-HIT concept in people living with HIV and seronegative patients with chronic conditions. Cross-3HIT Project.

Contreras Macías,

Espina Lozano,

Cantudo-Cuenca

et al. 2024

Eur J Hosp Pharm

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ObjectivesThis study aimed to assess and compare the occurrence of 3-HIT in people living with HIV (PLWH) and seronegative patients. Additionally, the study investigated whether HIV infection could serve as a predictor of the presence of 3-HIT.MethodsA cross-sectional study was conducted between December 2022 and January 2023 to compare PLWH with a group of seronegative patients with chronic diseases attending an outpatient hospital pharmacy service. The 3-HIT concept encompasses the simultaneous presence of non-adherence to concomitant treatment (NAC), drug–drug interactions (DDIs), and high pharmacotherapeutic complexity in polymedicated patients. The assessment of 3-HIT compliance included NAC, evaluated using both the Morisky-Green questionnaire and electronic pharmacy dispensing records. DDIs were analysed using the Liverpool University and Micromedex databases. Pharmacotherapeutic complexity was measured using the Medication Regimen Complexity Index (MRCI) tool. Logistic regression analysis was performed to identify independent factors related to 3-HIT. Additionally, an explanatory logistic model was created to investigate whether HIV infection, along with other adjustment variables, could predict compliance with the 3-HIT concept.ResultsThe study included 145 patients: 75 PLWH and 70 seronegative patients. The median age was 40 versus 39 years, respectively (p=0.22). Seronegative patients exhibited a higher prevalence of NAC (p<0.01). HIV infection was identified as a protective factor in the context of DDIs (p<0.01). Male sex (p<0.01) and age (p=0.01) were identified as being associated with an MRCI ≥11.25 points. A higher prevalence of 3-HIT was observed in seronegative patients (18.7% vs 48.6%, p<0.01). However, the developed regression model identified HIV infection as a risk factor associated with an increased likelihood of 3-HIT (OR 4.00, 95% CI 1.88 to 8.52, p<0.01).ConclusionsThe 3-HIT concept exhibited a high prevalence among seronegative patients with chronic diseases, with HIV infection identified as a predicted risk factor for NAC and the development of 3-HIT.

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Patient Experience Evaluation of the CMO-Based Pharmaceutical Care Model vs Usual Care in People Living with HIV

Cited by 10 publications

References 30 publications

Influence of baseline characteristics and stratification level of patients living with HIV on pharmaceutical interventions developed according to the Capacity-Motivation-Opportunity methodology

Influence of baseline characteristics and stratification level of patients living with HIV on pharmaceutical interventions developed according to the Capacity-Motivation-Opportunity methodology

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

Comparative analysis of the prevalence 3-HIT concept in people living with HIV and seronegative patients with chronic conditions. Cross-3HIT Project.

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