Can Physicians Deliver Chronic Medications at the Point of Care?

Am J Med Qual. 2016 May;31(3):256-64. doi: 10.1177/1062860614568646. Epub 2015 Feb 13.

Abstract

Interventions aimed at improving medication adherence are challenging to integrate into clinical practice. Point-of-care medication delivery systems (POCMDSs) are an emerging approach that may be sustainable. A mixed methods approach was used to evaluate the implementation of a POCMDS in a capitated network of clinics serving vulnerable populations. The analytical approach was informed by the RE-AIM (Reach, Effectiveness, Adoption, Implementation, Maintenance) and CFIR (Consolidated Framework for Implementation Research) theoretical frameworks. Data were obtained through key informant interviews, site visits, patient surveys, and claims data. POCMDS has been implemented in 23 practices in 4 states. Key facilitators were leadership and staff commitment, culture of prevention, and a feasible business model. Of the 426 diabetic patients surveyed, 92% stated that POCMDS helps them, 90% stated that refilling medications is more convenient, 90% reported better understanding of the medications, and 80% stated that POCMDS had improved communication with the physician. POCMDS is a feasible patient-centered intervention that reduces adherence barriers.

Keywords: diabetes; innovation; medication adherence; qualitative analysis.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Chronic Disease / drug therapy
  • Diabetes Mellitus / drug therapy
  • Drug Therapy* / methods
  • Female
  • Florida
  • Humans
  • Male
  • Medication Adherence
  • Medication Systems / organization & administration*
  • Patient Satisfaction
  • Point-of-Care Systems*
  • Primary Health Care / methods
  • Primary Health Care / organization & administration
  • Quality Improvement / organization & administration