title: Can Physicians Deliver Chronic Medications at the Point of Care?
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.
authors: Miller School of Medicine at the University of Miami, Miami, FL Veterans Affairs Medical Center, Miami, FL apalacio2@med.miami.edu.
authors: Ana
authors: A
authors: Palacio
authors: Miller School of Medicine at the University of Miami, Miami, FL.
authors: Vaughn F
authors: VF
authors: Keller
authors: Chen Neighborhood Medical Centers, Miami, FL.
authors: Jessica
authors: J
authors: Chen
authors: Miller School of Medicine at the University of Miami, Miami, FL Veterans Affairs Medical Center, Miami, FL.
authors: Leonardo
authors: L
authors: Tamariz
authors: Miller School of Medicine at the University of Miami, Miami, FL.
authors: Olveen
authors: O
authors: Carrasquillo
authors: Chen Neighborhood Medical Centers, Miami, FL.
authors: Craig
authors: C
authors: Tanio
mesh_terms: D000368:Aged; D002908:Chronic Disease / Q000188:drug therapy; D003920:Diabetes Mellitus / Q000188:drug therapy; D004358:Drug Therapy / Q000379:methods; D005260:Female; D005431:Florida; D006801:Humans; D008297:Male; D055118:Medication Adherence; D008509:Medication Systems / Q000458:organization & administration*; D017060:Patient Satisfaction; D019095:Point-of-Care Systems; D011320:Primary Health Care / Q000379:methods / Q000458:organization & administration; D058996:Quality Improvement / Q000458:organization & administration
keywords: diabetes; innovation; medication adherence; qualitative analysis