Category: Spinal Cord Injury; Health Services Research
Objective : To explore clinicians’ experiences and perceptions of medication therapy management (MTM) for individuals with spinal cord injury and dysfunction (SCI/D).
Design : A qualitative study.
Setting : Canada.
Participants (or Animals, Specimens, Cadavers) :
Healthcare providers were recruited through clinical organizations and researchers’ personal contacts. Participants were purposefully selected for diversity in profession and were required to be English speaking and to have provided care to at least one individual with a SCI/D. Thirty-two semi-structured interviews were conducted by telephone. Participants included physicians, pharmacists, occupational and physical therapists, nurses and care coordinators. The interviews involved a short intake demographic survey (confidence level scales for different medication therapy management tasks) and qualitative (open-ended, semi-structured) questions.
Interventions : Not applicable.
Main Outcome Measure(s) : Healthcare providers’ experiences with, and perceptions of, MTM for individuals with SCI/D and their self-rated confidence levels with different clinical tasks related to MTM.
Results : The median confidence of participants in supporting this population with MTM was 8 on a 10-point scale, despite many participants expressing a desire for more SCI/D-specific education or information. Healthcare providers’ roles with MTM closely mirrored their professional scope of practice; however, some providers felt limited in providing MTM support because of their scope of practice. Common clinical roles related to MTM, included assessing risk/benefit and tailoring medications, exploring medication-alternatives, and providing education. Enabling factors for improving MTM included: healthcare providers’ knowledge/confidence, information sharing and clinical support, clinician-patient relationships and patients’ medication knowledge.
Conclusions : Healthcare providers’ experiences and perceptions of MTM clinical roles emphasize further need for clinical education or specialist support for SCI/D in general and SCI/D-medications more specifically. This could be achieved through online sources or more interprofessional collaboration.
Sara Guilcher– Assistant Professor, University of Toronto, Toronto, Ontario
Tanya Packer– Professor, Dalhousie University, Halifax, Nova Scotia
Sander Hitzig– Scientist, St. John’s Rehab Research Program, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, Ontario
Tejal Patel– Clinical Assistant Professor, University of Waterloo, Kitchener, Ontario
Amanda Everall– Research Officer, Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario
Aisha Lofters– Clinician Scientist, St. Michael’s Hospital, Toronto, Ontario