Spatial analysis of disparities in asthma treatment among adult asthmatics

Deshpande, Maithili; Zahnd, Whitney E.; Bandy, Lindsay; Lorenson, Jessica; Fifer, Amber

doi:10.1016/j.sapharm.2018.09.020

Cited by 5 publications

(2 citation statements)

References 33 publications

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“…The direct expected benefit concerns the improvement of the patients’ satisfaction by reducing the mental burden due to the geographical and organizational constraints to hospital pharmacies [ 8 ]. As observed in the management of other diseases, distance to the pharmacy may play a role in pharmaceutical management, leading, for example, to inappropriate and inadequate medication and management of asthma for patients living further from their preferred pharmacy [ 25 ]. Also, the dispensing by community pharmacies may provide better access and satisfaction to the patients [ 26 ].…”

Section: Discussionmentioning

confidence: 99%

Evaluation of the Care Pathway in the Context of the Dispensing of Emicizumab (Hemlibra) in Community Pharmacies in France: Protocol for a Cross-sectional Study Based on the Kirkpatrick Model

Fraticelli¹,

Freyssenge²,

Promé-Combel³

et al. 2023

JMIR Res Protoc

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Background Commercialized since 2019, emicizumab (Hemlibra) was available only in French hospital pharmacies for prophylaxis of hemophilia A with or without inhibitors. Since June 15, 2021, patients can choose between a hospital and community pharmacy. These changes in the care pathway have important organizational consequences for patients, their relatives, and health professionals. Two training programs are available for community pharmacists: the “HEMOPHAR” training program proposed by the national reference center for hemophilia and the Roche training program proposed by the laboratory that markets the product. Objective The PASODOBLEDEMI study aims to evaluate the direct impact of the training programs provided to community pharmacists in the context of the dispensing of emicizumab, and to evaluate patients’ satisfaction with their treatment whether they choose dispensation from a community pharmacy or retained dispensation from the hospital pharmacy. Methods We designed a cross-sectional study based on the 4-level Kirkpatrick evaluation model: the immediate reaction of community pharmacists following training (Reaction), the knowledge acquired during the training (Learning), the professional practice of community pharmacists during dispensing of the product (Behavior), and patients’ satisfaction related to the treatment whether it is dispensed from a hospital or from a community pharmacy (Results). Results Considering that single outcome measures cannot adequately reflect the complexity of this new organization, the Kirkpatrick evaluation model provides 4 distinct outcomes: the immediate reaction after the HEMOPHAR training program, the level of knowledge acquired after the HEMOPHAR training program, the impact of training on professional practice, and patient satisfaction with access to emicizumab. We developed specialized questionnaires for each of the 4 levels of the Kirkpatrick evaluation model. All community pharmacists involved in dispensing emicizumab, whether they have followed the HEMOPHAR or the Roche training program or neither, were eligible for inclusion. All patients with severe hemophilia A were eligible, irrespective of inhibitor use, age, treatment with emicizumab, and whether they chose dispensation from a community pharmacy or retained dispensation from a hospital pharmacy. Conclusions The new organization for dispensing emicizumab to patients with hemophilia A in French community pharmacies must be accompanied by optimal safety and quality conditions due to the risk of serious and urgent bleeding situations in the management of rare bleeding diseases. The elaboration of the PASODOBLEDEMI protocol has already a positive impact with the commitment of all health professionals, physicians, hospital and community pharmacists, and the patient community. The results will be disseminated among the French authorities and will enable, if necessary, proposing this access model to other rare diseases. Trial Registration ClinicalTrials.gov NCT05449197, https://clinicaltrials.gov/ct2/show/NCT05449197?term=NCT05449197; ClinicalTrials.gov NCT05450640, https://clinicaltrials.gov/ct2/show/NCT05450640?term=NCT05450640 International Registered Report Identifier (IRRID) DERR1-10.2196/43091

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Section: Discussionmentioning

confidence: 99%

Evaluation of the Care Pathway in the Context of the Dispensing of Emicizumab (Hemlibra) in Community Pharmacies in France: Protocol for a Cross-sectional Study Based on the Kirkpatrick Model

Fraticelli¹,

Freyssenge²,

Promé-Combel³

et al. 2023

JMIR Res Protoc

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“…In a previous study, the geographic accessibility of haemophilia patients in the Rhône‐Alpes region to hospital pharmacies underlined that approximately 72% of the study area was accessible to a hospital pharmacy in less than 30 min, 6 without considering the perception of patients and their caregivers who are impacted throughout their lives by the quality and availability of their treatment. Despite socio‐economic inequities 7,8 and geographic availability, 9,10 no study in France takes into account the perception of patients themselves regarding access to their treatment. However, the latter is important to take into account because it conditions the burden of the disease, particularly for disabling chronic diseases 8 …”

Section: What Is Known and Objectivementioning

confidence: 99%

PHAREO study: Perceived and observed accessibility to therapeutic drugs used for treating patients with inherited bleeding disorders

Chamouard

Fraticelli

Freyssenge

et al. 2022

Clinical Pharmacy Therapeu

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What Is Known and Objective The dispensing of clotting factor concentrates in hospital pharmacies imposes accessibility constraints on patients and their caregivers, thereby increasing the disease burden. Very few studies have addressed these issues so far in terms of individual perceptions and actual difficulties. The PHAREO study aims to report patient's perception of treatment accessibility and evaluate spatial accessibility. Methods The PHAREO study is an observational survey based on a questionnaire specifically designed for the study purpose in collaboration with patients' representatives in the second demographic and economic French region. Results and Discussion We collected 293 responses (participation rate of 64.1%) which show that 89.8% of respondents were either very or rather satisfied with regard to access to treatment. However, respondents reported difficulties in accessing the hospital pharmacy. The data also showed that 79.2% of respondents tended to over‐estimate travel time which was reported above their acceptable threshold for 39.2% of them. The main determinants of dissatisfaction were parental burden (OR 2.5 [1.3; 4.8], p = 0.008) and waiting time at the hospital pharmacy (OR 1.5 [1.1;2.0], p = 0.016, per 10 min increase). What Is New and Conclusion The PHAREO study provides subjective and objective data regarding satisfaction levels of persons with haemophilia and other coagulation deficiencies, with a high representativeness rate for patients on prophylaxis (87.5%). Both respondents and hospital pharmacists pled for an evolution of the current dispensing circuit to improve access to treatment and reduce the burden for patients. Currently, the community pharmacists are apart from the dispensing circuit. The authors propose improvements in the pathway of care for patients and their caregivers by including the community pharmacists alongside the hospital pharmacists in a centralized coordination scheme.

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Spatio-temporal modelling of asthma-prone areas using a machine learning optimized with metaheuristic algorithms

Razavi-Termeh

Sadeghi‐Niaraki

Choi

2022

Geocarto International

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Spatial analysis of disparities in asthma treatment among adult asthmatics

Cited by 5 publications

References 33 publications

Evaluation of the Care Pathway in the Context of the Dispensing of Emicizumab (Hemlibra) in Community Pharmacies in France: Protocol for a Cross-sectional Study Based on the Kirkpatrick Model

Evaluation of the Care Pathway in the Context of the Dispensing of Emicizumab (Hemlibra) in Community Pharmacies in France: Protocol for a Cross-sectional Study Based on the Kirkpatrick Model

PHAREO study: Perceived and observed accessibility to therapeutic drugs used for treating patients with inherited bleeding disorders

Spatio-temporal modelling of asthma-prone areas using a machine learning optimized with metaheuristic algorithms

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