A Qualitative Assessment of the Saskatchewan Medication Assessment Program in Patients with Renal Failure or Renal Replacement
Bibliographic record
Abstract
Background: The Saskatchewan Medication Assessment Program (SMAP) is a provincially funded service enabling community pharmacists to perform medication reviews for eligible Saskatchewan residents, with the goal of optimizing patient care. Individuals with renal failure, and/or those requiring renal replacement therapy have unique needs and receive specialized care provided by nephrologists and renal pharmacists. Little is known about the benefits and/or challenges of performing community based medication assessments in complex populations.\nObjective: A qualitative analysis was undertaken to examine the perceptions of health care providers involved in the SMAP process in complex patients (i.e. renal patients). \nMethods: All nephrologists, renal pharmacists, and community pharmacies in Saskatoon and Regina were sent an invitation to participate in the study. A semi-structured interview was completed with interested participants, and the interviews were audio-recorded and transcribed verbatim. Coding was performed using NVIVO qualitative software to identify common themes. \nResults: Ten renal pharmacists, eight nephrologists, and nine community pharmacists were interviewed. Community pharmacists had mixed levels of comfort providing SMAPs for renal patients, but expressed the desire to provide the best care possible. Some themes were consistent amongst all participant groups including ‘the importance of collaboration/communication’, ‘challenges’ and ‘suggestions for improvements’. Specific themes such as ‘unique needs of renal patients’ and ‘duplication of service’ were common amongst both renal pharmacists and nephrologists. The nephrologists had very little knowledge of the program and of the role of the community pharmacist, indicating the need for improved education and communication. \nConclusion: Despite some negative experiences, none of the participants believed the program should be eliminated. Several recommendations, however, are suggested to improve the SMAP process in renal patients.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.019 | 0.023 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.003 |
| Science and technology studies | 0.017 | 0.009 |
| Scholarly communication | 0.005 | 0.003 |
| Open science | 0.003 | 0.009 |
| Research integrity | 0.002 | 0.004 |
| Insufficient payload (model declined to judge) | 0.005 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".