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4CPS-186 Implementation of a patient stratification model in outpatient pharmacy for immune-mediated dermatological diseases
  1. H Suñer,
  2. PA López Broseta,
  3. I Sacanella Anglès,
  4. D Pascual Carbonell,
  5. CD Ciuciu,
  6. S Jornet Montaña,
  7. I Plo Seco,
  8. MÁ Roch Ventura,
  9. MF Vuelta Arce,
  10. L Canadell Vilarrasa
  1. Hospital Universitari Joan Xxiii, Pharmacy, Tarragona, Spain


Background and Importance Pharmaceutical care (PC) involves pharmacists engaging with patients to achieve safe pharmacotherapeutic goals, improving health outcomes. The Spanish Society of Hospital Pharmacy devised the CMO stratification model (Capacity, Motivation, Opportunity) to determine patient follow-up frequency and target those who benefit most from PC. It assigns patients to priority levels 1, 2, or 3 (normally 10%, 30% and 60% of stratified patients respectively) aiding pharmacists in optimising resources and tailored interventions.

Aim and Objectives To determine the complexity of patients with immunomediated dermatological diseases initiating biological therapy in our hospital, using the CMO model, and compare the results with the expected model outcomes.

Material and Methods A cross-sectional study completed between May and September 2023 at a Spanish Tertiary hospital. Patients diagnosed with immunomediated dermatological diseases, initiating biological therapy were included. To determine the complexity level, the CMO model was applied, encompassing 23 variables in demographic, socio-sanitary and cognitive, healthcare service utilisation, and treatment-related categories. The patient‘s total score was calculated by combining the points assigned to each variable. Data were collected from patient medical records, electronic prescription dispensing records, and clinical interviews in pharmaceutical care consultations. Results were compared with the percentage distribution proposed for each complexity level by the model.

Results A total of 52 patients were stratified, 94% adults and 56% males. Among them, 88% had psoriasis, 8% atopic dermatitis, and 4% hidradenitis. Variables such as active smokers (23%), language barrier (4%), psychiatric history (31%), and reduced quality of life (83%) were identified. Additionally, 29% had ≥2 chronic diseases, and 73% exhibited moderate/high disease activity. Regarding treatment, 27% were on polypharmacy, 42% were treatment-naive, 8% had a risk of significant interactions with their existing medication, and 10% of non-adherence.

Upon applying the CMO model, 8% (4) fell into priority 1, 48% (25) priority 2, and 44% (23) priority 3.

Conclusion and Relevance Against expectations from the CMO, most patients were in level 2 instead of level 3, possibly due to stratification timing, occurring during treatment initiation or changes when patients‘ diseases were most exacerbated.

Through the CMO application, we identified patients most likely to benefit from PC, enabling us to reallocate resources for more regular follow-up, ensuring comprehensive patient support.

Conflict of Interest No conflict of interest.

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