Browsing by Subject "Community pharmacy services"

Now showing 1 - 6 of 6
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    A user-centered evaluation of medication therapy management alerts for community pharmacists: Recommendations to improve usability and usefulness
    (Elsevier, 2021) Snyder, Margie E.; Adeoye-Olatunde, Omolola A.; Gernant, Stephanie A.; DiIulio, Julie; Jaynes, Heather A.; Doucette, William R.; Russ-Jara, Alissa L.; Medicine, School of Medicine
    Background: Community pharmacists provide comprehensive medication reviews (CMRs) through pharmacy contracts with medication therapy management (MTM) vendors. These CMRs are documented in the vendors' web-based MTM software platforms, which often integrate alerts to assist pharmacists in the detection of medication therapy problems. Understanding pharmacists' experiences with MTM alerts is critical to optimizing alert design for patient care. Objectives: The objectives of this study were to 1) assess the usability and usefulness of MTM alerts for MTM vendor-contracted community pharmacists and 2) generate recommendations for improving MTM alerts for use by community pharmacists. Methods: This was a convergent, parallel mixed-methods evaluation of data collected from 3 sources, with individual pharmacists contributing data to one or more sources: 1) community pharmacists' submissions of observational data about MTM alerts encountered during routine MTM provision, 2) videos of naturalistic usability testing of MTM alerts, and 3) semi-structured interviews to elicit pharmacists' perspectives on MTM alert usefulness and usability. MTM alert data submitted by pharmacists were summarized with descriptive statistics. Usability testing videos were analyzed to determine pharmacists' time spent on MTM alerts and to identify negative usability incidents. Interview transcripts were analyzed using a hybrid approach of deductive and inductive codes to identify emergent themes. Triangulation of data (i.e., determination of convergence/divergence in findings across all data sources) occurred through investigator discussion and identified overarching findings pertaining to key MTM alert challenges. These resulted in actionable recommendations to improve MTM alerts for use by community pharmacists. Results: Collectively, two and four overarching key challenges pertaining to MTM alert usability and usefulness, respectively, were identified, resulting in 15 actionable recommendations for improving the design of MTM alerts from a user-centered perspective. Conclusions: Recommendations are expected to inform enhanced MTM alert designs that can improve pharmacist efficiency, patient and prescriber satisfaction with MTM, and patient outcomes.
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    Bridging the Gap in Tobacco Cessation Services: Utilizing Community Pharmacists to Facilitate Transitions of Care in the USA
    (Springer, 2022) Newlon, Jenny; Ellis Hilts, Katy; Champion, Victoria; Suchanek Hudmon, Karen; School of Nursing
    Interprofessional strategies for promoting tobacco cessation lead to enhanced quit rates among patients; however, current approaches might not effectively support patients with their quit attempts after they are discharged from the hospital. This paper explores opportunities for interprofessional collaboration between health system-based providers and community pharmacists, as one proposed approach to bridging tobacco cessation services during transitions of care. Suggested strategies include (1) increasing other healthcare professionals' awareness of legislative advances that permit pharmacists to prescribe cessation medications in some states, and (2) encouraging bi-directional communication between health system-based and community-based providers, especially via integrated electronic health records. Community pharmacists can offer a convenient solution to obtain the post-discharge medication and counseling support that patients need to increase their chances of quitting for good. Additional steps are discussed to improve broadscale capacity of this service being provided in community pharmacies.
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    Closing the Tobacco Treatment Gap: A Qualitative Study of Tobacco Cessation Service Implementation in Community Pharmacies
    (MDPI, 2024-03-28) Ellis Hilts, Katy; Elkhadragy, Nervana; Corelli, Robin L.; Hata, Micah; Tong, Elisa K.; Vitale, Francis M.; Suchanek Hudmon, Karen; Health Policy and Management, Richard M. Fairbanks School of Public Health
    Tobacco use remains a leading preventable cause of morbidity and mortality, with pharmacotherapy and counseling recognized as effective cessation aids. Yet, the potential role of pharmacists and pharmacy technicians in tobacco cessation services is underutilized. This study explores the integration of such services in community pharmacies, identifying facilitators and barriers to their implementation. A qualitative study was conducted across seven community pharmacies in California that were affiliated with the Community Pharmacy Enhanced Services Network. Participants included 22 pharmacists and 26 pharmacy technicians/clerks who completed tobacco cessation training. Data were collected through semi-structured interviews, focusing on experiences with implementing cessation services. The analysis was guided by Rogers' Diffusion of Innovations Theory. MAXQDA software was used for data management and thematic analysis. Sixteen pharmacy personnel participated in the study, highlighting key themes around the integration of cessation services. Compatibility with existing workflows, the importance of staff buy-in, and the crucial role of pharmacy technicians emerged as significant facilitators. Challenges included the complexity of billing for services, software limitations for documenting tobacco use and cessation interventions, and gaps in training for handling complex patient cases. Despite these barriers, pharmacies successfully initiated cessation services, with variations in service delivery and follow-up practices. Community pharmacies represent viable settings for delivering tobacco cessation services, with pharmacists and technicians playing pivotal roles. However, systemic changes are needed to address challenges related to billing, documentation, and training. Enhancing the integration of cessation services in community pharmacies could significantly impact public health by increasing access to effective cessation support.
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    Factors Associated with Comprehensive Medication Review Completion Rates: A National Survey of Community Pharmacists
    (Elsevier, 2020-05) Snyder, Margie E.; Jaynes, Heather A.; Gernant, Stephanie A.; Lantaff, Wendy M.; Doucette, William R.; Suchanek Hudmon, Karen; Perkins, Susan M.; Biostatistics, School of Public Health
    Background: Completion rates for medication therapy management (MTM) services have been lower than desired and the Centers for Medicare and Medicaid Services has added MTM comprehensive medication review (CMR) completion rates as a Part D plan star measure. Over half of plans utilize community pharmacists via contracts with MTM vendors. Objectives: The primary objective of this survey study was to identify factors associated with the CMR completion rates of community pharmacies contracted with a national MTM vendor. Methodsl: Representatives from 27,560 pharmacy locations contracted with a national MTM vendor were surveyed. The dependent variable of interest was the pharmacies' CMR completion rate. Independent variables included the pharmacy's progressiveness stratum and number of CMRs assigned by the MTM vendor during the time period, as well as self-reported data to characterize MTM facilitators, barriers, delivery strategies, staffing, selected items from a modified Assessment of Chronic Illness Care, and pharmacist/pharmacy demographics. Univariate negative binomial models were fit for each independent variable, and variables significant at p < 0.05 were entered into a multivariable model. Results: Representatives from 3836 (13.9%) pharmacy locations responded; of these, 90.9% (n = 3486) responses were useable. The median CMR completion rate was 0.42. Variables remaining significant at p < 0.05 in the multivariable model included: progressiveness strata; pharmacy type; scores on the facilitators scale; responses to two potential barriers items; scores on the patient/caregiver delivery strategies sub-scale; providing MTM at multiple locations; reporting that the MTM vendor sending the survey link is the primary MTM vendor for which the respondent provides MTM; and the number of hours per week that the pharmacy is open. Conclusions: Factors at the respondent (e.g., responses to facilitators scale) and pharmacy (e.g., pharmacy type) levels were associated with CMR completion rates. These findings could be used by MTM stakeholders to improve CMR completion rates.
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    Implementation of a Pharmacist-led Hormonal Contraceptive Prescribing Service in a Campus Community Pharmacy in Indiana, United States
    (Elsevier, 2022) Ahmad, Zoona M.; Noel, Nicole L.; Rudd, Trexie M.; Nadelson, Craig S.; Ott, Mary A.; Wilkinson, Tracey A.; Meredith, Ashley H.; Pediatrics, School of Medicine
    Objective(s): College-age people have the highest numbers of unintended pregnancies and pharmacies within college campuses are in a unique position to meet student needs. Our objective was to implement a pharmacist contraceptive prescribing service in a campus pharmacy and examine the service utilization. Study design: The Purdue University Pharmacy (Indiana, United States) implemented a pharmacist hormonal contraception prescribing service via a collaborative drug therapy management agreement with the campus student health center. The collaborative drug therapy management agreement enables pharmacists to independently prescribe pills, patches, rings, injections, and emergency contraception to students meeting eligibility criteria. After completing a patient health screening and blood pressure check, the pharmacist discusses the eligible method(s) and prescribes up to a 12-month supply. A referral to another provider for long-acting reversible contraception or further evaluation may also be provided. We collected basic information about each encounter (e.g., age, blood pressure, method of contraception prescribed, and time). Results: During the 2020-2021 academic year, 125 prescribing consultations took place with an average appointment length of 20 minutes (range, 12-65 minutes). The median patient age was 21 years (range, 18-30 years). Eligible patients (n = 123, 98%) received a prescription and 119 (95%) prescriptions were written: combined oral pill (n = 91, 77%), injection (n = 12, 10%), patch (n = 6, 5%), vaginal ring (n = 5, 4%), and progestin only pill (n = 5, 4%). Conclusion(s): The pharmacist contraception prescribing service developed by the Purdue University Pharmacy and Student Health Center is a unique approach to meeting the needs of students. Few external resources are required for implementation, and most patients were medically eligible to receive hormonal contraception. Implications: Collaboration between on-campus student health centers and pharmacies can be explored as 1 approach to increase access to hormonal contraception for students.
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    Positive Deviants for Medication Therapy Management: A Mixed-Methods Comparative Case Study of Community Pharmacy Practices
    (Elsevier, 2021) Adeoye-Olatunde, Omolola A.; Lake, Leslie M.; Strohmier, Celena A.; Gourley, Amanda K.; Ray, Ashli R.; Zillich, Alan J.; Snyder, Margie E.; Medicine, School of Medicine
    Background: To optimize medication use in older adults, the Centers for Medicare & Medicaid Services (CMS) launched Medication Therapy Management (MTM) services as part of Medicare Part D policy; however, strategies for achieving high quality MTM outcomes are not well understood. Objective: The objective of this study was to generate hypotheses for strategies contributing to community pharmacies' high performance on policy-relevant MTM quality measures. Methods: This mixed-methods comparative case study was guided by the Positive Deviance approach and Chronic Care Model. The study population consisted of pharmacy staff employed by a Midwestern division of a national supermarket-community pharmacy chain. Data consisted of demographics and qualitative data from semi-structured interviews. Qualitative and quantitative data were analyzed deductively and inductively or using descriptive statistics, respectively. MTM quality measures used to evaluate participant pharmacies' MTM performance mirrored select 2017 Medicare Part D Plans' Star Rating measures. Results: Thirteen of 18 selected case pharmacies (72.2%) participated in this study, of which 5 were categorized as high performers, 4 moderate performers, and 4 low performers. Eleven pharmacists, 11 technicians, and 3 student interns participated in interviews. Eight strategies were hypothesized as contributing to MTM performance: Strong pharmacy staff-provider relationships and trust, Inability to address patients' social determinants of health (negatively contributing), Technician involvement in MTM, Providing comprehensive medication reviews in person vs. phone alone, Placing high priority on MTM, Using available clinical information systems to identify eligible patients, Technicians using clinical information systems to collect/document information for pharmacists, Faxing prescribers adherence medication therapy problems (MTPs) and calling on indication MTPs. Conclusions: Eight strategies were hypothesized as contributing to community pharmacies' performance on MTM quality measures. Findings from this work can inform MTM practice and Medicare Part D MTM policy changes to positively influence patient outcomes. Future research should test hypotheses in a larger representative sample of pharmacies.