Browsing by Subject "Pharmacist"

Now showing 1 - 6 of 6
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    Determining user implementation needs for pharmacist-prescribed contraception using concept mapping: A participatory, multiple stakeholder approach
    (Elsevier, 2024-10-11) Newlon, Jenny L.; Campi, Jennifer A.; Rafie, Sally; Meredith, Ashley H.; Medicine, School of Medicine
    Background: As of October 2024, 29 states and the District of Columbia allow community pharmacists to prescribe hormonal contraceptives. Pharmacists have reported many challenges and barriers to service implementation. Methods: Concept mapping was used to gather insights from diverse stakeholders to identify resources to facilitate implementation of pharmacist-prescribed contraceptive services. Stakeholders included end-users (pharmacy managers, staff pharmacists) and decision-makers (pharmacy owners/executives). Participants' ideas for resources were collected via multi-stakeholder focus groups. Participants then rated each idea (i.e. statement) in terms of importance and feasibility (1 = not at all important/feasible, 4 = extremely important/feasible) and sorted ideas into groups based on similarity via an online survey. Sorting data were analyzed using multidimensional scaling and hierarchical cluster analysis to develop a cluster map. Descriptive statistics were used to analyze rating data to develop a go-zone map, where statements rated above average in terms of both importance and feasibility are plotted in the "go-zone" and are considered the most actionable ideas. Results: Participants (focus groups n = 19, survey n = 48) generated 46 unique statements which created four clusters via multidimensional scaling: 1) implementation guidance for practice setup, 2) marketing resources, 3) billing and payment resources, and 4) appointment management. The majority of the statements (13 of 15) considered the most actionable were from the implementation guidance and appointment management clusters. Conclusions: Stakeholders seek guidance on implementation, marketing, billing and payment, and appointment management. To increase the ability of community pharmacies to meet the contraceptive needs of patients, resources should be dedicated to creating tools and solutions to address these identified needs.
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    Emergency Contraception Counseling in California Community Pharmacies: A Mystery Caller Study
    (MDPI, 2019-04-23) Ditmars, Lindsay; Rafie, Sally; Kashou, Gellan; Cleland, Kelly; Bayer, Lisa; Wilkinson, Tracey A.; Pediatrics, School of Medicine
    This study was conducted to determine which emergency contraception (EC) methods are offered by community pharmacists in response to patient calls. Female mystery callers called all community pharmacies in two California cities using standardized scripts. The callers inquired about options available to prevent pregnancy after sex and whether that method was available at the pharmacy, using follow-up probes if necessary. A total of 239 calls were completed in San Diego (n = 127, 53%) and San Francisco (n = 112, 47%). Pharmacists indicated availability at most sites (n = 220, 92%) with option(s) reported as levonorgestrel only (LNG; n = 211, 88.3%), both ulipristal acetate (UPA) and LNG (n = 4, 1.6%), UPA only (n = 1, 0.4%), or non-specific EC (n = 4, 1.7%). Nineteen pharmacies (7.9%) did not have EC available on the day of the call. Following additional probing, some pharmacists discussed UPA (n = 49, 20.5%) or the copper intrauterine device (n = 1, 0.4%) as EC options. LNG EC products were available same-day in 90.1% of pharmacies, whereas UPA was available same-day in 9.6% of pharmacies. The majority of pharmacies called in this study offered and stocked at least one EC option, but the focus of discussions was on LNG and matched what was in stock and available.
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    Implementing Brief Tobacco Cessation Interventions in Community Pharmacies: An Application of Rogers’ Diffusion of Innovations Theory
    (MDPI, 2022-05-30) Hilts, Katy Ellis; Corelli, Robin L.; Prokhorov, Alexander V.; Zbikowski, Susan M.; Zillich, Alan J.; Hudmon, Karen Suchanek; Health Policy and Management, School of Public Health
    Pharmacists, as highly accessible members of the healthcare team, have considerable potential to address tobacco use among patients. However, while published data suggest that pharmacists are effective in helping patients quit, barriers exist to routine implementation of cessation services in community pharmacy settings. Within the context of a randomized trial (n = 64 pharmacies), surveys were administered over a period of 6 months to assess pharmacists' perceptions of factors associated with the implementation of "Ask-Advise-Refer", a brief intervention approach that facilitates patient referrals to the tobacco quitline. Study measures, grounded in Rogers' Diffusion of Innovations Theory, assessed pharmacists' perceptions of implementation facilitators and barriers, perceptions of intervention materials provided, and perceived efforts and personal success in implementing Ask-Advise-Refer at 6-months follow-up. Findings indicate that while the brief intervention approach was not difficult to understand or implement, integration into normal workflows presents greater challenges and is associated with overall confidence and implementation success. Lack of time was the most significant barrier to routine implementation. Most (90.6%) believed that community pharmacies should be active in promoting tobacco quitlines. Study results can inform future development of systems-based approaches that lead to broad-scale adoption of brief interventions, including but not limited to tobacco cessation, in pharmacy settings.
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    Pharmacist-Led Implementation of Brief Tobacco Cessation Interventions during Mobile Health Access Events
    (MDPI, 2023-04-07) Hudmon, Karen Suchanek; Czarnik, Julia S.; Lahey, Alexa M.; Crowe, Susie J.; Conklin, Megan; Corelli, Robin L.; Gonzalvo, Jasmine D.; Ellis Hilts, Katy; Health Policy and Management, School of Public Health
    To address gaps in care for individuals from under-resourced communities disproportionately affected by tobacco use, this pharmacist-led demonstration project evaluated the feasibility of implementing tobacco use screening and brief cessation interventions during mobile health access events. A brief tobacco use survey was administered verbally during events at two food pantries and one homeless shelter in Indiana to assess the interest and potential demand for tobacco cessation assistance. Individuals currently using tobacco were advised to quit, assessed for their readiness to quit, and, if interested, offered a tobacco quitline card. Data were logged prospectively, analyzed using descriptive statistics, and group differences were assessed by site type (pantry versus shelter). Across 11 events (7 at food pantries and 4 at the homeless shelter), 639 individuals were assessed for tobacco use (n = 552 at food pantries; n = 87 at the homeless shelter). Among these, 189 self-reported current use (29.6%); 23.7% at food pantries, and 66.7% at the homeless shelter (p < 0.0001). About half indicated readiness to quit within 2 months; of these, 9 out of 10 accepted a tobacco quitline card. The results suggest that pharmacist-led health events at sites serving populations that are under-resourced afford unique opportunities to interface with and provide brief interventions for people who use tobacco.
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    Pharmacists’ Perceptions, Barriers, and Potential Solutions to Implementing a Direct Pharmacy Access Policy in Indiana
    (Sage, 2021-12) Beal, Jenny L.; Ades, Ryan S.; Vernon, Veronica; Wilkinson, Tracey A.; Meredith, Ashley H.; Pediatrics, School of Medicine
    This study assessed pharmacists' perceptions, barriers, and potential solutions for implementing a policy allowing pharmacists to prescribe hormonal contraceptives in Indiana. A mixed-method survey (n = 131, 22.3% response rate), using Likert-type scales, dichotomous responses (yes/no), and open-ended questions, was distributed to pharmacy preceptors in Indiana. Pharmacists felt prescribing contraceptives would be beneficial (79.1%) and were interested in providing this service (76.0%), but only 35.6% reported having the necessary resources. Participants with a PharmD were significantly more likely to feel the service would be beneficial (odds ratio [OR] = 10.360, 95% confidence interval [CI: 1.679, 63.939]) and be interested in prescribing contraceptives (OR = 9.069, 95% CI [1.456, 56.485]). Reimbursement (86.4%), training courses (84.7%), private counseling rooms (69.5%), and increasing technician responsibilities (52.5%) were identified as ways to ease implementation. Women had significantly greater odds of being more comfortable than men prescribing injections (OR = 2.237, 95% CI [1.086, 4.605]), and intravaginal rings (OR = 2.215, 95% CI [1.066, 4.604]), when controlling for age, degree, and setting. Qualitative findings reinforced quantitative findings.
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    Role of the community pharmacist in emergency contraception counseling and delivery in the United States: current trends and future prospects
    (Dove Press, 2017-03-23) Rafie, Sally; Stone, Rebecca H.; Wilkinson, Tracey A.; Borgelt, Laura M.; El-Ibiary, Shareen Y.; Ragland, Denise; Pediatrics, School of Medicine
    Women and couples continue to experience unintended pregnancies at high rates. In the US, 45% of all pregnancies are either mistimed or unwanted. Mishaps with contraceptives, such as condom breakage, missed pills, incorrect timing of patch or vaginal ring application, contraceptive nonuse, forced intercourse, and other circumstances, place women at risk of unintended pregnancy. There is a critical role for emergency contraception (EC) in preventing those pregnancies. There are currently three methods of EC available in the US. Levonorgestrel EC pills have been available with a prescription for over 15 years and over-the-counter since 2013. In 2010, ulipristal acetate EC pills became available with a prescription. Finally, the copper intrauterine device remains the most effective form of EC. Use of EC is increasing over time, due to wider availability and accessibility of EC methods. One strategy to expand access for both prescription and nonprescription EC products is to include pharmacies as a point of access and allow pharmacist prescribing. In eight states, pharmacists are able to prescribe and provide EC directly to women: levonorgestrel EC in eight states and ulipristal acetate in seven states. In addition to access with a prescription written by a pharmacist or other health care provider, levonorgestrel EC is available over-the-counter in pharmacies and grocery stores. Pharmacists play a critical role in access to EC in community pharmacies by ensuring product availability in the inventory, up-to-date knowledge, and comprehensive patient counseling. Looking to the future, there are opportunities to expand access to EC in pharmacies further by implementing legislation expanding the pharmacist scope of practice, ensuring third-party reimbursement for clinical services delivered by pharmacists, and including EC in pharmacy education and training.