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AHRQ Research Studies Date
Topics
- Access to Care (2)
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- Medication (17)
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- (-) Provider: Pharmacist (23)
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AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 23 of 23 Research Studies DisplayedFerrari RM, Atkins DL, Wangen M
Patient perspectives on a proposed pharmacy-based colorectal cancer screening program.
The objective of this study was to assess patient perspectives on receiving fecal immunochemical colorectal cancer (CRC) screening tests through pharmacies. Researchers conducted semi-structured interviews with participants in North Carolina and Washington. Survey participants reported pharmacy-based CRC screening programs to be highly acceptable, citing convenience, ease of access, and avoidance of co-pays, but they also had concerns about privacy and coordination with primary care providers. The researchers concluded that CRC screening in pharmacies is potentially a good option, provided patients have privacy and their primary care providers are informed.
AHRQ-funded; HS026122.
Citation: Ferrari RM, Atkins DL, Wangen M .
Patient perspectives on a proposed pharmacy-based colorectal cancer screening program.
Transl Behav Med 2023 Dec 15; 13(12):909-18. doi: 10.1093/tbm/ibad057..
Keywords: Provider: Pharmacist, Cancer: Colorectal Cancer, Colonoscopy, Screening, Prevention
Watterson TL, Stone JA, Kleinschmidt PC
CancelRx case study: implications for clinic and community pharmacy work systems.
This study examined the impact of implementation of CancelRx, a health IT system that automatically communicates medication discontinuations from the clinic electronic health record to the community pharmacy dispensing platform, theoretically improving communication. The system was implemented across a Midwest academic health system in October 2017, using their 15 outpatient community pharmacies to test it. Interviews were conducted with 9 medical assistants, 12 community pharmacists, and 3 pharmacy administrators employed by the health system across 3-time periods between 2017 and 2018: 3-months prior to CancelRx implementation, 3-months after CancelRx implementation, and 9-months after CancelRx implementation. While CancelRx automated and streamlined how medication discontinuation messages were received and processed, it also increased workload and introduced new errors.
AHRQ-funded; HS025793.
Citation: Watterson TL, Stone JA, Kleinschmidt PC .
CancelRx case study: implications for clinic and community pharmacy work systems.
BMC Health Serv Res 2023 Dec 6; 23(1):1360. doi: 10.1186/s12913-023-10396-9..
Keywords: Cancer, Provider: Pharmacist, Medication
Kaufman BG, Holland DE, Vanderboom CE
Multicomponent pharmacist intervention did not reduce clinically important medication errors for ambulatory patients initiating direct oral anticoagulants.
The aim of this randomized controlled trial study was to evaluate the effectiveness of a multicomponent intervention for decreasing clinically important medication errors (CIMEs). The researchers included ambulatory patients beginning a DOAC or resuming one after a complication. The intervention included pharmacist evaluation and monitoring based on the implementation of a recently published checklist. The primary measure was anticoagulant-related CIMEs and non-anticoagulant-related CIMEs over 90 days from DOAC initiation. Primary variables included evaluation of the appropriateness of DOAC, need for DOAC affordability assistance, three pharmacist-initiated telephone consultations, access to a DOAC hotline, documented hand-off to the patient's continuity provider, and monitoring of follow-up laboratory tests. A total of 561 patients contributed 479 anticoagulant-CIMEs including 31 preventable and ameliorable ADEs and 448 significant anticoagulant medication errors without subsequent documented ADEs. The most common anticoagulant-related CIMEs were failure to perform required blood tests and concurrent, inappropriate usage of a DOAC with aspirin or NSAIDs despite pharmacist documentation systematically identifying these issues when present. There was no reduction in anticoagulant-related CIMEs among intervention patients or non-anticoagulant-related CIMEs.
AHRQ-funded; HS02592401.
Citation: Kaufman BG, Holland DE, Vanderboom CE .
Multicomponent pharmacist intervention did not reduce clinically important medication errors for ambulatory patients initiating direct oral anticoagulants.
J Gen Intern Med 2023 Dec; 38(16):3526-34. doi: 10.1007/s11606-023-08315-z..
Keywords: Provider: Pharmacist, Medication, Adverse Drug Events (ADE), Adverse Events, Medical Errors, Blood Thinners, Medication: Safety, Patient Safety
Wu L, Chang C, Lo K
Telephone-based social health screening by pharmacists in the nonadherent Medicare population.
The study examined social health needs among Medicare patients and pharmacist-led screening's impact on medication adherence and healthcare use. Using a predictive algorithm, higher-risk patients were identified. Patients accepting referrals had better statin adherence, while those declining had more hospital stays and fewer primary care visits. The findings suggest pharmacist interventions can improve medication adherence without worsening healthcare use or plan membership.
AHRQ-funded; HS027343.
Citation: Wu L, Chang C, Lo K .
Telephone-based social health screening by pharmacists in the nonadherent Medicare population.
J Manag Care Spec Pharm 2023 Nov; 29(11):1184-92. doi: 10.18553/jmcp.2023.29.11.1184..
Keywords: Provider: Pharmacist, Patient Adherence/Compliance, Social Determinants of Health, Medication
Ranusch A, Lin YJ, Dorsch MP
Role of individual clinician authority in the implementation of informatics tools for population-based medication management: qualitative semistructured interview study.
The objective of this study was to examine how individual authority of clinical pharmacists and anticoagulation nurses is affected by the implementation success of an electronic health record (EHR) direct oral anticoagulant (DOAC) Dashboard for safe DOAC medication prescribing. Researchers conducted semistructured interviews with pharmacists and nurses after the implementation of the EHR DOAC Dashboard at three clinical sites. Results showed that a high level of individual clinician authority was associated with high levels of key facilitators for effective use of the DOAC Dashboard; conversely, a lack of individual authority was associated with key barriers to effective use. The researchers concluded that increased individual clinician authority is a necessary antecedent to the effective implementation of an EHR DOAC Population Management Dashboard.
AHRQ-funded; HS026874.
Citation: Ranusch A, Lin YJ, Dorsch MP .
Role of individual clinician authority in the implementation of informatics tools for population-based medication management: qualitative semistructured interview study.
JMIR Hum Factors 2023 Oct 24; 10:e49025. doi: 10.2196/49025..
Keywords: Medication, Provider: Pharmacist, Electronic Health Records (EHRs), Health Information Technology (HIT), Provider: Nurse, Blood Thinners
Pitts SI, Olson s, Yanek LR
Pharmacy e-prescription dispensing before and after CancelRx implementation.
The objective of this study was to evaluate the association of implementation of e-prescription cancellation messaging (CancelRx) with medication dispensing after discontinuation of e-prescriptions in electronic health records (EHRs). Patients who had at least one medication e-prescribed in ambulatory care to a health system pharmacy and discontinued within the study period participated in a case series with interrupted time series analysis. Findings indicated that CancelRx implementation was associated with an immediate and sustained reduction in the proportion of e-prescriptions sold after discontinuation in the EHR. The authors concluded that widespread implementation of CancelRx could significantly improve medication safety through the reduction of medication dispensing after discontinuation by prescribers.
AHRQ-funded; HS026584.
Citation: Pitts SI, Olson s, Yanek LR .
Pharmacy e-prescription dispensing before and after CancelRx implementation.
JAMA Intern Med 2023 Oct; 183(10):1120-26. doi: 10.1001/jamainternmed.2023.4192..
Keywords: Medication, Electronic Prescribing (E-Prescribing), Health Information Technology (HIT), Provider: Pharmacist
Smith SN, Lanham M, Seagull FJ
Implementing pharmacist-prescriber collaboration to improve evidence-based anticoagulant use: a randomized trial.
This article described a study designed to improve existing alert systems for direct oral anticoagulant medications (DOAC) by testing novel alerts that encourage collaboration between prescribers and expert pharmacists working in anticoagulation clinics. Its goals were to determine the effect of notifications targeting existing inappropriate DOAC prescriptions, to examine the effect of alerts on newly prescribed inappropriate DOACs, and to examine changes in the magnitude of effects over time for both the new and existing prescription alerts. Prescribing healthcare providers would be randomized to different types of electronic health record medication alerts when a patient has an unsafe anticoagulant prescription; the authors identified which alerts are most effective at encouraging evidence-based prescribing.
AHRQ-funded; HS028562.
Citation: Smith SN, Lanham M, Seagull FJ .
Implementing pharmacist-prescriber collaboration to improve evidence-based anticoagulant use: a randomized trial.
Implement Sci 2023 May 15; 18(1):16. doi: 10.1186/s13012-023-01273-4..
Keywords: Provider: Pharmacist, Blood Thinners, Medication, Evidence-Based Practice
Watterson TL, Chui MA
Subjective perceptions of occupational fatigue in community pharmacists.
The objective of this study was to describe subjective perceptions of occupational fatigue in community pharmacists. Wisconsin pharmacists who were eligible to participate completed a demographic questionnaire, a Pharmacist Fatigue Instrument, and semi-structured interview. Interview results were separated into overarching themes that included mental fatigue, physical fatigue, active fatigue, and passive fatigue. The researchers concluded that interventions aimed at improving occupational fatigue in community pharmacies should consider key themes of fatigue that pharmacists experience.
AHRQ-funded; HS027766.
Citation: Watterson TL, Chui MA .
Subjective perceptions of occupational fatigue in community pharmacists.
Pharmacy 2023 May 9; 11(3):84. doi: 10.3390/pharmacy11030084..
Keywords: Provider: Pharmacist, Burnout
Wilson AS, Pham T, Mbusa D
Pharmacist-led, checklist intervention did not improve adherence in ambulatory patients starting/resuming DOACs.
This study’s aim was to determine whether checklist-driven care from a clinical pharmacist improved adherence in ambulatory patients starting a direct-acting anticoagulant (DOAC) or resuming it after a setback (thromboembolic event or bleeding) in an ambulatory setting. Clinical pharmacists using the DOAC checklist verified DOAC appropriateness, instructed dose de-escalation, educated through 3 tele-visits, fielded hotline calls, and handed off to a continuity provider after 3 months. Coupons and help with completing manufacturer-based medication assistance applicants were made available to intervention and control patients. Using pharmacy dispense records, the authors measured medication possession ratio (MPR) at 90 days (primary outcome) and proportion of days covered (PDC) at 90 days and MPR and PDC at 180 and 365 days (secondary outcomes). Of the 561 patients randomized, only 427 had sufficient records to analyze. Adherence was high with only 41 patients having MPR less than 80% at 90 days. There was no difference in adherence between intervention and control patients for primary outcome (odds ratio 0.94)) or secondary outcomes. The authors felt that given the already high levels of adherence in both study groups, reassessing the DOAC checklist outside of a traditional trial may be more fruitful.
AHRQ-funded; HS02592401.
Citation: Wilson AS, Pham T, Mbusa D .
Pharmacist-led, checklist intervention did not improve adherence in ambulatory patients starting/resuming DOACs.
J Am Pharm Assoc 2023 May-Jun; 63(3):878-84.e3. doi: 10.1016/j.japh.2023.02.019..
Keywords: Provider: Pharmacist, Patient Adherence/Compliance, Blood Thinners, Medication
Herges JR, May HP, Meade L
Pharmacist-provider collaborative visits after hospital discharge in a comprehensive acute kidney injury survivor model.
This pilot study’s objective was to describe pharmacist contributions to a comprehensive postdischarge acute kidney injury (AKI) survivorship program in primary care (the AKI in Care Transitions [ACT] program). The program was piloted from May to December of 2021 at Mayo Clinic as a bundled care strategy for patients who survived an episode of AKI and were discharged home without the need for hemodialysis. Predischarge patients received education and care coordination from nurses and later completed postdischarge laboratory assessment and clinician follow-up in primary care. During follow-up, patients completed a 30-minute comprehensive medication management visit with a pharmacist focusing on AKI survivorship considerations. Pharmacists made 28 medication therapy recommendations (median 3 per patient) and identified 14 medication discrepancies for the 11 patients who completed the pilot program, with 86% of the medication therapy recommendations being acted on by the PCP within 7 days. Six recommendations were made to initiate renoprotective medications, and 5 were acted on.
AHRQ-funded; HS028060.
Citation: Herges JR, May HP, Meade L .
Pharmacist-provider collaborative visits after hospital discharge in a comprehensive acute kidney injury survivor model.
J Am Pharm Assoc 2023 May-Jun; 63(3):909-14. doi: 10.1016/j.japh.2022.12.029..
Keywords: Provider: Pharmacist, Kidney Disease and Health, Hospital Discharge
Pham T, Patel P, Mbusa D
Impact of a pharmacist intervention on DOAC knowledge and satisfaction in ambulatory patients.
This randomized clinical trial’s goal was to assess the impact on knowledge and satisfaction of an intervention framed around a newly developed direct oral anticoagulants (DOAC) Checklist to guide and educate patients initiating or resuming DOACs. The cohort included ambulatory patients starting a DOAC or resuming one after setback (bleeding, stroke, or transient ischemic attack) in an ambulatory setting (office, emergency department, or short stay hospitalization). The study included three educational clinical pharmacist tele-visits, hotline access to the pharmacist, and coordination with continuity providers in 3 months. An abbreviated version of the Duke Anticoagulation Satisfaction Survey was administered to 463 patients. Scores were similar for the 233 intervention patients vs. 203 control patients (63.7% vs 62.2% correct). Satisfaction scores on the 7-point Likert scale were also virtually identical. The pharmacist-led intervention framed around the DOAC checklist had little impact on knowledge and satisfaction. There were delays between the intervention end and completion of the follow-up questionnaires, which may have obscured benefits experienced earlier.
AHRQ-funded; HS026859.
Citation: Pham T, Patel P, Mbusa D .
Impact of a pharmacist intervention on DOAC knowledge and satisfaction in ambulatory patients.
J Thromb Thrombolysis 2023 Feb;55(2):346-54. doi: 10.1007/s11239-022-02743-0.
Keywords: Provider: Pharmacist, Blood Thinners, Medication, Patient Experience, Ambulatory Care and Surgery
Patel P, Hemmeger H, Kozak MA
Community pharmacist participation in a practice-based research network: a report from the Medication Safety Research Network of Indiana (Rx-SafeNet).
The researchers described the experiences and opinions of pharmacists serving as site coordinators for the Medication Safety Research Network of Indiana (Rx-SafeNet). In general, Rx-SafeNet site coordinators appeared to experience increased confidence in research engagement after joining the network. While respondents identified a number of benefits associated with network participation, concerns about potential time constraints remained a key barrier to participation.
AHRQ-funded; HS022119.
Citation: Patel P, Hemmeger H, Kozak MA .
Community pharmacist participation in a practice-based research network: a report from the Medication Safety Research Network of Indiana (Rx-SafeNet).
J Am Pharm Assoc (2003) 2015 Nov-Dec;55(6):649-55. doi: 10.1331/JAPhA.2015.14244.
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Keywords: Community-Based Practice, Medication: Safety, Practice-Based Research Network (PBRN), Provider: Pharmacist
Wiener ES, Mullins CD, Pincus KJ
A framework for pharmacist-assisted medication adherence in hard-to-reach patients.
This study aimed to create a model for use in patient-centered, pharmacist-led interactions to improve medication adherence. The Health Action Process Approach (HAPA), a behavioral change framework, was adapted to known barriers of medication adherence. The study concluded that the newly developed framework provides a patient centered approach to facilitate and improve pharmacist-patient conversations regarding medication adherence.
AHRQ-funded; HS022135.
Citation: Wiener ES, Mullins CD, Pincus KJ .
A framework for pharmacist-assisted medication adherence in hard-to-reach patients.
Res Social Adm Pharm 2015 Sep-Oct;11(5):595-601. doi: 10.1016/j.sapharm.2014.11.0.
Keywords: Medication, Patient Adherence/Compliance, Patient-Centered Outcomes Research, Access to Care, Provider: Pharmacist
Kennelty KA, Chewning B, Wise M
Barriers and facilitators of medication reconciliation processes for recently discharged patients from community pharmacists' perspectives.
The objectives of this study were to: 1) examine the barriers and facilitators community pharmacists face when reconciling medications for recently discharged patients; and 2) identify pharmacists’ preferred content and modes of information transfer regarding updated medication information for recently discharged patients. It found that major individual-level factors affecting the medication reconciliation process included: pharmacists’ perceived responsibility, relationships, patient perception of pharmacist, and patient characteristics.
AHRQ-funded; HS021984.
Citation: Kennelty KA, Chewning B, Wise M .
Barriers and facilitators of medication reconciliation processes for recently discharged patients from community pharmacists' perspectives.
Res Social Adm Pharm 2015 Jul-Aug;11(4):517-30. doi: 10.1016/j.sapharm.2014.10.008..
Keywords: Hospital Discharge, Medication, Patient Safety, Provider: Pharmacist
Doucette WR, Pendergast JF, Zhang Y
Stimulating comprehensive medication reviews among Medicare Part D beneficiaries.
The authors assessed the impact of a patient engagement intervention utilizing the Medication User Self-Evaluation (MUSE) tool on the completion percentage of comprehensive medication reviews (CMRs) among Medicare Part D beneficiaries. They found that the estimated odds of having a CMR among those who received the MUSE intervention were 2 times that of their counterparts. They concluded that Part D plans could use the MUSE to engage targeted beneficiaries in using pharmacist-provided MTM services.
AHRQ-funded; HS018353.
Citation: Doucette WR, Pendergast JF, Zhang Y .
Stimulating comprehensive medication reviews among Medicare Part D beneficiaries.
Am J Manag Care 2015 Jun;21(6):e372-8.
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Keywords: Elderly, Medicare, Medication, Patient and Family Engagement, Provider: Pharmacist
Mehrotra A, Gidengil CA, Setodji CM
Antibiotic prescribing for respiratory infections at retail clinics, physician practices, and emergency departments.
The authors compared antibiotic prescribing among retail clinics, primary care practices, and emergency departments (EDs) for acute respiratory infections (ARIs): antibiotics-may-be-appropriate ARIs and antibiotics-never-appropriate ARIs. They found that, compared with primary care practices and EDs, there was no difference at retail clinics in overall ARI antibiotic prescribing, which was more diagnosis-appropriate.
AHRQ-funded; HS018419.
Citation: Mehrotra A, Gidengil CA, Setodji CM .
Antibiotic prescribing for respiratory infections at retail clinics, physician practices, and emergency departments.
Am J Manag Care 2015 Apr;21(4):294-302.
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Keywords: Antibiotics, Emergency Department, Provider: Pharmacist, Primary Care, Respiratory Conditions
Snyder ME, Earl TR, Gilchrist S
Collaborative drug therapy management: case studies of three community-based models of care.
The objectives of this study were to understand how collaborative drug therapy management (CDTM) practices were implemented in 3 community settings and to identify common and unique facilitators and barriers to implementing CDTM. The authors believe that the models described in this study could be used to strengthen clinical–community linkages through team-based care, particularly for chronic disease prevention and management.
AHRQ-funded; HS022119.
Citation: Snyder ME, Earl TR, Gilchrist S .
Collaborative drug therapy management: case studies of three community-based models of care.
Prev Chronic Dis 2015 Mar 26;12:E39. doi: 10.5888/pcd12.140504..
Keywords: Care Management, Case Study, Community-Based Practice, Medication, Primary Care: Models of Care, Provider: Pharmacist
Huet AL, Frail CK, Lake LM
Impact of passive and active promotional strategies on patient acceptance of medication therapy management services.
The researchers assessed the impact of passive and active promotional strategies on patient acceptance of medication therapy management (MTM) services, and identified reasons for patient acceptance or refusal. No significant differences were identified among the four promotional methods or between active and passive methods in the analyses. Patients' most frequent reasons for accepting MTM services were potential cost savings and review of how the medications were working.
AHRQ-funded; HS022119.
Citation: Huet AL, Frail CK, Lake LM .
Impact of passive and active promotional strategies on patient acceptance of medication therapy management services.
J Am Pharm Assoc 2015 Mar-Apr;55(2):178-81. doi: 10.1331/JAPhA.2015.14091.
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Keywords: Care Management, Community-Based Practice, Health Promotion, Medication, Patient Adherence/Compliance, Provider: Pharmacist
Olenik NL, Gonzalvo JD, Snyder ME
Perceptions of Spanish-speaking clientele of patient care services in a community pharmacy.
This study aimed to identify perceptions of Spanish-speaking patients living in the U.S. with a focus on the care provided in community pharmacies, as well as to determine their satisfaction with community pharmacies. Based on 12 interviews, it found that primary themes included lack of insurance coupled with high medical care costs serving as a barrier for acquisition of health care and difficulty accessing timely and convenient primary care.
AHRQ-funded; HS022119.
Citation: Olenik NL, Gonzalvo JD, Snyder ME .
Perceptions of Spanish-speaking clientele of patient care services in a community pharmacy.
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Keywords: Access to Care, Community-Based Practice, Provider: Pharmacist, Racial and Ethnic Minorities
Wellman BR, Frail CK, Zillich AJ
Pharmacists' experiences with a telephonic medication therapy management program for home health care patients.
This qualitative study involved interviewing four pharmacists on their experiences with a telephone medication therapy management (MTM) program. Several themes emerged from the analysis, including: communication and relationships, coordinating care and patient self-management, logistics, professional fulfillment, service delivery and content, and training opportunities. The researchers concluded that their study provides possible strategies to overcome barriers and facilitate service provision for future telephonic MTM services.
AHRQ-funded; HS022119.
Citation: Wellman BR, Frail CK, Zillich AJ .
Pharmacists' experiences with a telephonic medication therapy management program for home health care patients.
Consult Pharm 2015 Mar;30(3):163-74. doi: 10.4140/TCP.n.2015.163..
Keywords: Home Healthcare, Medication, Provider: Pharmacist, Patient Self-Management
Snyder ME, Pater KS, Frail CK
Utility of a brief screening tool for medication-related problems.
The objective of this study was to estimate the psychometric properties of a brief self-administered scale as a screening tool for medication-related problems (MRPs). Its findings suggest scores on the nine-item scale are a statistically significant, although fairly modest, predictor of MRPs when controlling for other significant predictors of problems.
AHRQ-funded; HS022119.
Citation: Snyder ME, Pater KS, Frail CK .
Utility of a brief screening tool for medication-related problems.
Res Social Adm Pharm 2015 Mar-Apr;11(2):253-64. doi: 10.1016/j.sapharm.2014.08.005..
Keywords: Care Management, Community-Based Practice, Medication, Provider: Pharmacist, Screening
Viswanathan M, Kahwati LC, Golin CE
Medication therapy management interventions in outpatient settings: a systematic review and meta-analysis.
Medication therapy management (MTM) services (also called clinical pharmacy services) aim to reduce medication-related problems and their downstream outcomes. The purpose of this study was to assess the effect of MTM interventions among outpatients with chronic illnesses. The investigators graded the evidence as insufficient for most outcomes because of inconsistency and imprecision that stemmed in part from underlying heterogeneity in populations and interventions.
AHRQ-funded; 290201200008I.
Citation: Viswanathan M, Kahwati LC, Golin CE .
Medication therapy management interventions in outpatient settings: a systematic review and meta-analysis.
JAMA Intern Med 2015 Jan;175(1):76-87. doi: 10.1001/jamainternmed.2014.5841..
Keywords: Medication, Ambulatory Care and Surgery, Chronic Conditions, Evidence-Based Practice, Patient-Centered Outcomes Research, Provider: Pharmacist, Provider
Kozak MA, Gernant SA, Hemmeger HM
Lessons learned in the growth and maturation stages of a community pharmacy practice-based research network: experiences of the Medication Safety Research Network of Indiana (Rx-SafeNet).
In 2012, the authors reported on their early experiences developing the Medication Safety Research Network of Indiana (Rx-SafeNet) after establishing the Network in 2010. In this article, they report on lessons learned over the past 3 years.
AHRQ-funded; HS022119.
Citation: Kozak MA, Gernant SA, Hemmeger HM .
Lessons learned in the growth and maturation stages of a community pharmacy practice-based research network: experiences of the Medication Safety Research Network of Indiana (Rx-SafeNet).
Innov Pharm 2015;6(2).
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Keywords: Community-Based Practice, Medication: Safety, Medication, Provider: Pharmacist, Practice-Based Research Network (PBRN)