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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 25 of 32 Research Studies DisplayedGreen TC, Bratberg J, Baird J
Rurality and differences in pharmacy characteristics and community factors associated with provision of naloxone in the pharmacy.
Researchers studied pharmacy-level naloxone dispensed from one large US community pharmacy chain from the 1st quarter of 2013 to the 2nd quarter of 2017, examining associations between naloxone provision and pharmacy-level characteristics and community factors in two US states, Rhode Island and Massachusetts. They found that more rural pharmacies, pharmacies with higher volumes of all prescriptions and of buprenorphine, that sell more nonprescription syringes, that have drive-throughs and longer weekend hours, and that are located in communities with younger age distributions were associated with increased likelihood of ever dispensing naloxone and a greater number of naloxone doses dispensed. They concluded that pharmacy naloxone dispensing may be an especially effective strategy to alter the overdose risk environment in rural communities.
AHRQ-funded; HS024021.
Citation: Green TC, Bratberg J, Baird J .
Rurality and differences in pharmacy characteristics and community factors associated with provision of naloxone in the pharmacy.
Int J Drug Policy 2020 Nov;85:102602. doi: 10.1016/j.drugpo.2019.11.010..
Keywords: Medication, Provider: Pharmacist, Community-Based Practice, Rural Health
Alley L, Novak K, Havlin T
Development and pilot of a prescription drug monitoring program and communication intervention for pharmacists
The authors developed the Resources Encouraging Safe Prescription Opioid and Naloxone Dispensing (RESPOND) Toolkit to enhance community pharmacists' understanding of their role in addressing opioid safety; to improve integration of prescription drug monitoring program (PDMP) into daily workflow; and to enhance communication between pharmacists, prescribers, and patients. In this paper, they described the development of the RESPOND Toolkit and summarized their findings from initial pilot testing. They concluded that the RESPOND Toolkit has promise as an effective and scalable approach to providing community pharmacist-tailored training to promote behavioral shifts supporting opioid safety for patients.
AHRQ-funded; HS024227.
Citation: Alley L, Novak K, Havlin T .
Development and pilot of a prescription drug monitoring program and communication intervention for pharmacists
Res Social Adm Pharm 2020 Oct;16(10):1422-30. doi: 10.1016/j.sapharm.2019.12.023..
Keywords: Opioids, Substance Abuse, Medication, Medication: Safety, Patient Safety, Tools & Toolkits, Communication, Provider: Pharmacist, Provider, Training
Donovan E, Bratberg J, Baird J
Pharmacy leaders' beliefs about how pharmacies can support a sustainable approach to providing naloxone to the community.
The objective of this qualitative study was to understand how leaders in pharmacy organizations perceive pharmacies and pharmacy staff can optimize dispensing of naloxone. Five main themes emerged: importance of staff training to increase comfort; strength through coordination of efforts; pharmacies acting as community leaders in the opioid crisis; persisting stigma; ongoing workflow challenges. These results uniquely reflect the experiences and insights of pharmacy leaders implementing public health initiatives during the opioid crisis and can be used for gaining insight into how pharmacists can efficiently provide naloxone to their communities.
AHRQ-funded; HS024021.
Citation: Donovan E, Bratberg J, Baird J .
Pharmacy leaders' beliefs about how pharmacies can support a sustainable approach to providing naloxone to the community.
Res Social Adm Pharm 2020 Oct;16(10):1493-97. doi: 10.1016/j.sapharm.2020.01.006..
Keywords: Provider: Pharmacist, Provider, Community-Based Practice, Opioids, Medication, Substance Abuse
Jones AE, King JB, Kim K
The role of clinical pharmacy anticoagulation services in direct oral anticoagulant monitoring.
The objective of this study was to describe direct oral anticoagulant (DOAC) management in patients who were and were not managed by an anticoagulation management service (AMS). Subjects were patients with atrial fibrillation at the University of Utah Health (UUH) who received DOAC therapy. Results showed that patients managed by AMS providers were more complex and had more frequent encounters regarding their DOAC therapy than those managed by non-AMS providers. However, there was evidence of duplicative DOAC therapy management efforts. No difference between AMS and non-AMS groups in the composite clinical endpoint was detected.
AHRQ-funded; HS026156.
Citation: Jones AE, King JB, Kim K .
The role of clinical pharmacy anticoagulation services in direct oral anticoagulant monitoring.
J Thromb Thrombolysis 2020 Oct;50(3):739-45. doi: 10.1007/s11239-020-02064-0..
Keywords: Blood Thinners, Medication, Provider: Pharmacist, Provider, Care Management, Healthcare Delivery
Gernant SA, Adeoye-Olatunde OA, Murawski MM
Experiences applying technology to overcome common challenges in pharmacy practice-based research in the United States.
Despite the importance of pharmacy practice-based research in generating knowledge that results in better outcomes for patients, health systems and society alike, common challenges to PPBR persist. In this paper, the authors described PPBR challenges their research teams have encountered, and their experiences using technology-driven solutions to overcome such challenges. The authors describe the technology driven solutions they have used to address PPBR challenges.
AHRQ-funded; HS025943.
Citation: Gernant SA, Adeoye-Olatunde OA, Murawski MM .
Experiences applying technology to overcome common challenges in pharmacy practice-based research in the United States.
Pharmacy 2020 May 30;8(2):93. doi: 10.3390/pharmacy8020093..
Keywords: Provider: Pharmacist, Provider, Health Information Technology (HIT), Patient-Centered Outcomes Research, Evidence-Based Practice, Health Services Research (HSR)
Snyder ME, Jaynes HA, Germant SA
Factors associated with comprehensive medication review completion rates: a national survey of community pharmacists.
The primary objective of this survey study was to identify factors associated with the comprehensive medication review (CMR) completion rates of community pharmacies contracted with a national medication therapy management (MTM) vendor. The investigators concluded that factors at the respondent (e.g., responses to facilitators scale) and pharmacy (e.g., pharmacy type) levels were associated with CMR completion rates. The investigators indicated that the findings could be used by MTM stakeholders to improve CMR completion rates.
AHRQ-funded; HS022119.
Citation: Snyder ME, Jaynes HA, Germant SA .
Factors associated with comprehensive medication review completion rates: a national survey of community pharmacists.
Res Social Adm Pharm 2020 May;16(5):673-80. doi: 10.1016/j.sapharm.2019.08.008..
Keywords: Medication, Provider: Pharmacist, Provider
Burstein D, Baird J, Bratberg J
Pharmacist attitudes toward pharmacy-based naloxone: a cross-sectional survey study.
This study examined pharmacist attitudes towards recommending pharmacy-based naloxone (PBN). The authors looked at the influence of gender, practice setting, number of years of practice, state location, and PBN involvement. Barriers and facilitators were also assessed. A 71-question survey was mailed to approximately 2900 licensed pharmacists in Massachusetts and Rhode Island and was open from April 5, 2016 until July 13, 2016. Out of those 2900, 402 responded (13%) and 245 were included in the analyses. The majority (79%) identified as White and 127 (51.8%) indicated that they had dispensed naloxone, with 85 having done so in the past 30 days. The results of the cross-sectional survey was used to develop the Opioid Overdose Prevention Attitude (OOPA) scale which consists of 3 subscales: Opioid Overdose Prevention Attitude, Public Health Attitude, and Naxolone Dispensing Attitude. Pharmacists working in a pharmacy that had a standing order or collaborative practice agreement to dispense naxolone without a physician’s prescription had a more positive attitude than other pharmacists.
AHRQ-funded; HS024021.
Citation: Burstein D, Baird J, Bratberg J .
Pharmacist attitudes toward pharmacy-based naloxone: a cross-sectional survey study.
J Am Pharm Assoc 2020 Mar-Apr;60(2):304-10. doi: 10.1016/j.japh.2019.11.004.
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Keywords: Medication, Provider: Pharmacist, Provider, Opioids, Substance Abuse, Prevention
Gilson AM, Xiong KZ, Stone JA
Improving patient-pharmacist encounters with over-the-counter medications: a mixed-methods pilot study.
This study evaluated the impact of having an abbreviated medication section in pharmacies specifically for older adults (Senior Section™) on the frequency and content of over-the-counter (OTC) medication encounters between pharmacy staff and patients. An intervention mixed-methods design was created to generate data from patient OTC encounters, and interviews with two pharmacists and two technicians, throughout the study. The interview transcripts were coded, and frequencies and chi-square analyses demonstrated pre/post-intervention comparisons for the OTC encounter variables. After implementation, pharmacy staff were more likely to initiate (and be involved in) patient encounters, address more topics or problem/symptoms, provide details about OTC products, discuss appropriateness of OTC use, and discuss medication classes highlighted in the Senior Section. Pharmacy staff were less likely to need to leave the prescription counter for extended periods, and they also had fewer prolonged encounters or encounters about product location.
AHRQ-funded; HS024490.
Citation: Gilson AM, Xiong KZ, Stone JA .
Improving patient-pharmacist encounters with over-the-counter medications: a mixed-methods pilot study.
Innov Pharm 2020 Feb 14;11(1). doi: 10.24926/iip.v11i1.2295..
Keywords: Provider: Pharmacist, Medication, Medication: Safety, Communication, Patient Safety
Ailabouni NJ, Marcum ZA, Schmader KE
Medication use quality and safety in older adults: 2018 update.
This study identified four key articles from 2018 that address medication use quality and safety for older adults. The first study highlighted a cluster-randomized trial that utilized a pharmacist-led education-based intervention delivered to both patients and doctors to deprescribe four types of inappropriate medications. The second study from the UK examined the association between anticholinergic exposure, overall and by medication class, and dementia risk in 40,770 older adults. The third study was a Swedish longitudinal cohort study examining the association between antihypertensive medications and incident dementia. The fourth and last study was a randomized, double-blind, placebo-controlled trial and examined the effect of daily low-dose aspirin for primary prevention of cardiac events and hemorrhage in 19,144 community-dwelling older adults.
AHRQ-funded; HS022982.
Citation: Ailabouni NJ, Marcum ZA, Schmader KE .
Medication use quality and safety in older adults: 2018 update.
J Am Geriatr Soc 2019 Dec;67(12):2458-62. doi: 10.1111/jgs.16243..
Keywords: Elderly, Medication, Medication: Safety, Patient Safety, Quality of Care, Provider: Pharmacist, Provider
Reddy A, Lester CA, Stone JA
Applying participatory design to a pharmacy system intervention.
Researchers used participatory design (PD) to develop a patient-centered prototype for a community pharmacy. The stakeholders recruited for the intervention were pharmacy staff and older adult patients who received prescriptions at the pharmacy corporation involved in this study. The PD process is a series of six adaptive sessions: 1) problem identification, 2) solution generation, 3) convergence, 4) prototyping, 5) initial evaluation, and 6) formative evaluation. The sessions resulted in the development of a patient-centered community pharmacy prototype.
AHRQ-funded; HS024490.
Citation: Reddy A, Lester CA, Stone JA .
Applying participatory design to a pharmacy system intervention.
Res Social Adm Pharm 2019 Nov;15(11):1358-67. doi: 10.1016/j.sapharm.2018.11.012..
Keywords: Provider: Pharmacist, Patient-Centered Healthcare, Medication, Patient Safety
Kurian S, Baloy B, Baird J
Attitudes and perceptions of naloxone dispensing among a sample of Massachusetts community pharmacy technicians.
AHRQ-funded; HS024021.
Citation: Kurian S, Baloy B, Baird J .
Attitudes and perceptions of naloxone dispensing among a sample of Massachusetts community pharmacy technicians.
J Am Pharm Assoc 2019 Nov-Dec;59(6):824-31. doi: 10.1016/j.japh.2019.08.009..
Keywords: Medication, Medication: Safety, Opioids, Substance Abuse, Provider: Pharmacist, Provider, Patient Safety
Gilson AM, Stone JA, Reddy A
Exploring how pharmacists engage with patients about over-the-counter medications.
This study used an innovative information-gathering approach to provide insight into the nature and structure of pharmacy staff encounters with patients seeking over-the-counter (OTC) medications and revealed specific activities of pharmacy staff around these encounters. Through an 8-item OTC Encounter Form, results showed that pharmacists play a key role in ensuring that the benefits of OTC medications outweigh the risks, thereby providing an important resource for patient engagement about safe medication selection and use. Examining the features of OTC encounters creates an evidence base to promote best practices for OTC encounters, increasing pharmacists' ability to help people, especially older adults, navigate the intricacies of OTC medication use, without significantly increasing pharmacy staff workload.
AHRQ-funded; HS024490.
Citation: Gilson AM, Stone JA, Reddy A .
Exploring how pharmacists engage with patients about over-the-counter medications.
J Am Pharm Assoc 2019 Nov - Dec;59(6):852-56. doi: 10.1016/j.japh.2019.08.001..
Keywords: Medication, Provider: Pharmacist, Provider, Patient and Family Engagement
Bach P, Hartung D
Leveraging the role of community pharmacists in the prevention, surveillance, and treatment of opioid use disorders.
This narrative review explores the literature describing novel programs designed to capitalize on the role of the community pharmacist in helping to reduce opioid-related harms, as well as evaluations of existing practices already in place in the US and elsewhere around the world. Specific approaches examined include strategies to facilitate pharmacist monitoring for problematic opioid use, to increase pharmacy-based harm reduction efforts (including naloxone distribution and needle exchange programs), and to involve community pharmacists in the dispensation of opioid agonist therapy.
AHRQ-funded; HS024227; 2902015000091.
Citation: Bach P, Hartung D .
Leveraging the role of community pharmacists in the prevention, surveillance, and treatment of opioid use disorders.
Addict Sci Clin Pract 2019 Sep 2;14(1):30. doi: 10.1186/s13722-019-0158-0..
Keywords: Medication, Opioids, Provider, Provider: Pharmacist, Substance Abuse
McCarthy DM, Russell AM , Effler MR
Implementation fidelity of patient-centered prescription label to promote opioid safe use.
The authors assessed implementation of a patient-centered "PRN" (as needed) label entitled "Take-Wait-Stop" (TWS) with three deconstructed steps replacing traditional wording. They found that exact intervention adherence was not achieved in the majority of cases, limiting impact, but that community pharmacies were responsive to new instructions, with higher implementation reliability requiring additional supports.
AHRQ-funded; HS023459.
Citation: McCarthy DM, Russell AM , Effler MR .
Implementation fidelity of patient-centered prescription label to promote opioid safe use.
Pharmacoepidemiol Drug Saf 2019 Sep;28(9):1251-57. doi: 10.1002/pds.4795..
Keywords: Opioids, Patient Safety, Health Literacy, Medication, Provider: Pharmacist, Provider
Nolan K, Zullo AR, Bosco E
Controlled substance diversion in health systems: a failure modes and effects analysis for prevention.
This study’s purpose was to demonstrate the utility of failure modes and effects analysis (FMEA) to identify potential sources of controlled substance diversion and developing solutions in an academic health system. A cross-functional team of 18 members was developed from the department of pharmacy. Scoring criteria was developed and ways were identified in which step of the medication supply there could be failure and result in diversion of controlled substances. Failure was indicated with a vulnerability score of 48 or 64. A total of 10 major steps and 30 substeps in the supply process was identified. From this 103 potential failure modes were identified, with 24 modes (23%) considered failing. Notable failure included controlled substance activity under temporary patients and discrepancy trends. Expanded use of cameras in high-risk areas and added verification checks were implemented after the analysis.
AHRQ-funded; HS022998.
Citation: Nolan K, Zullo AR, Bosco E .
Controlled substance diversion in health systems: a failure modes and effects analysis for prevention.
Am J Health Syst Pharm 2019 Jul 18;76(15):1158-64. doi: 10.1093/ajhp/zxz116..
Keywords: Medication, Provider: Pharmacist, Hospitals, Quality Improvement, Quality of Care
Snyder ME, Jaynes H, Gernant SA
Alerts for community pharmacist-provided medication therapy management: recommendations from a heuristic evaluation.
This study evaluated the effectiveness of alerts for community pharmacist-provided medication therapy management (MTM). The alerts come in five categories: indication, effectiveness, safety, adherence, and cost-containment. The heuristic evaluation used the Instrument for Evaluating Human-Factors Principles in Medication-Related Decision Support Alerts (I-MeDeSA). Four analysts’ individual ratings were summed for each alert, and a mean score on the modified I-MeDeSA was computed. The analysts’ scores were similar. The scores indicated opportunities for improvement across all MTM alert categories including principles of alert prioritization; text-based information; alarm philosophy; and corrective actions.
AHRQ-funded; HS025005.
Citation: Snyder ME, Jaynes H, Gernant SA .
Alerts for community pharmacist-provided medication therapy management: recommendations from a heuristic evaluation.
BMC Med Inform Decis Mak 2019 Jul 16;19(1):135. doi: 10.1186/s12911-019-0866-0..
Keywords: Decision Making, Health Information Technology (HIT), Medication, Provider, Provider: Pharmacist
Donovan E, Case P, Bratberg JP
Beliefs associated with pharmacy-based naloxone: a qualitative study of pharmacy-based naloxone purchasers and people at risk for opioid overdose.
The purpose of this study was to understand factors that impact the likelihood of obtaining pharmacy-based naloxone. Results showed that several themes emerged from the interview data: individual, interpersonal, pharmacy, community, and societal, suggesting that these factors can be used to inform interventions seeking to increase the provision of pharmacy-based naloxone.
AHRQ-funded; HS024021.
Citation: Donovan E, Case P, Bratberg JP .
Beliefs associated with pharmacy-based naloxone: a qualitative study of pharmacy-based naloxone purchasers and people at risk for opioid overdose.
J Urban Health 2019 Jun;96(3):367-78. doi: 10.1007/s11524-019-00349-1..
Keywords: Medication, Provider, Provider: Pharmacist, Opioids, Risk, Substance Abuse
Schiff GD, Klinger E, Salazar A
Screening for adverse drug events: a randomized trial of automated calls coupled with phone-based pharmacist counseling.
In this study, the investigators evaluated an automated telephone surveillance system coupled with transfer to a live pharmacist- to screen potentially drug-related symptoms after newly starting medications for four common primary care conditions: hypertension, diabetes, depression, and insomnia. Systematic automated telephone outreach monitoring coupled with real-time phone referral to a pharmacist identified a substantial number of previously unidentified potentially drug-related symptoms, many of which were validated as probably or possibly related to the drug by the pharmacist or their physicians.
AHRQ-funded; HS021094.
Citation: Schiff GD, Klinger E, Salazar A .
Screening for adverse drug events: a randomized trial of automated calls coupled with phone-based pharmacist counseling.
J Gen Intern Med 2019 Feb;34(2):285-92. doi: 10.1007/s11606-018-4672-7..
Keywords: Adverse Drug Events (ADE), Adverse Events, Medication, Medication: Safety, Health Information Technology (HIT), Provider: Pharmacist, Provider, Patient Safety
Ndefo UA, Moultry AM, Davis PN
Provision of medication therapy management by pharmacists to patients with type-2 diabetes mellitus in a federally qualified health center.
This article describes a medication therapy management (MTM) pilot program that was implemented at a federally qualified health center. This program was implemented at three clinics involving patients with uncontrolled diabetes, defined as hemoglobin A1c (HbA1c) greater than 8 percent. Fifty-seven patients met the established criteria and were enrolled in the six-month program. Thirty-seven patients completed the program and had an average 15 percent reduction in HbA1c.
AHRQ-funded; 290201100001C.
Citation: Ndefo UA, Moultry AM, Davis PN .
Provision of medication therapy management by pharmacists to patients with type-2 diabetes mellitus in a federally qualified health center.
P&T 2017 Oct;42(10):632-37.
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Keywords: Diabetes, Medication, Chronic Conditions, Patient-Centered Healthcare, Provider: Pharmacist
Chui MA, Stone JA, Holden RJ
Improving over-the-counter medication safety for older adults: a study protocol for a demonstration and dissemination study.
This study proposes to evaluate the effectiveness of the intervention for preventing misuse of high-risk OTC medications by older adults; and to evaluate the implementation of the intervention in community pharmacies. The primary outcome will be a comparison of proportion of older adults who misuse OTC medication from baseline to post-intervention.
AHRQ-funded; HS024490.
Citation: Chui MA, Stone JA, Holden RJ .
Improving over-the-counter medication safety for older adults: a study protocol for a demonstration and dissemination study.
Res Social Adm Pharm 2017 Sep - Oct;13(5):930-37. doi: 10.1016/j.sapharm.2016.11.006.
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Keywords: Adverse Drug Events (ADE), Elderly, Medication: Safety, Medication, Provider: Pharmacist
Rowan CG, Flory J, Gerhard T
Agreement and validity of electronic health record prescribing data relative to pharmacy claims data: a validation study from a US electronic health record database.
The researchers conducted a retrospective cohort study among patients with linked claims and EHR data in OptumLabs Data Warehouse. Their aim was to evaluate the validity of classifying medication exposure using EHR prescribing (EHR-Rx) data. They concluded that, despite substantial variability among different medications, there was very good agreement between EHR-Rx data and PC-Rx data.
AHRQ-funded; HS023898.
Citation: Rowan CG, Flory J, Gerhard T .
Agreement and validity of electronic health record prescribing data relative to pharmacy claims data: a validation study from a US electronic health record database.
Pharmacoepidemiol Drug Saf 2017 Aug;26(8):963-72. doi: 10.1002/pds.4234.
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Keywords: Data, Electronic Health Records (EHRs), Medication, Provider: Pharmacist
Calo WA, Gilkey MB, Shah P
Parents' willingness to get human papillomavirus vaccination for their adolescent children at a pharmacy.
The researchers sought to examine parents' willingness to get human papillomavirus (HPV) vaccination for their children at pharmacies. Overall, their national survey found that 29 percent of parents would be willing to get HPV vaccine for their children at a pharmacy. Parental willingness was associated with believing that pharmacists are skilled at administering vaccines.
AHRQ-funded; HS000032.
Citation: Calo WA, Gilkey MB, Shah P .
Parents' willingness to get human papillomavirus vaccination for their adolescent children at a pharmacy.
Prev Med 2017 Jun;99:251-56. doi: 10.1016/j.ypmed.2017.02.003.
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Keywords: Children/Adolescents, Infectious Diseases, Provider: Pharmacist, Sexual Health, Vaccination
Roy B, Gottlieb AS
The career advising program: a strategy to achieve gender equity in academic medicine.
This paper discusses the significant gender disparities in academic rank which exist at US medical schools, even after controlling for age, time since training, specialty, and measures of productivity, and despite increasing numbers of women entering medicine over the past 30 years. They highlight the Society of General Internal Medicine’s Women and Medicine Task Force and the model they launched in 2013 to address these disparities- the Career Advising Program (CAP).
AHRQ-funded; HS023000.
Citation: Roy B, Gottlieb AS .
The career advising program: a strategy to achieve gender equity in academic medicine.
J Gen Intern Med 2017 Jun;32(6):601-02. doi: 10.1007/s11606-016-3969-7..
Keywords: Education: Academic, Education: Continuing Medical Education, Provider: Pharmacist
Schroeder SR, Salomon MM, Galanter WL
Cognitive tests predict real-world errors: the relationship between drug name confusion rates in laboratory-based memory and perception tests and corresponding error rates in large pharmacy chains.
The researchers conducted a study to assess the association between error rates in laboratory-based tests of drug name memory and perception and real-world drug name confusion error rates. They found that across two distinct pharmacy chains, there is a strong and significant association between drug name confusion error rates observed in the real world and those observed in laboratory-based tests of memory and perception.
AHRQ-funded; HS021093.
Citation: Schroeder SR, Salomon MM, Galanter WL .
Cognitive tests predict real-world errors: the relationship between drug name confusion rates in laboratory-based memory and perception tests and corresponding error rates in large pharmacy chains.
BMJ Qual Saf 2017 May;26(5):395-407. doi: 10.1136/bmjqs-2015-005099.
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Keywords: Adverse Drug Events (ADE), Medical Errors, Medication: Safety, Medication, Provider: Pharmacist
Green TC, Potter N, Bratberg J
Detecting naloxone prejudices in the pharmacy setting.
This survey asked pharmacists how concerned they would be about dispensing pain medications (or Suboxone) to customers who are getting or already have naloxone. Fifty-nine percent of respondents indicated no or little increased concern about dispensing either medication to a known naloxone recipient. Greater concern was reported by pharmacists when considering dispensing pain medications to a known naloxone recipient.
AHRQ-funded; Letter related to AHRQ-funded MOON project (HS024021).
Citation: Green TC, Potter N, Bratberg J .
Detecting naloxone prejudices in the pharmacy setting.
J Am Pharm Assoc 2017 Mar - Apr;57(2s):S10-s11. doi: 10.1016/j.japh.2016.12.068.
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Keywords: Medication, Provider: Pharmacist, Social Media, Substance Abuse