National Healthcare Quality and Disparities Report
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Search All Research Studies
Topics
- Adverse Drug Events (ADE) (4)
- Adverse Events (4)
- Ambulatory Care and Surgery (1)
- Blood Thinners (1)
- Caregiving (1)
- Care Management (2)
- Children/Adolescents (1)
- Chronic Conditions (1)
- Clinical Decision Support (CDS) (1)
- Communication (1)
- Community-Based Practice (1)
- Decision Making (1)
- Elderly (2)
- Emergency Department (1)
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- Infectious Diseases (1)
- Medical Errors (2)
- Medication (19)
- Medication: Safety (7)
- Opioids (7)
- Patient-Centered Healthcare (1)
- Patient-Centered Outcomes Research (3)
- Patient Adherence/Compliance (1)
- Patient and Family Engagement (1)
- Patient Safety (8)
- Prevention (3)
- Primary Care (1)
- (-) Provider (21)
- (-) Provider: Pharmacist (21)
- Provider: Physician (1)
- Quality of Care (1)
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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 21 of 21 Research Studies DisplayedGonzales HM, Fleming JN, Gebregziabher M
Pharmacist-led mobile health intervention and transplant medication safety: a randomized controlled clinical trial.
The goal of this study was to examine the efficacy of improving medication safety through a pharmacist-led, mobile health-based intervention. In this single-center study of adult kidney recipients 6-36 months post-transplant, findings showed that participants receiving the intervention experienced a significant reduction in medication errors and a significantly lower incidence risk of Grade 3 or higher adverse events. The intervention arm also demonstrated significantly lower rates of hospitalizations.
AHRQ-funded; HS023754.
Citation: Gonzales HM, Fleming JN, Gebregziabher M .
Pharmacist-led mobile health intervention and transplant medication safety: a randomized controlled clinical trial.
Clin J Am Soc Nephrol 2021 May 8;16(5):776-84. doi: 10.2215/cjn.15911020..
Keywords: Medication: Safety, Medication, Patient Safety, Transplantation, Telehealth, Health Information Technology (HIT), Provider: Pharmacist, Provider, Medical Errors, Adverse Drug Events (ADE), Adverse Events
Gurwitz JH, Kapoor A, Garber L
Effect of a multifaceted clinical pharmacist intervention on medication safety after hospitalization in persons prescribed high-risk medications: a randomized clinical trial.
The purpose of this study was to determine whether a multifaceted clinical pharmacist intervention improves medication safety for patients who are discharged from the hospital and prescribed medications within 1 or more of these high-risk drug classes: anticoagulants, diabetes agents, and opioids. The randomized clinical trial was conducted at a large multidisciplinary group practice in Massachusetts and included patients 50 years or older. Findings showed that there was not an observed lower rate of adverse drug-related incidents or clinically important medication errors during the posthospitalization period that was associated with a clinical pharmacist intervention.
AHRQ-funded; HS023774.
Citation: Gurwitz JH, Kapoor A, Garber L .
Effect of a multifaceted clinical pharmacist intervention on medication safety after hospitalization in persons prescribed high-risk medications: a randomized clinical trial.
JAMA Intern Med 2021 May;181(5):610-18. doi: 10.1001/jamainternmed.2020.9285..
Keywords: Elderly, Medication: Safety, Medication, Patient Safety, Adverse Drug Events (ADE), Adverse Events, Provider: Pharmacist, Provider
Snyder ME, Chewning B, Kreling D
An evaluation of the spread and scale of PatientToc™ from primary care to community pharmacy practice for the collection of patient-reported outcomes: a study protocol.
Patient-reported outcomes (PROs), measuring adherence challenges pertaining to both remembering and intention to take medication, offer a rich data source for pharmacists and prescribers to use to resolve medication non-adherence. PatientToc™ is a PROs collection software developed to facilitate collection of PROs data from low-literacy and non-English speaking patients in Los Angeles. This study evaluated the spread and scale of PatientToc™ from primary care to community pharmacies for the collection and use of PROs data pertaining to medication adherence.
AHRQ-funded; HS025943.
Citation: Snyder ME, Chewning B, Kreling D .
An evaluation of the spread and scale of PatientToc™ from primary care to community pharmacy practice for the collection of patient-reported outcomes: a study protocol.
Res Social Adm Pharm 2021 Feb;17(2):466-74. doi: 10.1016/j.sapharm.2020.03.019..
Keywords: Medication, Patient Adherence/Compliance, Primary Care, Provider: Pharmacist, Provider, Health Information Technology (HIT)
Kane-Gill SL, Wong A, Culley CM
JA, et al. Transforming the medication regimen review process using telemedicine to prevent adverse events.
The objective of this study was to determine the impact of pharmacist-led telemedicine services on reducing high-risk medication adverse drug events (ADEs) for nursing home (NH) residents using medication reconciliation and prospective medication regimen reviews (MRRs) on admission plus ongoing clinical decision support alerts throughout the residents' stay. Studying residents in four NHs in Southwestern Pennsylvania, findings showed that the intervention group had a 92% lower incidence of alert-specific ADEs than usual care, and all-cause hospitalization was similar between groups, as were 30-day readmissions.
AHRQ-funded; HS02420.
Citation: Kane-Gill SL, Wong A, Culley CM .
JA, et al. Transforming the medication regimen review process using telemedicine to prevent adverse events.
J Am Geriatr Soc 2021 Feb;69(2):530-38. doi: 10.1111/jgs.16946..
Keywords: Medication: Safety, Medication, Adverse Drug Events (ADE), Adverse Events, Medical Errors, Patient Safety, Telehealth, Health Information Technology (HIT), Provider: Pharmacist, Provider, Clinical Decision Support (CDS), Prevention
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
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
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
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
Shah PD, Calo WA, Marciniak MW
Support for pharmacist-provided HPV vaccination: national surveys of U.S. physicians and parents.
Cancer Epidemiol Biomarkers Prev 2018 Aug;27(8):970-78. doi: 10.1158/1055-9965.Epi-18-0380.
State laws about pharmacists providing human papillomavirus (HPV) vaccines vary considerably, limiting many pharmacists' ability to provide this important cancer prevention service. In this study, the investigators characterized physician and parent support for pharmacist-provided HPV vaccination for adolescents who are past due for vaccination. The authors concluded that to increase support for HPV vaccination services, pharmacists should raise awareness about their immunization training and standardize vaccination protocols that ensure coordination with primary care.
State laws about pharmacists providing human papillomavirus (HPV) vaccines vary considerably, limiting many pharmacists' ability to provide this important cancer prevention service. In this study, the investigators characterized physician and parent support for pharmacist-provided HPV vaccination for adolescents who are past due for vaccination. The authors concluded that to increase support for HPV vaccination services, pharmacists should raise awareness about their immunization training and standardize vaccination protocols that ensure coordination with primary care.
AHRQ-funded; HS000032.
Citation: Shah PD, Calo WA, Marciniak MW .
Support for pharmacist-provided HPV vaccination: national surveys of U.S. physicians and parents.
Cancer Epidemiol Biomarkers Prev 2018 Aug;27(8):970-78. doi: 10.1158/1055-9965.Epi-18-0380..
Keywords: Caregiving, Children/Adolescents, Infectious Diseases, Provider, Provider: Pharmacist, Provider: Physician, Vaccination
Gernant SA, Snyder ME, Jaynes H
The effectiveness of pharmacist-provided telephonic medication therapy management on emergency department utilization in home health patients.
This article's objective is to evaluate the effectiveness of a telephonic medication therapy management (MTM) service on reducing emergency department utilization within a Medicare-insured home health population. The authors found that this pharmacist-delivered telephonic medication therapy management program did not decrease emergency department utilization overall but may further reduce the such risk among patients who are at lower risk of utilization.
AHRQ-funded; HS022119.
Citation: Gernant SA, Snyder ME, Jaynes H .
The effectiveness of pharmacist-provided telephonic medication therapy management on emergency department utilization in home health patients.
J Pharm Technol 2016 Oct 1;32(5):179-84. doi: 10.1177/8755122516660376.
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Keywords: Care Management, Emergency Department, Medication, Patient-Centered Healthcare, Patient-Centered Outcomes Research, Prevention, Provider: Pharmacist, Provider
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