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AHRQ Research Studies Date
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- Access to 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 18 of 18 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
Bartsch SM, Taitel MS, DePasse JV
Epidemiologic and economic impact of pharmacies as vaccination locations during an influenza epidemic.
During an influenza epidemic, where early vaccination is crucial, pharmacies may be a resource to increase vaccine distribution reach and capacity. In this paper, the investigators utilized an agent-based model of the US and a clinical and economics outcomes model to simulate the impact of different influenza epidemics and the impact of utilizing pharmacies in addition to traditional (hospitals, clinic/physician offices, and urgent care centers) locations for vaccination for the year 2017.
AHRQ-funded; HS023317.
Citation: Bartsch SM, Taitel MS, DePasse JV .
Epidemiologic and economic impact of pharmacies as vaccination locations during an influenza epidemic.
Vaccine 2018 Nov 12;36(46):7054-63. doi: 10.1016/j.vaccine.2018.09.040..
Keywords: Healthcare Costs, Influenza, Provider: Pharmacist, Public Health, Vaccination
Hartung DM, Hall J, Haverly SN
Pharmacists' role in opioid safety: a focus group investigation.
This qualitative study explores the pharmacist's role in promoting opioid safety from the perspective of pharmacists and patients. Using focus groups, results showed that pharmacists expressed discomfort filling potentially high-risk opioid prescriptions and noted barriers such as lack of clinical information and discomfort policing high-risk prescribing; and that patients were concerned about pharmacists potentially overstepping their professional responsibilities by interfering with prescribers' clinical decisions.
AHRQ-funded; HS024227.
AHRQ-funded; HS024227.
AHRQ-funded; HS024227.
Citation: Hartung DM, Hall J, Haverly SN .
Pharmacists' role in opioid safety: a focus group investigation.
Pain Med 2018 Sep;19(9):1799-806. doi: 10.1093/pm/pnx139..
Keywords: Provider: Pharmacist, Opioids, Medication: Safety, Medication, Patient Safety
Shah PD, Trogdon JG, Golden SD
Impact of pharmacists on access to vaccine providers: a geospatial analysis.
This study analyzed the impact of pharmacists on access to vaccines. The study concluded that pharmacists are more geographically dispersed across census tracts than primary care physicians. As a result, adding pharmacists to the workforce would increase the availability of vaccine providers in areas with inadequate primary care provider coverage.
AHRQ-funded; HS000032.
Citation: Shah PD, Trogdon JG, Golden SD .
Impact of pharmacists on access to vaccine providers: a geospatial analysis.
Milbank Q 2018 Sep;96(3):568-92. doi: 10.1111/1468-0009.12342.
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Keywords: Access to Care, Provider: Pharmacist, Vaccination
Johnston K, Alley L, Novak K
Pharmacists' attitudes, knowledge, utilization, and outcomes involving prescription drug monitoring programs: a brief scoping review.
Researchers sought to identify and synthesize findings from current literature on community pharmacists' attitudes toward, knowledge of, and registration and utilization behaviors regarding prescription drug monitoring programs (PDMPs). While considered studies varied greatly in methodological approach, generally, pharmacists' attitudes and knowledge of PDMPs positively influenced likelihood to register and use state's program. The researchers recommended pharmacist-targeted PDMPs and opioid safety training in order to increase knowledge of and insight into behavioral change.
AHRQ-funded; HS024227.
Citation: Johnston K, Alley L, Novak K .
Pharmacists' attitudes, knowledge, utilization, and outcomes involving prescription drug monitoring programs: a brief scoping review.
J Am Pharm Assoc 2018 Sep - Oct;58(5):568-76. doi: 10.1016/j.japh.2018.06.003..
Keywords: Medication, Provider: Pharmacist, Policy
Jones CD, Anthony A, Klein MD
The effect of a pharmacist-led multidisciplinary transitions-of-care pilot for patients at high risk of readmission.
The purpose of this study was to evaluate the feasibility and effect of a pharmacist-led transitions-of-care (TOC) pilot targeted to patients at high risk of readmission on process measures, hospital readmissions, and emergency department visits. Results showed that a pharmacist-led TOC pilot demonstrated potential for reducing hospital readmissions. The intervention was time intensive and led to the creation of a TOC pharmacist role to implement medication-related transitional care.
AHRQ-funded; HS024569.
Citation: Jones CD, Anthony A, Klein MD .
The effect of a pharmacist-led multidisciplinary transitions-of-care pilot for patients at high risk of readmission.
J Am Pharm Assoc 2018 Sep - Oct;58(5):554-60. doi: 10.1016/j.japh.2018.05.008..
Keywords: Hospital Readmissions, Provider: Pharmacist, Transitions of Care
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
Shah PD, Marciniak MW, Golden SD
Pharmacies versus doctors' offices for adolescent vaccination.
This study sought to understand the relative advantage of pharmacies compared to doctors' offices for delivering HPV vaccination to adolescents. The authors concluded that to be more appealing to parents as HPV vaccine providers, pharmacy providers within community and hospital settings should build on their relative advantage with respect to accessibility and enhance their appeal of their healthcare environment.
AHRQ-funded; HS000032.
Citation: Shah PD, Marciniak MW, Golden SD .
Pharmacies versus doctors' offices for adolescent vaccination.
Vaccine 2018 Jun 7;36(24):3453-59. doi: 10.1016/j.vaccine.2018.04.088..
Keywords: Children/Adolescents, Health Services Research (HSR), Ambulatory Care and Surgery, Provider: Pharmacist, Vaccination
Shah PD, Calo WA, Marciniak MW
Service quality and parents' willingness to get adolescents HPV vaccine from pharmacists.
The researchers sought to examine whether pharmacy service quality was associated with parents' willingness to have immunizing pharmacists administer human papillomavirus (HPV) vaccine to their adolescent children. They found that parents who went to independent pharmacies had lower willingness to get HPV vaccine from pharmacists compared to parents who went to chain pharmacies, but there was no difference in willingness for parents who went to clinic versus chain pharmacies.
AHRQ-funded; HS000032.
Citation: Shah PD, Calo WA, Marciniak MW .
Service quality and parents' willingness to get adolescents HPV vaccine from pharmacists.
Prev Med 2018 Apr;109:106-12. doi: 10.1016/j.ypmed.2018.01.002.
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Keywords: Children/Adolescents, Decision Making, Infectious Diseases, Provider: Pharmacist, Vaccination
Chang AC, Lincoln J, Lantaff WM
Characterization of actions taken during the delivery of medication therapy management: a time-and-motion approach.
The purpose of this study was to characterize actions performed by pharmacists and support staff during provision of medication therapy management (MTM) and to compare actions performed according to practice characteristics. The investigators found that MTM activities were longer at Later Maturity Level practices, and these practices were more likely to use paid pharmacy interns and to receive physician referrals for MTM.
AHRQ-funded; HS022119.
Citation: Chang AC, Lincoln J, Lantaff WM .
Characterization of actions taken during the delivery of medication therapy management: a time-and-motion approach.
J Am Pharm Assoc 2018 Jan - Feb;58(1):61-66.e7. doi: 10.1016/j.japh.2017.09.059.
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Keywords: Medication, Practice Patterns, Provider: Pharmacist
Kim HS, McCarthy DM, Hoppe JA
Emergency department provider perspectives on benzodiazepine-opioid coprescribing: a qualitative study.
This study examined attitudes of emergency department residents, attending physicians, and pharmacists from three hospitals on coprescribing benzodiazepines and opioids. There is mounting evidence that this increases overdose risk. Focus groups were conducted using semistructured interviews which were audio-recorded and transcribed. Participants were reluctant to admit coprescribing and said when they did that specific discharge instructions were provided. The decision was also influenced by a provider’s belief in the efficacy of combination therapy as well as self-imposed pressure to escalate care or avoid hospital admission. They did not like the idea of using computerized alerts, but were support of pharmacist-assisted interventions.
AHRQ-funded; HS023011; HS000078.
Citation: Kim HS, McCarthy DM, Hoppe JA .
Emergency department provider perspectives on benzodiazepine-opioid coprescribing: a qualitative study.
Acad Emerg Med 2018 Jan;25(1):15-24. doi: 10.1111/acem.13273..
Keywords: Emergency Department, Guidelines, Medication, Opioids, Practice Patterns, Provider: Clinician, Provider: Pharmacist, Provider: Physician