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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
26 to 50 of 98 Research Studies DisplayedTaber DJ, Fleming JN, Su Z
Significant hospitalization cost savings to the payer with a pharmacist-led mobile health intervention to improve medication safety in kidney transplant recipients.
This paper examined hospitalization cost savings to the payer with a pharmacist-led mobile health intervention to improve medication safety in kidney transplant recipients. This study was an economic analysis of a 12-month, parallel arm, randomized controlled trial in adult kidney recipients 6 to 36 months posttransplant (NCT03247322). All participants received usual posttransplant care, while the intervention arm received supplemental clinical pharmacist-led medication therapy monitoring and management, via a smartphone-enabled mHealth app, integrated with risk-based televisits.
AHRQ-funded; HS023754.
Citation: Taber DJ, Fleming JN, Su Z .
Significant hospitalization cost savings to the payer with a pharmacist-led mobile health intervention to improve medication safety in kidney transplant recipients.
Am J Transplant 2021 Oct;21(10):3428-35. doi: 10.1111/ajt.16737..
Keywords: Healthcare Costs, Provider: Pharmacist, Telehealth, Health Information Technology (HIT), Transplantation, Hospitalization, Medication: Safety, Medication
Gilson AM, Stone JA, Morris AO
Impact of a pilot community pharmacy system redesign on reducing over-the-counter medication misuse in older adults.
This pilot study’s goal was to decrease misuse of over-the-counter (OTC) medications by older adults aged 65 years or older by creating a pharmacy “Senior Section”. The Senior Section contains a curated selection of OTC medications and it located close to the prescription department to facilitate pharmacy staff-patient engagement to reduce misuse. The study recruited 87 older adults from 3 pharmacies. Misuse outcomes measured were drug-drug, drug-disease, drug-age, and drug-label, with 5 subtypes. The Senior Section reduced drug-label misuse for different models. Misuse was found to decrease after implementation for 7 of 11 comparisons.
AHRQ-funded; HS024490.
Citation: Gilson AM, Stone JA, Morris AO .
Impact of a pilot community pharmacy system redesign on reducing over-the-counter medication misuse in older adults.
J Am Pharm Assoc (2003) 2021 Sep-Oct;61(5):555-64. doi: 10.1016/j.japh.2021.04.007..
Keywords: Elderly, Provider: Pharmacist, Medication, Medication: Safety
Snyder ME, Adeoye-Olatunde OA, Gernant SA
A user-centered evaluation of medication therapy management alerts for community pharmacists: recommendations to improve usability and usefulness.
Community pharmacists provide comprehensive medication reviews (CMRs) through pharmacy contracts with medication therapy management (MTM) vendors. These CMRs are documented in the vendors' web-based MTM software platforms, which often integrate alerts to assist pharmacists in the detection of medication therapy problems. The objectives of this study were to 1) assess the usability and usefulness of MTM alerts for MTM vendor-contracted community pharmacists and 2) generate recommendations for improving MTM alerts for use by community pharmacists.
AHRQ-funded; HS025005.
Citation: Snyder ME, Adeoye-Olatunde OA, Gernant SA .
A user-centered evaluation of medication therapy management alerts for community pharmacists: recommendations to improve usability and usefulness.
Res Social Adm Pharm 2021 Aug;17(8):1433-43. doi: 10.1016/j.sapharm.2020.10.015..
Keywords: Medication, Provider: Pharmacist, Community-Based Practice
De Oliveira GS, Castro-Alves LJ, Kendall MC
Effectiveness of pharmacist intervention to reduce medication errors and health-care resources utilization after transitions of care: a meta-analysis of randomized controlled trials.
The main objective of the current investigation was to examine the effectiveness of pharmacist-based transition-of-care interventions on the reduction of medication errors after hospital discharge. Findings showed that pharmacist transition-of-care intervention is an effective strategy to reduce medication errors after hospital discharge and also reduces subsequent emergency room visits.
AHRQ-funded; HS024158.
Citation: De Oliveira GS, Castro-Alves LJ, Kendall MC .
Effectiveness of pharmacist intervention to reduce medication errors and health-care resources utilization after transitions of care: a meta-analysis of randomized controlled trials.
J Patient Saf 2021 Aug 1;17(5):375-80. doi: 10.1097/pts.0000000000000283..
Keywords: Medication: Safety, Medication, Adverse Drug Events (ADE), Adverse Events, Medical Errors, Patient Safety, Provider: Pharmacist, Transitions of Care
Green TC, Stopka T, Xuan Z
Examining nonprescription syringe sales in Massachusetts and Rhode Island community pharmacies.
The authors sought to describe, compare, and assess the convergent validity of staff-reported nonprescription syringe (NPS) sales volume and NPS administrative sales data from community pharmacies in Massachusetts and Rhode Island. They found that the counts of administrative pharmacy syringe sales data in both states indicated high need, substantial volume, and notable access at community pharmacies. They recommended future research of NPS sales data rather than self-reported data to track emerging trends and to tailor local responses.
AHRQ-funded; HS024021.
Citation: Green TC, Stopka T, Xuan Z .
Examining nonprescription syringe sales in Massachusetts and Rhode Island community pharmacies.
J Am Pharm Assoc 2021 Jul-Aug;61(4):e237-e41. doi: 10.1016/j.japh.2021.03.004..
Keywords: Provider: Pharmacist
Gonzales 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
Gilson AM, Xiong KZ, Stone JA
A pharmacy-based intervention to improve safe over-the-counter medication use in older adults.
This study assessed whether the development of a physical redesign that located a curated inventory of lower-risk over-the-counter (OTC) medications proximal to the pharmacy prescription area was helpful to discourage inappropriate use from OTC medications. An area called the Senior Section™ was developed and placed in 4 pharmacies within a single chain. Eight pharmacists and 5 technicians participated in semi-structured interviews which were transcribed. The staff viewed the Senior Section as contributing to notable improvements in proximity, medication safety, convenience, and patient selection behaviors. It also streamlined the coordination of services between pharmacists and technicians and did not interfere with existing pharmacy workflows.
AHRQ-funded; HS024490.
Citation: Gilson AM, Xiong KZ, Stone JA .
A pharmacy-based intervention to improve safe over-the-counter medication use in older adults.
Res Social Adm Pharm 2021 Mar;17(3):578-87. doi: 10.1016/j.sapharm.2020.05.008..
Keywords: Elderly, Medication: Safety, Medication, Patient Safety, Provider: Pharmacist
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
Green 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