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Ellis Hilts K, Elkhadragy N, Corelli RL, Hata M, Tong EK, Vitale FM, Hudmon KS. Closing the Tobacco Treatment Gap: A Qualitative Study of Tobacco Cessation Service Implementation in Community Pharmacies. PHARMACY 2024; 12:59. [PMID: 38668085 PMCID: PMC11055024 DOI: 10.3390/pharmacy12020059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Revised: 03/17/2024] [Accepted: 03/19/2024] [Indexed: 04/29/2024] Open
Abstract
Tobacco use remains a leading preventable cause of morbidity and mortality, with pharmacotherapy and counseling recognized as effective cessation aids. Yet, the potential role of pharmacists and pharmacy technicians in tobacco cessation services is underutilized. This study explores the integration of such services in community pharmacies, identifying facilitators and barriers to their implementation. A qualitative study was conducted across seven community pharmacies in California that were affiliated with the Community Pharmacy Enhanced Services Network. Participants included 22 pharmacists and 26 pharmacy technicians/clerks who completed tobacco cessation training. Data were collected through semi-structured interviews, focusing on experiences with implementing cessation services. The analysis was guided by Rogers' Diffusion of Innovations Theory. MAXQDA software was used for data management and thematic analysis. Sixteen pharmacy personnel participated in the study, highlighting key themes around the integration of cessation services. Compatibility with existing workflows, the importance of staff buy-in, and the crucial role of pharmacy technicians emerged as significant facilitators. Challenges included the complexity of billing for services, software limitations for documenting tobacco use and cessation interventions, and gaps in training for handling complex patient cases. Despite these barriers, pharmacies successfully initiated cessation services, with variations in service delivery and follow-up practices. Community pharmacies represent viable settings for delivering tobacco cessation services, with pharmacists and technicians playing pivotal roles. However, systemic changes are needed to address challenges related to billing, documentation, and training. Enhancing the integration of cessation services in community pharmacies could significantly impact public health by increasing access to effective cessation support.
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Affiliation(s)
- Katy Ellis Hilts
- Richard M. Fairbanks School of Public Health, Indiana University, Indianapolis, IN 46202, USA;
| | | | - Robin L. Corelli
- School of Pharmacy, University of California San Francisco, San Francisco, CA 94143, USA;
| | - Micah Hata
- College of Pharmacy, Western University of Health Sciences, Pomona, CA 91766, USA;
| | - Elisa K. Tong
- Department of Internal Medicine, UC Davis, Sacramento, CA 95817, USA;
| | - Francis M. Vitale
- College of Pharmacy, Purdue University, West Lafayette, IN 47907, USA;
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Newlon JL, Goswami S, Bentley JP, Illingworth KS. Community pharmacists' readiness to take action to improve working conditions. J Am Pharm Assoc (2003) 2023; 63:1600-1606.e1. [PMID: 37454873 DOI: 10.1016/j.japh.2023.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 06/19/2023] [Accepted: 07/11/2023] [Indexed: 07/18/2023]
Abstract
OBJECTIVE The objective of this study was to assess pharmacists' readiness to take actions resulting in change at the individual level or systemic level. DESIGN/SETTING AND PARTICIPANTS/OUTCOME MEASURES An online survey was distributed via pharmacy-related social media pages and several state pharmacy association newsletters and e-mail listservs. Fifteen items assessed participants' readiness to pursue change using a 5-point scale based on the transtheoretical model of behavior change (1 = Do not plan on doing, 2 = Plan to take in the next 6 months, 3 = Plan to take in the next month, 4 = Took in the past 6 months, 5 = Took more than 6 months ago). Categorical principal components analysis (CATPCA) was used as a data reduction technique to identify underlying components of the 15 items assessing readiness to improve working conditions. Component scores for each component were calculated and used as dependent variables in multivariable linear regression models to test associations between the components and sociodemographic and work-related predictors. RESULTS CATPCA revealed a 12-item scale with 2 components accounting for 39.97% of the total variance. Pharmacists working in independent pharmacies had a significantly higher willingness than chain pharmacists to pursue actions with potential to result in systemic-level changes, such as contacting or joining an organization to attempt to improve their current working conditions (regression coefficient = 0.623, P < 0.001). Pharmacists working in independent pharmacies had a significantly lower willingness than chain pharmacists to pursue actions resulting in individual-level changes, such as changing their current job or quitting (regression coefficient = -0.485, P < 0.001). CONCLUSION Pharmacists working in national chains may be less willing than independent pharmacists to pursue systemic-level changes owing to fear of discipline from employers. Future research should examine the effect of interventions intended to increase pharmacists' motivation and readiness to pursue changes to improve working conditions.
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Singleton BA, Al-Dahir S, Gillard C, Earls M, Bommarito J, Duhe M, Phi K. Perceived Role, Identity and Experiences of Pharmacists and the Potential Impact on COVID-19 Vaccine Uptake per Louisiana Region: A Prospective Cohort Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6459. [PMID: 37569001 PMCID: PMC10418418 DOI: 10.3390/ijerph20156459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/24/2023] [Revised: 07/21/2023] [Accepted: 07/21/2023] [Indexed: 08/13/2023]
Abstract
Some of the lowest COVID-19 community vaccination rates in America are found in Louisiana. This study investigated: (1) barriers that Louisiana pharmacists encountered during the pandemic; and (2) the effect of pharmacists' role and identity confidence on willingness to enforce vaccine mandates, and COVID-19 vaccine uptake. Fifty-four community pharmacists from nine regions of Louisiana participated in the study. Pharmacists completed questionnaires about: personal demographics, patient population, vaccination encouragement, COVID-19 concerns, and vaccination administration rates. The importance of feeling like a trusted voice in the community, as well as professional perception and self-assurance, were measured using Likert scale questions. During focus groups, participants discussed experiences with the COVID-19 vaccination rollout and vaccination-related obstacles. As the pandemic progressed, pharmacists reported being overworked, understaffed, and overburdened with new responsibilities. In regions with lower vaccination rates, pharmacists were less likely to feel at ease enforcing vaccine mandates. Independent pharmacists were less comfortable enforcing vaccine mandates than chain pharmacists but had more positive perceptions of their role and identity. This study contributes to further understanding of pharmacy workflow obstacles and pharmacists' perceptions of their professional roles and identities in the community.
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Affiliation(s)
- Brittany A. Singleton
- Division of Clinical and Administrative Sciences, Xavier University of Louisiana, New Orleans, LA 70125, USA
| | - Sara Al-Dahir
- Division of Clinical and Administrative Sciences, Xavier University of Louisiana, New Orleans, LA 70125, USA
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Kim E, Worley MM, Law AV. Pharmacist roles in the medication use process: Perceptions of patients, physicians, and pharmacists. J Am Pharm Assoc (2003) 2023; 63:1120-1130. [PMID: 37207709 DOI: 10.1016/j.japh.2023.05.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 04/25/2023] [Accepted: 05/12/2023] [Indexed: 05/21/2023]
Abstract
OBJECTIVES It is uncertain whether stakeholder perceptions of pharmacist roles in the medication use process (MUP) have evolved alongside pharmacist advanced scope of practice. This study aimed to examine patient, pharmacist, and physician perceptions of pharmacist roles in the MUP. DESIGN This IRB-approved study used a cross-sectional design with online panels of patients, pharmacists, and physicians. SETTING AND PARTICIPANTS A Qualtrics panel of 1,004 patients, 205 pharmacists, and 200 physicians completed the surveys between August-November 2021. OUTCOME MEASURES Using role theory as framework, 12-item surveys were developed to examine perceptions regarding effectiveness of and best choice for improving each MUP step. Data analysis included descriptive statistics, correlations, and comparisons. RESULTS Majority of the physician, pharmacist, and patient samples believed that physicians prescribe the best possible medications (93.5%, 83.4%, 89.0% respectively), prescriptions are filled accurately (59.0%, 61.4%, 92.6% respectively) and timely (86.0%, 68.8, 90.2% respectively). Majority of physicians (78.5%) opined prescriptions are generally error free and patients are monitored (71%); fewer pharmacists agreed (42.9%, 51%; p<0.05). Most patients (92.4%) reported taking medications as directed; only 60% professionals agreed (p<0.05). Physicians selected 'pharmacists' as top choice for reducing dispensing errors, providing counseling, and helping patients take medications as directed. Patients wanted pharmacists to help manage their medications (87.0%) and 'someone' to periodically check on their health (100%). All 3 groups agreed physician-pharmacist collaboration was important to improve patient care and outcomes (90.0%-97.1%); however, 24% of physicians were uninterested in collaboration. Both professionals reported lack of time, appropriate setup, and interprofessional communication as challenges to collaboration. CONCLUSION Pharmacists believe their roles have evolved to align with expanded opportunities. Patients perceived pharmacists play comprehensive roles in medication management through counseling and monitoring. Physicians recognized pharmacist roles in dispensing and counseling, but not in prescribing or monitoring. Clarity in role expectations amongst these stakeholders is critical to optimizing pharmacist roles and patient outcomes.
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Lahrman R, Shin YE, Porter B, Beatty S, Hincapie AL. Pharmacists' facilitators and barriers to implementing and billing for patient care services: Interviews from the Ohio Medicaid Project. J Am Pharm Assoc (2003) 2023; 63:1077-1086. [PMID: 37075903 DOI: 10.1016/j.japh.2023.04.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 03/30/2023] [Accepted: 04/10/2023] [Indexed: 04/21/2023]
Abstract
BACKGROUND In the past several decades, a growing body of literature is recognizing the benefits of pharmacist-led health care services in improving clinical and economic outcomes. Despite this evidence, pharmacists are not recognized on a federal level as health care providers in the United States. Ohio Medicaid managed care plans began partnering with local pharmacies in 2020 to launch initial programs for implementing pharmacist-provided clinical services. OBJECTIVES This study aimed to identify barriers and facilitators to implementing and billing for pharmacist-provided services in Ohio Medicaid managed care plan programs. METHODS This qualitative study interviewed pharmacists involved in the initial programs using a semistructured interview based on the Consolidated Framework for Implementation Research (CFIR). Interview transcripts were coded for thematic analysis. Identified themes were mapped to the CFIR domains. RESULTS Four Medicaid payors partnered with 12 pharmacy organizations, representing 16 unique sites of care. Interviews were conducted with 11 participants. The thematic analysis found data fit within the 5 domains with 32 total themes. Pharmacists described the implementation process of their services. The primary themes for improvement of implementation process were system integration, payor rule clarity, and patient eligibility and access. The 3 themes that emerged as key facilitators were communication between payors and pharmacists, communication between pharmacist and care teams, and the perceived value of the service. CONCLUSIONS Payors and pharmacists can work collaboratively to improve patient care opportunities by increasing access with sustainable reimbursement, clear guidelines, and open communication. Continued improvement is needed in system integration, payor rule clarity, and patient eligibility and access.
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DiPietro Mager N, Bright D. Advancing Public Health through Community Pharmacy Practice. PHARMACY 2023; 11:pharmacy11020056. [PMID: 36961034 PMCID: PMC10037598 DOI: 10.3390/pharmacy11020056] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 02/22/2023] [Indexed: 03/18/2023] Open
Abstract
The overarching goal of public health is to advance the health of individuals, communities, and populations [...].
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Affiliation(s)
- Natalie DiPietro Mager
- Department of Pharmacy Practice, Raabe College of Pharmacy, Ohio Northern University, Ada, OH 45810, USA
| | - David Bright
- Department of Pharmaceutical Sciences, Ferris State University College of Pharmacy, Big Rapids, MI 49307, USA
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Mueller K, Balthazar MS, Hamilton JB, Kimble LP. Integrating the Social Determinants of Health Into Prelicensure Nursing Pharmacology. J Nurs Educ 2023; 62:175-179. [PMID: 36881892 PMCID: PMC10448450 DOI: 10.3928/01484834-20230109-08] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/09/2023]
Abstract
BACKGROUND Nursing organizations have called for the incorporation of social determinants of health (SDOH) throughout nursing school curricula. Guidance is needed regarding best practices to integrate SDOH into pharmacology courses in prelicensure nursing programs. METHOD Using Emory University's School of Nursing SDOH framework to guide curriculum innovation, pharmacology faculty identified three pharmacology-centric SDOH topics: race-based medicine and pharmacogenomics, pharmacy deserts, and lack of diversity in clinical trials. These three SDOH topics were incorporated into preestablished pharmacology content. RESULTS Faculty integrated SDOH into pharmacology courses with heavy science content, and students were receptive to open discussion of SDOH topics. CONCLUSION The integration of SDOH into a prelicensure nursing pharmacology course across multiple cohorts of students was feasible, and student feedback was positive. Faculty faced several challenges, including time constraints. Additional and ongoing training is needed to support the integration of SDOH into nursing curricula. [J Nurs Educ. 2023;62(3):175-179.].
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Exploring barriers and facilitators to pharmacist-provided diabetes self-management education and support. J Am Pharm Assoc (2003) 2023; 63:74-79. [PMID: 36114100 PMCID: PMC10405629 DOI: 10.1016/j.japh.2022.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 08/01/2022] [Accepted: 08/02/2022] [Indexed: 01/25/2023]
Abstract
BACKGROUND Pharmacists have the necessary clinical experience and medication knowledge to effectively provide diabetes self-management education and support (DSMES); however, barriers exist to DSMES implementation by community pharmacists. OBJECTIVE The aim of this study is to explore DSMES from the community pharmacists' perspectives, identify barriers and facilitators to pharmacist DSMES implementation, and guide development of pharmacist-provided DSMES programs in Idaho. METHODS Implementation climate, the theoretical framework for this project, is focused on how community pharmacists in Idaho perceive they will be supported by patients, health care providers, and insurers in DSMES implementation. Pharmacist investigators with qualitative research experience conducted semistructured interviews with 6 licensed community pharmacists from Idaho via Zoom between March and June 2020. Recordings were transcribed verbatim and analyzed using HyperRESEARCH 4.5.1. Themes, patterns, and dominant concepts that emerged from respondents' about DSMES were explored, labeled, and categorized into modifiable and nonmodifiable barriers and facilitators. This study was granted expedited approval by the Idaho State University Investigational Review Board. RESULTS Relevant themes included current scope of practice, barriers, and facilitators. Subthemes related to the current scope of pharmacy practice included unclear roles and responsibilities and legislative constraints to practice. For barriers, subthemes included cost of set-up, billing and coding education, and the sustainability of services based on current reimbursement models. For facilitators, subthemes included the need for additional collaborations (external and internal), technology access, and trained pharmacy staff. CONCLUSION Pharmacists are underutilized health care providers, capable of providing DSMES services if provided the necessary resources. This work identifies barriers and facilitators to pharmacist-led DSMES that can be considered by others when implementing DSMES or other disease management services.
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Adekunle OA, Olson AW, Schommer JC, Brown LM. Influence of patient-pharmacist relationship on willingness to accept pharmacist-provided services. J Am Pharm Assoc (2003) 2022; 63:760-768.e1. [PMID: 36642668 DOI: 10.1016/j.japh.2022.12.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 10/16/2022] [Accepted: 12/15/2022] [Indexed: 12/23/2022]
Abstract
BACKGROUND Willingness to accept various pharmacist-provided services such as health promotion and medication management is still considered low. Evidence suggests that patient experience and socio-demographics partially explain patient willingness to use pharmacy services. However, the influence of a patient's relationship with their pharmacist may provide additional explanatory power. OBJECTIVES The aims of the study were to [1] explore the willingness to accept pharmacy services across patients' relationship with pharmacists and [2] evaluate the association between the patient-pharmacist relationship and patients' willingness to accept pharmacist-provided services. METHODS A total of 1521 respondents' data on the types of patient-pharmacist relationships and willingness to accept dispensing, drug information, medication management, and health promotional services were collected from the 2021 National Consumer Survey on Medication Experience and Pharmacists' Role. Willingness scores across the groups were evaluated using chi-square and analysis of variance. Binary logistic regression was used to investigate the associations between patient-pharmacist relationships and willingness to accept pharmacist-provided services. RESULTS More respondents were "definitely willing" to accept dispensing services (68.5%) and drug information (68.3%), while 56.5% and 50.1% were "definitely willing" to accept health promotion and medication management services, respectively. While respondents with "customer" and "client" archetype relationships were definitely willing to accept the 4 categories of pharmacy services, the highest proportion of respondents definitely willing to accept the services was observed among those with "partner" archetype relationships. Willingness scores increased significantly across the archetype relationships. Respondents with a "partner" archetype relationship had the highest and most significant odds ratio of accepting all the categories of pharmacist-provided services. CONCLUSION Willingness to accept services from pharmacists increased as the level of the patient-pharmacist relationship grew. Patients in "partner" archetype relationship were significantly more likely to accept all categories of pharmacist-provided services. Pharmacists are encouraged to embrace the patient-pharmacist relationship continuum to optimize patient care.
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Wunderlich JR, Engelberg RS, Tofighi B, Schwartz MD. Time for Pharmacy Co-dispensing of Naloxone with Prescribed Opioids? J Gen Intern Med 2022; 37:2621-2623. [PMID: 35581455 PMCID: PMC9411499 DOI: 10.1007/s11606-022-07643-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Affiliation(s)
| | - Rachel S Engelberg
- Department of Population Health, NYU Grossman School of Medicine, New York, NY, USA
| | - Babak Tofighi
- Department of Population Health, NYU Grossman School of Medicine, Bellevue Hospital Center Division of General Internal Medicine, Nathan Kline Institute for Psychiatry Research, New York, NY, USA
| | - Mark D Schwartz
- Department of Population Health, NYU Grossman School of Medicine, New York, NY, USA.
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Adunlin G, Pan K. Pharmacy Students’ Attitudes and Perceptions toward Financial Management Education. Healthcare (Basel) 2022; 10:healthcare10040683. [PMID: 35455859 PMCID: PMC9028782 DOI: 10.3390/healthcare10040683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Revised: 03/24/2022] [Accepted: 03/28/2022] [Indexed: 02/01/2023] Open
Abstract
(1) Background: Pharmacy-related financial management training and education are an integral part of the pharmacy curriculum. This study aims to evaluate pharmacy students’ perceptions toward financial management education, their attitudes on its clinical relevance, and their ability to use financial management knowledge in introductory and advanced pharmacy practice experiences. (2) Methods: An online survey was sent to third- and fourth-year pharmacy students. The survey assessed the following three themes: perceptions toward financial management education; attitudes toward the clinical relevance of financial management education; and the student’s ability to use knowledge of financial management in practice. Descriptive statistics were used to summarize the data. (3) Results: The overall response rate for the survey was 60% (139/233). Overall, the study showed a positive perception and attitude toward financial management education. Results indicate that pharmacy students were confident in their ability to use financial management knowledge in pharmacy practice. (4) Conclusions: This survey found an overall optimism in financial management education’s role in pharmacy practice and the ability to obtain financial management competencies in professional pharmacy training. With the evolving practice requirements, pharmacy schools should adapt their financial management curricula with relevant skills to prepare students to become effective entrepreneurs, innovators, and practice leaders.
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Affiliation(s)
- Georges Adunlin
- Department of Pharmaceutical, Social and Administrative Sciences, McWhorter School of Pharmacy, Samford University, 800 Lakeshore Drive, Birmingham, AL 35229, USA
- Correspondence:
| | - Kevin Pan
- Department of Economics, Finance and Quantitative Analysis, Brock School of Business, Samford University, 800 Lakeshore Drive, Birmingham, AL 35229, USA;
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Rafie S, Hildebrand M, Hurst S, Economou N, Stadnick NA, Mody SK. Barriers and facilitators for pharmacists prescribing emergency contraception under statewide protocol. JOURNAL OF THE AMERICAN COLLEGE OF CLINICAL PHARMACY 2021. [DOI: 10.1002/jac5.1558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- Sally Rafie
- Department of Pharmacy UC San Diego Health San Diego California USA
| | - Marisa Hildebrand
- Division of Family Planning, Department of Obstetrics, Gynecology, and Reproductive Sciences University of California San Diego La Jolla California USA
| | - Samantha Hurst
- Herbert Wertheim School of Public Health and Human Longevity Science University of California San Diego La Jolla California USA
| | - Nicole Economou
- Division of Family Planning, Department of Obstetrics, Gynecology, and Reproductive Sciences University of California San Diego La Jolla California USA
| | - Nicole A. Stadnick
- Department of Psychiatry University of California San Diego La Jolla California USA
- Altman Clinical and Translational Research Institute Dissemination and Implementation Science Center Child and Adolescent Services Research Center San Diego California USA
| | - Sheila K. Mody
- Division of Family Planning, Department of Obstetrics, Gynecology, and Reproductive Sciences University of California San Diego La Jolla California USA
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Richard C, Urick BY, Pathak S, Jackson J, Livet M. Performance-based pharmacy payment models: key components and critical implementation considerations for successful uptake and integration. J Manag Care Spec Pharm 2021; 27:1568-1578. [PMID: 34714107 PMCID: PMC10390937 DOI: 10.18553/jmcp.2021.27.11.1568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND: In the United States, the shift towards value-based health care seeks to improve patient outcomes while reducing health care spending. Although the federal government has led the implementation of performance-based models for physicians and health care systems, commercial entities have largely been responsible for the development of similar models within pharmacy. For the purposes of this study, performance-based pharmacy payment models (PBPPMs) were defined as prescription drug payment models that determine reimbursement or fees for community pharmacies based in part on measured performance. These PBPPMs incentivize pharmacies to improve patient care by linking reimbursement to performance measures. However, the design and implementation of PBPPMs lack transparency and have not been described in the literature. OBJECTIVES: To (1) describe the structure of PBPPMs in the United States and (2) identify contextual and motivational influences that need to be considered for successful uptake and integration of these models. METHODS: A search of peer-reviewed and grey literature was undertaken. In addition, semi-structured stakeholder interviews were conducted with a convenience sample of 17 individuals who were community pharmacists, payers, quality measure developers and vendors, academics, and pharmacy advocacy organization leaders. Data were analyzed to understand the current structure of PBPPMs and opportunities for improvement, as well as implementation considerations that included facilitators, barriers, and key insights. RESULTS: This study identified 4 major components of US PBPPMs: attribution, performance and quality measures, incentive structures, and patient care services. A number of barriers (eg, lack of alignment) and recommendations to improve the current structure of PBPPMs (eg, the need for adequate incentives to facilitate change) were highlighted. Notable implementation considerations centered around (1) establishing common ground among stakeholders to avoid misalignment and encourage engagement; (2) the importance of a quality-driven, innovative, and flexible organizational culture with access to data infrastructure, adjusted workflows, and relevant trainings; (3) supporting the cultural transition to value-based health care; and (4) application of financial incentives at the pharmacy or pharmacist level. CONCLUSIONS: To better develop and implement PBPPMs, it is first critical to understand the key components that define these models and the needed changes to their structure. In addition, identifying the contextual and motivational factors that influence their successful integration can improve future uptake. This study illustrates the landscape of PBPPMs in the United States, as well as makes recommendations for improvement in their design. To improve future development and implementation of these models, the following recommendations are highlighted: (1) increase transparency and alignment of measures with the incentive structure; (2) embrace innovative business models; (3) carefully plan and use roadmaps that outline successful uptake and implementation; and (4) foster culture of quality at all levels of health care. DISCLOSURES: This study was sponsored by Pharm-Alliance, an alliance between the pharmacy schools of the University of North Carolina at Chapel Hill, Monash University, and University College London. Urick reports consulting fees from Pharmacy Quality Solutions and Cardinal Health, unrelated to this work. The other authors have nothing to disclose. This study was a podium presentation under the title "What Makes Performance-Based Pharmacy Payment Models Work?" at AMCP Nexus Virtual, October 2020.
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Affiliation(s)
- Chloe Richard
- Center for Medication Optimization (CMO), Division of Practice Advancement and Clinical Education, Eshelman School of Pharmacy, University of North Carolina at Chapel Hill
| | - Benjamin Y Urick
- Center for Medication Optimization (CMO), Division of Practice Advancement and Clinical Education, Eshelman School of Pharmacy, University of North Carolina at Chapel Hill
| | - Shweta Pathak
- Center for Medication Optimization (CMO), Division of Practice Advancement and Clinical Education, Eshelman School of Pharmacy, University of North Carolina at Chapel Hill
| | - John Jackson
- Center for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Victoria, Australia
| | - Melanie Livet
- Center for Medication Optimization (CMO), Division of Practice Advancement and Clinical Education, Eshelman School of Pharmacy, University of North Carolina at Chapel Hill
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Newlon JL, Reed JB, Stone RH, Satterfield KG, Meredith AH. Pharmacist‐prescribed
hormonal contraception services: A systematic review of implementation studies. JOURNAL OF THE AMERICAN COLLEGE OF CLINICAL PHARMACY 2021. [DOI: 10.1002/jac5.1539] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Affiliation(s)
- Jenny L. Newlon
- Purdue University College of Pharmacy West Lafayette Indiana USA
| | - Jason B. Reed
- Purdue University Libraries and School of Information Studies West Lafayette Indiana USA
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