Patient-reported outcomes (PROs) have been the subject of research for decades and are increasingly being used in clinical settings. Commonly defined as any report of the status of a patient’s health condition as reported directly by the patient, providers report that PROs have the potential to enhance patient engagement and shared decision-making when integrated into clinical care. However, difficulties exist for providers, the healthcare team, and patients.
An Evaluation of the Spread and Scale of PatientToc™ From Primary Care to Community Pharmacy Practice for the Collection of Patient-Reported Outcomes
Project Final Report (PDF, 636.58 KB) Disclaimer
Disclaimer
Disclaimer details
Implementing a mobile application in community pharmacies for the purposes of identifying and resolving medication non-adherence is challenging and requires extensive pre-implementation work to mitigate barriers and promote adoption by pharmacy teams and patients.
Project Details -
Completed
-
Grant NumberR18 HS025943
-
AHRQ Funded Amount$1,434,492
-
Principal Investigator(s)
-
Organization
-
LocationWest LafayetteIndiana
-
Project Dates04/01/2019 - 03/31/2024
-
Technology
-
Care Setting
-
Population
-
Type of Care
-
Health Care Theme
Medication adherence--taking medications as prescribed--is critical to treating chronic conditions. Fifty percent of individuals taking at least one regularly scheduled prescribed medication are non-adherent with their medications. Reasons for this are multi-faceted, including forgetting to take a medication, an inability to obtain or afford them, and avoidance due to side effects. Typically, adherence is monitored by prescribing providers during in-person visits or may be informed by prescription fill histories and claims. However, relying on infrequent visits does not provide timely information, and merely filling a prescription does not necessarily mean that an individual is taking their medications as prescribed. Pharmacists may be in a unique position to improve medication non-adherence, given their accessibility and the frequency in which they see patients. The use of patient-reported outcomes (PROs) might allow for the collection of information on non-adherence which may be used by pharmacists and prescribers to improve non-adherence.
The research team implemented and evaluated PatientToc™ - a mobile application for PRO collection originally designed for use in primary care physician practices - in pharmacies to collect information on medication adherence.
The specific aims of the research were as follows:
- Conduct a pre-implementation developmental formative evaluation to determine community pharmacy workflow and current practices for identifying and resolving medication non-adherence, potential barriers, and facilitators to PatientToc™ implementation, and create a draft implementation toolkit.
- Conduct two plan-do-study-act cycles to refine an implementation toolkit for spreading and scaling the implementation of PatientToc™ in community pharmacies.
- Conduct a comprehensive, theory-driven evaluation of the quality of care, implementation, and patient health outcomes of spreading and scaling PatientToc™ to community pharmacies.
Researchers conducted site visits at primary care clinic offices already using PatientToc™ and community pharmacies interested in the future use of PatientToc™ to identify expected barriers, facilitators, and implementation recommendations for community pharmacies, collecting data via semi-structured interviews, observations, and contextual inquiries. Findings from the site visits informed an adaptation of PatientToc™ which was first piloted in three community pharmacies and then fully scaled to 12 pharmacies and evaluated. Overall, in the pilot and the full evaluations, adoption of PatientToc™ was low, only the pharmacist champion at each store used it, and fidelity to the intervention was poor. While generally considered easy to use and appropriate for a community pharmacy, issues with PatientToc™ acceptability and feasibility were still noted.
Disclaimer
Disclaimer details
Disclaimer
Disclaimer details