Projects

Highlighted Project

Implementing and Scaling Electronic Health Record Clinical Support Tools to Optimize Prescribing for Pain Medications

There is a critical need to address the opioid crisis in Jefferson County Wisconsin, where the death rate due to opioids has nearly tripled in recent years. Fort HealthCare (FHC), the primary health care system and only hospital in Jefferson County, has recognized this public health crisis and has been activated to address it. With support from the Cardinal Health Foundation, the Pharmacy Society of Wisconsin and the University of Wisconsin–Madison School of Pharmacy are partnering with Fort HealthCare, Cerner and community pharmacies to promote safe pain medication use and increased dispensing of life-saving naloxone in Jefferson County.

The overarching goals for this 2-year project are:

  • Improve opioid prescribing by prescribers affiliated with FHC through implementation of an EHR-based clinical decision support toolkit
  • Improve the rate of naloxone dispensing to FHC patients
  • Facilitate scalability and sustainability of opioid prescribing improvement and naloxone dispensing

Project Report: Exploring the Use of Opioid-related Best Practice Alerts Across Wisconsin (PDF)

For more information, contact Martha Maurer at mamaurer@wisc.edu.

Project Posters

Active Projects

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RxSocialConnect: Social Isolation and Loneliness Pharmacy Project

Principal Investigator: Mathew A. Letizia, PharmD,  Medical College of Wisconsin – School of Pharmacy

Dates: 12/1/2024-2/28/2025

According to the U.S. Surgeon General Dr. Vivek Murthy, “Our epidemic of loneliness and isolation has been an underappreciated public health crisis that has harmed individual and societal health.” About 33% of adults over 45 report feeling lonely and 1/4 of adults over 65 are considered to be socially isolated. Social isolation increases the risk for early death as much as smoking up to 15 cigarettes a day. Both social isolation and loneliness are associated with serious health impacts including a 29% increased risk of heart disease, a 32% increased risk of stroke, and a 50% increased risk of dementia as well as a significant increased risk for depression and anxiety. Older adults face many risk factors for social isolation and loneliness, such as living with a disability, caregiver responsibilities, loss of transportation, chronic health issues, bereavement, and living alone.

In this project, participating pharmacies/pharmacists in Milwaukee County will administer a brief, 3-question loneliness survey to patients 65 years of age and older who live in Milwaukee County. With consent, those who score “high risk” for loneliness will be referred to a social service provider to determine what risk factors may be contributing to their feelings of social disconnection. Ultimately, patients will be connected with many free or low cost resources, programs, and services provided by the Milwaukee County Area Agency on Aging to address barriers to social connection. Project implementation will continue for 3 months and can be integrated into the pre-existing workflow of the pharmacy and/or clinic site at the days and times that work best.

For additional information please contact: Dr. Mathew Letizia at mletizia@mcw.edu.

Implementing an Intervention to Reduce Misuse of Over-the-Counter Medications in Wisconsin for Hispanic/Latinx Older Adults: A Behind-the-Counter Approach

Principal Investigator: Aaron Gilson, MS, MSSW, PhD

Dates: 9/1/2024-5/31/2025

Most older adults are unaware of OTC safety risks, and are unfamiliar with appropriate OTC dosing or how an OTC medication may interact with their other medications (both OTC and prescription). This factor, coupled with healthcare providers not knowing which OTC medications their patients are consuming, exacerbates the potential for dangerous overdosing (hereafter referred to as misuse). People of Hispanic descent are viewed as being at an even greater risk of OTC misuse.

Behind the counter (BTC) signs were designed as part of a previous study to designate OTC medications that are considered to have a particularly high safety risk when taken chronically – that is, sleep products or combination cough/cold products containing diphenhydramine or doxylamine. These products were then relocated behind the counter (in the pharmacy department) and were accessible only through engagement with a pharmacist. During that study, few participants selected a BTC product and, during the older adult interviews, they reported understanding that the presence of a BTC sign indicated that the medication might be unsafe and that they would not select it. Furthermore, during a series of stakeholder focus groups, pharmacy staff from the participating health system pharmacies were extremely and consistently supportive of moving selected OTC medications from pharmacies’ shelves to an area where they would be the interface for safety information if necessary. The overarching goal for this proposal is to adapt and implement BTC signage for OTC medications in three selected independent community pharmacies in the PearlRx PBRN, and then develop a Toolkit to aid dissemination to other pharmacies.

The following specific aims support this goal:

Aim 1: Conceptualize a BTC signage template, containing both English and Spanish instructions, that would be feasible to adopt into an independent community pharmacy setting.

Aim 2: Implement BTC signage in a small pilot-sample of independent community pharmacies located in Wisconsin areas with a population of people of Hispanic descent above the state average.

Aim 3: Create an Implementation Toolkit providing recommendations and resources for independent community pharmacies that are interested in considering BTC signage for similar products.

For more information on this project, contact Aaron Gilson at aaron.gilson@wisc.edu.

Engineering Resilient Community Pharmacies (ENRICH) Patient Safety Learning Lab

Principal Investigators: Michelle Chui and Jay Ford
Dates: 9/30/23-8/31/27

This project, informed by resilience engineering, will address the challenges common in community pharmacies to achieve safe medication use in community-dwelling complex patients with multiple chronic conditions. The resulting outcome, the Engineering Resilient Community Pharmacies (ENRICH) Patient Safety Learning Lab, is expected to gain knowledge of strategies for building resilience capacity in community pharmacy work systems in conducting chronic care management (CCM). Please visit our website to learn more: https://wwwtest.pharmacy.wisc.edu/faculty/chui-sams-lab/research-project/patient-safety-learning-lab/

The following specific aims support this goal:

Aim 1. Identify and define community pharmacy work system design requirements for safe medication practices to enable resilient performance.

Aim 2. Design and develop MedSafeMap, a feasible and sustainable solution that facilitate safe medication practices through resilient performance.

Aim 3. Implement MedSafeMap in community pharmacies and pilot test its impact on pharmacy staff attitudes, behaviors, and performance.

For more information on this project, contact Katherine Moore:
katherine.moore@wisc.edu

A pharmacist works with a patient to fill in a questionnaire on a tablet

Opioids and Controlled Substances

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Practitioners’ Perceptions Regarding Psychedelic Assisted Therapies for Depression

Investigator: Cody Wenthur, PharmD, PhD

Dates: July 23, 2024 – September 3, 2024

There has been a growing interest in the therapeutic potential of psychedelic agents for application in the mental health and substance use disorder care landscape, especially considering the burden of untreated psychiatric conditions with current standard of care therapies. To aid in the translation of these developmental psychedelic therapies from bench to bedside, it is necessary to gauge the feasibility of such novel treatment approaches from healthcare practitioners, including pharmacists.

With the expanding role of the pharmacist and enactment of pharmacist provider status in Wisconsin, pharmacists may be involved in the dosing and administration of psychedelics, as well as the ongoing monitoring of patients participating in psychedelic-assisted therapy in the future. As the most accessible healthcare practitioner, pharmacist input regarding psychedelic assisted therapies is crucial, especially amidst a mental health care provider shortage.

In this study, we are surveying healthcare practitioners, including licensed pharmacists, physicians, and other advanced practice providers to gauge their opinions and perceived barriers regarding the implementation of psychedelic-assisted therapy to address depression. The data generated from this survey may be incorporated in the development of such psychedelic-assisted therapies and prove valuable for implementation strategies for such treatment options pending FDA approval for general practice.

For more information, please contact Cody Wenthur (wenthur@wisc.edu)

Pharmacy-Based Digital Opioid Safety Intervention

Investigator: Deepika Rao, PhD, MS, BPharm

Dates: April 16, 2024 – May 31, 2024

There was a 16% increase in prescription-opioid involved death rates in 2020, despite the declining trend in opioid prescribing rates observed since 2012. While stricter opioid prescribing guidelines have not sufficiently addressed opioid safety concerns, they have also led to opioid access issues especially among racial and ethnic minority populations. Prevention interventions such as screening education, prescription monitoring programs, and naloxone dispensing can reduce opioid misuse and promote opioid safety, while ensuring appropriate medication access. Community pharmacists are uniquely positioned to offer opioid misuse prevention interventions due to their high accessibility and medication expertise.

However, our initial research identified pharmacist reported implementation barriers including mixed perceptions for the need for change in pharmacy practice and perceived inability to change setting characteristics or workflows significantly to accommodate prevention interventions. Patient-identified needs regarding prevention interventions included opioid and safety education, privacy and convenience through digital rather than in-person formats, messaging in non-stigmatizing language, and improved communication with their healthcare teams. Among the various prevention interventions identified in our prior study, patients prioritized patient-centered opioid safety education while pharmacists highlighted the need for improved naloxone dispensing. Patient-centered digital educational interventions that promote pharmacist roles in opioid misuse prevention are lacking. Thus, there is a critical need to develop a digital opioid safety educational intervention that meets patient needs and promotes pharmacist dispensing of naloxone.

Overall, our objective of this pilot proposal is to develop a prototype of an opioid safety educational tool and evaluate its feasibility and acceptability among pharmacists and patients. Upon successful completion of this project, we will have a first-version prototype and storyboards of the opioid safety prototype educational tool that depicts program look-and-feel, includes program content and delivery approaches, and demonstrates program navigation and flow. We will also collect preliminary usability, feasibility, and acceptability data on this prototype from representative end-user patients and pharmacists. Findings from our pilot project will inform future research on pharmacist roles in prevention of opioid misuse, especially using digital health technologies.

For more information, please contact Dr. Rao at Deepika.M.Rao@dartmouth.edu.

Facilitating the Dissemination of an Opioid Stewardship Framework Across Wisconsin

Investigators: Michelle Chui, PhD, PharmD and David Mott, PhD, FAPhA

Dates: Feb 1, 2021 – Jan 31, 2022

This project aims to develop a toolkit that rural health systems can use to design, implement and evaluate opioid stewardship programs that leverage the electronic health record. This project developed from the successful collaboration between SoP and pharmacy leadership from Fort HealthCare (FHC) in Fort Atkinson, Wisconsin and the Pharmacy Society of Wisconsin.

Over the past two years, FHC has implemented extensive opioid stewardship initiatives, centered around an electronic health record clinical decision support tool. Building on the lessons learned from FHC’s experience, we will develop and disseminate a toolkit of “how to” modules to help health systems design, implement and evaluate opioid stewardship initiatives. Ultimately, the goal is to disseminate the toolkit through PSW channels and a new website linked with PearlRx, to make it available for rural health systems and communities throughout Wisconsin to optimize their opioid stewardship initiatives.

OPIOID STEWARDSHIP TOOLKIT: The free toolkit developed from this project can be accessed at https://wwwtest.pharmacy.wisc.edu/centers/sonderegger-research-center/toolkits/opioid-stewardship/

For more information, please contact Martha Maurer at mamaurer@wisc.edu.

Designing a Patient-Centered Opioid Misuse Screening and Brief Intervention for the Community Pharmacy - Phase 1

Phase 1:  2/9/21 – 4/19/21

Investigators: Olayinka Shiyanbola, PhD, BPharm and Deepika Rao, BPharm, MS

With 1 in 6 Wisconsin adults prescribed an opioid in 2019, there is a critical need to develop a pharmacy-based screening and brief intervention to address opioid misuse while maintaining access to opioid medications for patients who need it. The overall objective of the project is to design a patient-centered opioid misuse screening and brief intervention (SBI) protocol for the community pharmacy setting. The rationale is that addressing patient and pharmacist views in designing the intervention, prior to implementation will lead to the development of an intervention that is more acceptable to patients and more feasible to deliver, with greater chance of successful implementation.

Phase 1, consisting of semi-structured virtual interviews, has been conducted with pharmacists to explore needs and perceptions regarding the SBI. These data will be used to develop implementation measures that can aid future pharmacy-based SBI implementation research. Phase 2 will consist of cognitive interviews conducted with pharmacists to further refine the implementation measures.

Presentations/Publications:

Pharmacists’ Perceptions Regarding CBD and Cannabis-based Products

The use of CBD and cannabinoid related products is continuously on the rise. As the most accessible healthcare provider, it is important that pharmacists are up-to-date with current and accurate information regarding new CBD and other cannabinoid products for medicinal and recreational purposes.

A survey, created by Dr. Magdalena Szaflarski from the University of Alabama at Birmingham, has been adapted by Drs. Natalie Schmitz, Beth Martin, and team at the UW–Madison School of Pharmacy to assess pharmacists’ confidence, understanding and recommendations made to patients regarding CBD and cannabis based products. All responses to the survey will be de-identified and kept confidential.

Closing the knowledge gap of CBD and related products or prescriptions allows patients to seek advice from a trusted source in the community — pharmacists — while also improving our understanding of how CBD and other cannabinoids interact with drugs used in the inpatient setting. The results of this survey will identify what areas to emphasize in didactic coursework for pharmacy students tailor continuing education for practicing pharmacists to ultimately improve patient care.

Publication:

Emmerling S, Martin B, Schmitz NS. “Survey assessing pharmacist perception and recommendations for cannabidiol (CBD) and other cannabinoids.” J Am Pharm Assoc. In press.

Opinions of WI Healthcare Practitioners Concerning the Implementation of Novel Anti-Opioid Therapies for Substance Use Disorder

The Wenthur Lab group at UW–Madison is doing a research study regarding healthcare practitioners’ opinions and experiences regarding the opioid epidemic, access to and use of current treatment methods for opioid use disorder, and pragmatic and ethical concerns surrounding the use of novel vaccine-based treatment methods that are currently in development.

Preprint under review: Wartenweiler VM, Chung GS, Stuart A, Wenthur C. Pharmacy stakeholder reports on ethical and logistical considerations in anti-opioid vaccine development. BMC Medical Ethics.

Please do not hesitate to reach out to Cody Wenthur (wenthur@wisc.edu; 608-265-6743) with any questions about this study.

Addressing the opioid epidemic through community pharmacy engagement: a multi-state study

Investigators: Delesha Carpenter and Kevin Look

Dates: 2019

This multi-state study, supported by the National Institute on Drug Abuse (1R34DA046598-01A1) was conducted to empower rural pharmacists to more frequently and effectively dispense naloxone to prevent opioid overdose deaths in their communities. In the first phase, the investigators gathered formative data on barriers to engaging in naloxone conversations and preferences for naloxone counseling. These interviews were conducted with pharmacists, patients and caregivers across rural communities. In a planned second phase, the investigators will conduct a randomized controlled trial to evaluate whether an online module (Nalox-Comm) increases the frequency of naloxone dispensing.

Presentations/Publications:

lateral view of a brain glowing blue with electric acctivity

Patient Safety

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Preventing Medication Dispensing Errors in Pharmacy Practice with Interpretable Machine Intelligence

Investigator: Corey A. Lester, PhD, PharmD

Dates:

  • Wave 2: September 17, 2024 – October 31, 2024
  • Wave 1: August 24, 2021 – September 15, 2021

Dispensing errors occur approximately 2.4 million times each year in the United States. Artificial intelligence may be employed to assist in the verification process to help improve patient safety and avoid dispensing errors. The first wave of this study recruited pharmacists to act as expert advisors and engage in brainstorming solutions and prototyping designs that could safely and effectively support the verification process in the pharmacy. The second wave is recruiting pharmacists to participate in a mock verification task. The project is funded by a research grant from the NIH National Library of Medicine. If you would like to learn more about this project, please contact: Brigid Rowell at browell@umich.edu.

Preventing medication errors due to unsafe electronic prescription transactions with just-in-time feedback: User centered design

Investigator: Corey Lester, PhD, PharmD

Dates: January 30, 2023 – July 30, 2023

Electronic prescriptions have improved patient safety in some ways, but introduced new types of errors. During e-prescription processing, medication errors occur when the medication prescribed by a physician is a different ingredient, strength, or dosage form compared to the medication dispensed by the pharmacist.

To systematically identify unsafe e-prescription transactions, we developed an algorithm, called System Approach to Verifying E-Prescriptions (SAVE-Rx) that uses e-prescription transaction data to automatically identify cases where the e-prescription drug product description does not match either the e-prescription NDC or the NDC dispensed by the pharmacy. SAVE-Rx identifies mismatches between NDCs and drug product descriptions based on ingredient, strength, and dosage form using a named-entity recognition model and RxNorm drug terminology.

We recruited pharmacists, pharmacy technicians and informaticians to participate in a research study designed to learn about how to best implement a tool to automate the verification that the prescription received matches the prescription dispensed.

For more information, please contact whitmeg@umich.edu with the subject line “SaveRx.”

Publications

  • Whitaker Mhi M, Lester C, Rowell B. Handing Off Electronic Prescription Data From Prescribers to Community Pharmacies: A Qualitative Analysis of Pharmacy Staff Perspectives. J Patient Saf. 2024 May 15. doi: 10.1097/PTS.0000000000001244. Epub ahead of print. PMID: 38742931.

Prevalence and Factors Associated with Compassion Fatigue Among Pharmacists

Investigators: Ejura Yetunde Salihu, MSc., MA, and Betty Chewning, PhD, FAPhA

Dates: Aug 23, 2022 – Sept 18, 2022

Compassion fatigue (CF) is a syndrome closely related to traumatic and complex situations in the work context of healthcare professionals. It is stress from exposure to traumatized individuals or people with chronic conditions. CF in healthcare professionals has been associated with errors in medication management, poor patient care, absenteeism, and staff turnover. In the pharmacy workplace context, compassion fatigue is understudied. Using the Professional Quality of Life (ProQOL) and Brief Resilient Coping Scales, Ejura Yetunde Salihu and Dr. Betty Chewning at the UW–Madison School of Pharmacy assess pharmacists’ perceived compassion fatigue and resilience.

Presentations

Validating a Tool to Measure Pharmacist Fatigue: Implications for the Quadruple Aim

Investigators: Michelle Chui, PharmD, PhD and Taylor L. Watterson, PharmD

Dates: August 13, 2021 – November 29, 2021

As pharmacies continue to expand clinical services and increase prescription volume, the landscape of pharmacy is changing. Workdays characterized by long hours, limited breaks, and mentally challenging tasks can often lead pharmacists to feel strained or rundown by the end of the day. Research in other health professions has identified that employee fatigue often results in negative consequences for patient safety, employee well-being, and employee retention.

A University of Wisconsin – School of Pharmacy research project was conducted to measure the fatigue that community pharmacists experience over the course of a two-week period. Pharmacists were asked to:

  • Wear a specialty fatigue tracking device (similar to a commercial wearable activity tracker, such as Fitbit) on their wrist continuously for 14 day
  • Meet a member of the research team in-person at least once to receive the device
  • Complete 3 surveys (approximately 20 minutes total): a demographic questionnaire, fatigue survey and burnout survey to collection information about you and your experiences with fatigue
  • Participate in a 30-minute interview (via WebEx) to discuss their experiences with fatigue and their tracking device results.

Presentations/Publications:

  • Watterson TL, Chui MA. Subjective Perceptions of Occupational Fatigue in Community Pharmacists. Pharmacy. 2023; 11(3):84. DOI: /10.3390/pharmacy11030084
  • Watterson TL, Steege LM, Mott DA, Ford JH, Portillo EC, Chui MA. Tracking Fatigue: What Wearable Devices Tell Us About Pharmacist Fatigue. American Pharmacists Association Annual Meeting. 2022 March; San Antonio, TX, United States.
  • Watterson TL, Steege LM, Mott DA, Ford JH, Portillo EC, Chui MA. Factors Impacting Occupational Fatigue in Wisconsin Community Pharmacists: A Systems-Based Approach. Midwest Social and Administrative Pharmacy Conference. 2022 July; Chicago, IL, United States. (Abstract Submitted)

Pharmacist Perspectives on a Game-Based Approach to Creating Family Medication Safety Plans

Investigator: Dr. Olufunmilola Abraham PhD, MS, BPharm

Dates: August 24, 2021 – November 29, 2021

The School of Pharmacy at UW–Madison conducted a research study about the use of a serious game and family medication safety plan (FMSP) to educate patients on medication safety.

In this study, pharmacist participants participated in two sessions via Webex. In the first session, they were asked to play the game, “MedSMA℞T: Adventures in PharmaCity,” fill out a post-game survey, and complete an interview. In the second session, they reviewed the FMSP and completed a survey and interview.

Publications:

  • Abraham O, Slonac E, Paulsen Z. Pharmacists’ Perspectives on MedSMA℞T: a serious game to educate youth about opioid safety. J Am Pharm Assoc. Accepted April 20, 2023.
  • Abraham O, Peters J, Peterson KA. Characterizing pharmacist perspectives on utilizing a personalized family medication safety plan for opioid education with adolescents and parents. Pharmacy. 2023; 11(1):22. https://doi.org/10.3390/pharmacy11010022

Preventing Medication Dispensing Errors in Pharmacy Practice with Interpretable Machine Intelligence: Wave 1

Investigator: Corey A. Lester, PhD, PharmD

Dates: August 24, 2021 – September 15, 2021

Dispensing errors occur approximately 2.4 million times each year in the United States. Artificial intelligence may be employed to assist in the verification process to help improve patient safety and avoid dispensing errors. The first wave of this study recruited pharmacists to act as expert advisors and engage in brainstorming solutions and prototyping designs that could safely and effectively support the verification process in the pharmacy. The project is funded by a research grant from the NIH National Library of Medicine. Subsequent phases of this project will recruit pharmacists to test prototype designs and participate in a randomized controlled trial.

Reducing Clostridium difficile infection through ICU fluoroquinolone intervention

Investigator: Dr. Nasia Safdar, MD, PhD

Dates: 2/11/21 – 7/16/21

The infection control research group of Dr. Nasia Safdar obtained funding for an AHRQ proposal to evaluate the effectiveness and feasibility of a fluoroquinolone restriction intervention to reduce the incidence of hospital-acquired Clostridium Difficile infection (CDI) in adult ICUs using clinical decision support within an electronic medical record, supported by hospital-based antimicrobial stewardship teams that include pharmacist representation. More information about the study is available on our website: https://firsttrial.wiscweb.wisc.edu.

Please contact study lead Vishala Parmasad (vaparmas@medicine.wisc.edu) or administrator Shelly Zimbric (mzimbric@medicine.wisc.edu) to learn more about this study.

Building Bridges: Understanding Willingness of Black Americans to Participate in Dementia Research

Investigator: Shenikqua Bouges, MD

Dates: 4/22/21 – 6/2/21

Black Americans are affected by dementia at higher rates than other groups for reasons that are not fully understood. This study is recruiting Black or African American participants ages 45 and older for a voluntary group discussion, a community talk on dementia with a survey, and a medication review session with a survey to better understand this topic.

PearlRx pharmacies volunteered to share the patient flyer and/or a link to an overview video about this project with their patients:

For more information about this project, please contact the Building Bridges Research team at 608-262-2673.

Subjective and Objective Assessment of Pharmacist Fatigue

As pharmacies continue to expand clinical services and increase prescription volume, the landscape of pharmacy is changing. Workdays characterized by long hours, limited breaks, and mentally challenging tasks can often lead pharmacists to feel strained or rundown by the end of the day. Research in other health professions has identified that employee fatigue often results in negative consequences for patient safety, employee well-being, and employee retention.

Participants will wear a specialty fatigue tracking device continuously for 14 days, and they will complete one demographic questionnaire and one fatigue survey.

Please contact Taylor Watterson for questions about this project.

Improving Over-the-Counter Medication Safety in Older Adults — Pharmacist Survey

Michelle Chui, PharmD, PhD, and her research team at the University of WisconsinMadison School of Pharmacy are partnering with pharmacists in Wisconsin to help older adults more safely select and use over-the-counter (OTC) medications. An OTC aisle redesign named the “Senior Section” has been implemented in a few pharmacies and has improved OTC medication safety by heightening awareness of high-risk OTCs and facilitating communication between patients and pharmacists.

A survey was conducted to gain feedback about the feasibility of implementing the Senior Section in community pharmacies. The results from the survey will help us understand if pharmacists think the Senior Section would help older adults select medications more safely, fit into current pharmacy workflow, and if it something pharmacists would consider implementing in their pharmacy.

For more information, contact Jamie Stone at jamie.stone@wisc.edu.

a patient holds an iPad with a medication reminder app

Advancing Pharmacy Services

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Characteristics of Student Members of a Pharmacy Practice-Based Research

Investigators: Katherine Rotzenberg, PharmD, MBA, BCPS; Kajua Lor, PharmD, BCACP; Sarah Ray, PharmD, BCPS, FAPhA; Michael Oldani, PhD, MS

Dates: April 2, 2024 – October 31, 2024

Practice-based research networks (PBRNs) provide a pathway for conducting research in real-world practice settings, gaining insight from front-line health care professionals, and identifying research problems that are of high importance to current practitioners. Most practice-based research networks are comprised of organizational members (such as clinics or pharmacies) or of individual health care professionals (such as dentists or pharmacists). The members of the PBRN may be participants in the research or may have a more collaborative role in conducting a research project. It is uncommon for a practice-based research network to include health care professional students, although they may offer unique perspectives on their respective practice area. PearlRx, the Pharmacy Practice Education and Research Link, is a PBRN of pharmacists, pharmacy technicians, and pharmacy students across Wisconsin, and thus has a unique composition compared to other PBRNs.

In this study, we are surveying the pharmacy student members of PearlRx to explore their characteristics and attitudes towards research. Understanding these characteristics, motivators, and attitudes may help future pharmacy school faculty and researchers create new research opportunities for pharmacy students and further encourage pharmacy research as a whole.

For additional information, please contact Kate Rotzenberg (katherine.rotzenberg@wisc.edu).

Exploring Wisconsin Pharmacist Perceptions on Contraception and Emergency Contraception Following the Overturn of Roe v. Wade

Dates: June 1, 2023 – December 31, 2023

Investigators: Marina Maes, PharmD; Kassandra Bartelme, PharmD; Meng-Jung Wen, MS

Pharmacists are positioned to increase access to and provide education on contraception and emergency contraception which can reduce unintended pregnancy. Therefore, it is essential that pharmacists have the knowledge, skills, and resources to effectively provide these important reproductive healthcare services. However, it is currently unknown how the Supreme Court decision to overturn the landmark case Roe v. Wade in June 2022 is impacting pharmacists’ ability to effectively provide reproductive healthcare services which includes providing access to and education about contraception and emergency contraception.

The objectives of this study were to 1) examine the impact of the overturn of Roe v. Wade on community pharmacist perceptions and comfort in providing reproductive healthcare services in Wisconsin; and 2) determine the effect that community pharmacists’ attitudes, perceived norm, and personal agency have on intention to provide reproductive healthcare services in Wisconsin following the overturn of Roe v. Wade.

We recruited community pharmacists to participate in a survey and optional follow-up interview to understand pharmacist perceptions in the current political climate surrounding reproductive health. The knowledge gained from this work will be used to develop interventions and resources at the state level to decrease barriers for and support pharmacists in providing reproductive healthcare services, and to advocate for expanded access to hormonal contraception through pharmacist prescribing.

For more information, please contact marina.maes@wisc.edu

Evidence-Based Medicine (EBM) in Pharmacy Practice

Investigators:
Dr. Audrey Kostrzewa
Concordia University Wisconsin School of Pharmacy
Dr. Kelly Conn
Wegmans School of Pharmacy

Dates: June 13, 2023 – August 30, 2023

Critically evaluating literature and applying it to practice is paramount to being a pharmacist. Information and evidence are always changing and pharmacists must stay abreast of it to provide high quality care to patients. Placement and depth of evidence-based medicine (EBM) topics within each school or college of pharmacy curriculum can vary greatly which is well documented in the literature. However, there is a gap in the literature for those in practice.

This study sought to understand the ways in which EBM is utilized in practice; by understanding this, we will be able to make informed recommendations for how to improve EBM skills both for those in practice, as well as for students not yet in practice.  We recruited pharmacists to participate in a 10-minute, anonymous survey to share their experience and beliefs surrounding EBM. Participants received a $25 gift card.

For more information, please contact audrey.kostrzewa@cuw.edu

Community Pharmacists' Perspectives on COPD Interventions to Guide Future Implementation

Investigators: Sara Hernandez, PharmD and Jay Ford, PhD

Dates: April 1, 2023 – August 30, 2023

Pharmacist-provided patient care services improve chronic disease management, expand access to care, and decrease the cost of care. Community pharmacists can help improve outcomes such as increased medication adherence and reduced exacerbation risk for patients with COPD through several patient-centered strategies. These include educating patients about their medications and appropriate inhaler technique, supporting medication adherence and self-management, and providing smoking cessation services and vaccinations to decrease the incidence of lower respiratory tract infections.

This project aimed to (1) assess pharmacists’ intentions to employ COPD interventions in community pharmacies and (2) explore pharmacists’ perspectives of COPD management in their practice, their ideal COPD service, and materials and skills necessary to implement the service.  We recruited pharmacists to participate in a survey and optional follow-up interview to inform the development and implementation of a prototype intervention to deliver to patients with COPD in the community setting. We expect that increasing the provision of COPD interventions in community pharmacies will expand patient access to these services and improve outcomes including appropriate inhaler use, immunization rate, and exacerbation risk.

For more information, please contact sehernandez2@wisc.edu

Publications/Presentations:

Engaging Youth, Parents, and Community Pharmacists in the Exploration, Design, and Implementation of a Vaping Prevention Intervention

Investigators: Olufunmilola Abraham, PhD, MS, BPharm, and Jenny Li, PharmD

Dates: August 30, 2022 – July 31, 2023

Electronic cigarettes (e-cigarettes) are the latest innovation in the tobacco industry. Initially developed as a smoking cessation aid for adults, e-cigarettes are the most prevalent tobacco product abused by youth. The Surgeon General calls all healthcare providers to educate and protect adolescents against vaping, and yet, pharmacists have been uninvolved in adolescent vaping prevention. Although pharmacists are historically successful in implementing tobacco cessation programs, they are untapped and underutilized in addressing the youth vaping epidemic.

This project aims to gather the perspectives of pharmacists, adolescents, and parents to develop and test an innovative and sustainable intervention for educating adolescents and their families about e-cigarettes and vaping.

For more information, please contact vapestudy@pharmacy.wisc.edu with the subject line, “EVAPE Study.”

Publications/Presentations:

Expanding Community Pharmacists’ Role in HIV Prevention

Investigator: Maeleigh Tidd, HSRP graduate student

Dates: Survey 6/16/21 – 7/16/21; Interviews 2/18/21 – 4/19/21

The community pharmacist’s role in providing pre-exposure prophylaxis (PrEP) for HIV prevention care has the potential to expand beyond dispensing and medication treatment therapy. However, previous research emphasizes that pharmacists express limited knowledge about PrEP. Pharmacists’ lack of knowledge on successful PrEP care hinders their confidence and comfort with providing effective PrEP-care services in their community pharmacy setting. Still, pharmacists express a willingness to provide advance PrEP-care services in their community practice setting with additional education and training.

Maeleigh Tidd, a graduate student in the Health Services Research in Pharmacy PhD program at the University of Wisconsin-Madison School of Pharmacy, has developed a practiced-based tool to facilitate community pharmacists’ knowledge of and communication with patients to enhance their retention and adherence to PrEP care. Community pharmacists provided constructive feedback to refine the tool during interviews and were subsequently surveyed on the tool’s acceptability and the pharmacists’ intentions to use the tool in practice.

Publications/Presentations:

MILK-PHED: Medication Management in Lactation – A Pharmacist Education Pilot Project

Investigator: Julia Muzzy Williamson, PharmD, CNSC, BCPPS, BCNSP

Dates: 4/28/21 – 5/26/21

A pharmacy research team at North Dakota State University conducted an IRB-approved survey to assess pharmacists’ comfort with providing counseling to patients who are breastfeeding as the first step of a bigger project to create an educational program for pharmacists across the country. By collecting these data, the educational needs and comfort levels can be assessed for pharmacists in a variety of settings including, but not limited to community, ambulatory care, rural hospitals, and medical centers. After the survey data are collected, the research team’s goal is to create an educational program for pharmacists to help bridge any knowledge gap.

Publications/Presentations:

  • Byerley EM, Perryman DC, Dykhuizen SN, Haak JR, Grindeland CJ, Muzzy Williamson JD. Breastfeeding and the pharmacist’s role in maternal medication management: identifying barriers and the need for continuing education. J Pediatr Pharmacol Ther. 2022;27:102-108.
  • Byerley EM, Dykhuizen SN, Haak JR, Grindeland CJ, Muzzy Williamson JD. Medication management in lactation – a pharmacist education pilot project: part one. J Am Pharm Assoc (2003). 2022 Mar 8;S1544-3191(22)00075-9. doi: 10.1016/j.japh.2022.03.003. Online ahead of print.

Exploration of Population Health Management Activities Conducted by Wisconsin Pharmacists

Investigator: Michael Nagy, PharmD, BCACP (mnagy@mcw.edu)

Survey of PearlRx pharmacists in Wisconsin that lays the groundwork to see where we currently sit in the use of population health management by pharmacists and pharmacy learners and what barriers exist for its implementation.

Presentation:

  • Nagy MW, Bell M. Characterization of population health management activities and barriers of Wisconsin pharmacists. JPSW. May/June 2023:29-35.
  • Bell M, Nagy MW. Exploration of population health management activities conducted by Wisconsin pharmacists. Virtually Presented at: 2021 Pharmacy Society of Wisconsin Educational Conference, April 14, 2021. https://www.jpswi.org/jpsw-supplements.html

Public Awareness and Readiness to Access Pharmacist-Led Technology-based Advanced Patient Care Services

As part of a multi-state team, Dr. Olayinka Shiyanbola at the UW–Madison School of Pharmacy is conducting a survey of patients’ awareness and readiness levels to utilize pharmacist-provided care through technology-based solutions in different community pharmacy settings (chain, independent, and grocery). In total, the multi-state survey aims to survey 4,000 patients.

Characterizing Outpatient Pharmacy Services Needed to Support Young People Living with Cystic Fibrosis

Olufunmilola Abraham, PhD, MS, BPharm, Assistant Professor in the Social and Administrative Sciences Division in the University of WisconsinMadison School of Pharmacy has conducted a research study about the role of pharmacists in supporting young people with cystic fibrosis (CF). Pharmacists in any setting who interact with individuals living with CF participated in an interview to learn more about how they support this patient population.

Publications:

Identifying Medication Use Research Priorities in Wisconsin

Five health system pharmacy leaders were interviewed in February and March 2019 about their top medication use problems within their system. Common themes included rising drug prices, drug shortages, reimbursement changes and access to information, and recognition of the value of the pharmacist.

Presentation:

  • Chui MA, Rotzenberg K. “Identifying medication use research priorities in Wisconsin.” Presented at the Pharmacy Society of Wisconsin Educational Conference. Madison WI, April 2019.

Physician Referral for Pharmacist MTM Services

Principal Investigator: David Kreling, PhD

Four physician-PearlRx pharmacist dyads were studied as they navigated the process of patient referral, exchange of patient information, and two-way exchange of plans as the pharmacists helped physicians referred patients aged 65 years and older to better manage their medication regimens.

Presentations:

  • Chewning BA, Kreling DH, Sangasubana N, Hahn D. “The power of physician referral for pharmacist MTM service provision.” Presented at the Pharmacy Society of Wisconsin Annual Meeting, Wisconsin Dells, WI, August 2016.
  • Chewning BA, Sangasubana N, Kreling DH, Petit A, Buckingham W. “Regional comparison of community pharmacies’ pneumococcal immunizations for older adults.” Presented at the Pharmacy Society of Wisconsin Educational Conference, Madison, WI, April 2016.
  • Kreling DH, Sangasubana N, Chewning BA, Hahn D. “Say what? Physician, pharmacist, and patient language differences related to MTM.” Presented at the Pharmacy Society of Wisconsin Educational Conference, Madison, WI, April 2016.
  • Cech CP, Dulak DJ, Gardipee CR. “What works to improve adult immunization 2016.” Presented at the National Adult and Influenza Immunization Summit, Centers for Disease Control.  Atlanta, May 2016.
  • Chewning BA, Petit A, Cech CP. “Partnership between the Wisconsin Immunization Registry and Wisconsin community pharmacies.” Presented at the National Adult and Influenza Immunization Summit, Centers for Disease Control.  Atlanta, May 2016.

PearlRx/WREN Collaboration Interest Survey

Researchers: David Kreling, PhD | BA Chewning, PhD | D Hahn, MD

As a follow-up to the survey in 2013, PearlRx and WREN members were surveyed specifically about possible collaboration on a grant proposal.

Presentations:

  • Chewning BA, Kreling DH, Hahn D. “Joint surveys by pharmacist & physician based research networks on collaboration.” Presented at the 2014 International Social Pharmacy Workshop.  Boston, MA, August 2014.
  • Kreling DH, Chewning BA, Hahn D. “Helping patients manage multiple medications, a primary care physician-pharmacist collaboration.” Presented at the 2014 WREN Convocation of Practices.  Wisconsin Dells, WI, September 2014.

A pharmacist chats with an elderly patient to better understand how her medication regimen is going

Public Health and Immunization

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Shared Decision Making for PCV13 Vaccinations

Investigator: Paul Hunter, MD

Dates: 7/13/21 – 7/28/21

The Wisconsin Research and Education Network (WREN) developed a questionnaire to understand pharmacist views on the pneumococcal conjugate vaccine 13 valent (PCV13) vaccine for adults older than 65 years as part of a quality improvement project, led by Paul Hunter, MD, Associate Professor in the UW-Madison Department of Family Medicine and Community Health. The project aims to develop tools for shared decision making (SDM) for PCV13 vaccinations. The CDC recommends SDM for PCV13 vaccinations for adults 65 and older who do not have an immunocompromising condition, cerebrospinal fluid leak, or cochlear implant. We are interested in pharmacist understanding of and attitudes towards these CDC recommendations, which have changed in recent years.

Please contact WREN at wren@fammed.wisc.edu for more information or questions.

Publications:

COVID-19 Patient Questions Survey

PearlRx is pleased to partner with the Center for Health Enhancement System Studies (CHESS) to provide a reliable and accurate source of COVID-19 information to pharmacists and their patients throughout Wisconsin.

PearlRx members were surveyed regarding the most common patient questions and misinformation they encounter in their practice setting to provide direction for app content that will be most helpful for patients. The app is currently available at www.covid19wisconsinconnect.org, and information will be updated as new information becomes available.

For more information about this project, please contact Marie-Louise Mares at mares@wisc.edu.

Increasing Awareness and Implementation of the Standards for Adult Immunization Practice through Partnership with State and Local Immunization Programs

Principal Investigator: Wisconsin Immunization Registry

The goal is to use various strategies to implement adult immunization standards locally in community pharmacies with PearlRx pharmacists.

Presentations:

  • Chewing BA. “Partnership between the Wisconsin Immunization Registry and Wisconsin community pharmacies.” Presented to Roundtable on Adult Immunizations, The Gerontological Society of America.  Washington DC, November 2017.

Beyond Influenza: One Wisconsin Pharmacy Tests New Protocols to Increase Immunization Rates among Adult Patients

Researchers: CP Cech, PharmD | DJ Dulak, PharmD | CR Gardipee, PharmD |M Girdaukis, RPh | BA Chewning, PhD

An efficient standardized protocol was implemented at a community chain pharmacy with a PearlRx pharmacist to increase adult immunization rates.

Publications/Presentations:

  • Cech CP, Dulak DJ, Gardipee CR. (2015). “Boosting vaccine awareness, administration and WIR use.”  The Journal of the Pharmacy Society of Wisconsin, September/October: 51-52.
  • Publication handout: Beyond Influenza (PDF)

A mom, dad, and their 3rd-grade daughter proudly display their bandaids after getting vaccinated