Practice Based Research in the Community Pharmacy Stephanie A. - PDF document

12/5/2018 Disclosure • Dr. Gernant has no actual or potential conflict of interest associated with this presentation Practice Based Research in the Community Pharmacy Stephanie A. Gernant, PharmD MS. Assistant Professor, Department of Pharmacy Practice. University of Connecticut School of Pharmacy. 69 North Eagleville Road. Storrs, Connecticut 06269. P: 860 ‐ 486 ‐ 8887 e: stephanie.gernant@uconn.edu Objectives Objectives Why start one? • Define Practice Based Research, and its distinction from drug trials What do they do? Who’s involved? • Describe the history of Practice Based Research Networks • Identify opportunities for and benefits of Practice Based Research in Community Community Pharmacies Pharmacy What does it Research have to do with Networks me? Where are they? (CPRNS) What are they? How does it function? What do you think when you hear “research”? Converting Research to Care Original On average, it takes 17 years to Research Benefits to Patients implement 14% of research findings into clinical care. Original Research Implementation Research Guidelines Peer Review (submission/accep Synthesis tance/publication) • Image adapted from: Ross Brownson. British Sports Medicine. Available from: https://twitter.com/BJSMPlus/status/1052111739146432512 1

12/5/2018 Benefits of Practice ‐ Based Research “Practice ‐ Based Research” • Slow and insufficient use of research findings • Study  Practice = Average 17 years • Only ~14% of findings are implemented into practice • Patients receive only 55% of recommended care • Practice ‐ Based Research address traditional research challenges • Clinicians involved in research process and idea development = quick, useful findings 1) Fraser I. Demand ‐ driven research: working through delivery ‐ based networks. San Diego: AcademyHealth Annual Research Meeting. June 8,2004. 2) McGlynn EA, Asch SM, Adams j, et al. The quality of health care delivered to adults in the United States. N Image from: Gilbert, G . Improving dental care through research . National Institute of Dental and Craniofacial Research; The National Dental Practice ‐ Based Research Network. December, 2014. Available from: Eng J Med 2003;348:2635 ‐ 45. 3) Yawn BP, Graham DG, Bertram SL, et al. Practice ‐ based research network studies and institutional review boards: two new issues. J Am Board Fam Med. 2009;22:453 ‐ 460. [http://www.nidcr.nih.gov/ScienceSpotlight/InterviewsbyTopic/DentalPBRN/Improving ‐ Dental ‐ Care ‐ through ‐ Research.htm] Providers as Investigators: The Early Years 1907, London: “I fear the day may come when a heart specialist will no longer be a physician looking at the body as a whole, but one with more and more complicated instruments working in a narrow and restricted area of the body ….. I had not been long in the practice when I discovered how defective was my knowledge…. I came to recognize that the kind of information I wanted did not exist.” Sir James Mackenzie University of Dundee. Museum Services. https://www.dundee.ac.uk/museum/exhibitions/medical/cardiology/cardiology1/ Brought to Life Science Museum. http://broughttolife.sciencemuseum.org.uk/broughttolife/objects/display?id=93324. James Mackenzie’s first Larry A. Green, MD and John Hickner, MD, MSc. A Short History of Primary Care Practice ‐ based Research Networks: From Concept to Essential Research Laboratories J Am Board Fam Med. 2006 Jan ‐ Feb;19(1):1 ‐ polygraph, United Kingdom, 1906 ‐ 1910 10. Image from: https://www.dundee.ac.uk/museum/exhibitions/medical/cardiology/cardiology1/ Fast Forward: Primary Care in the 1980’s The Arrival of Practice ‐ Based Research Networks • Collaboration between practitioners and researchers • Examine questions that are relevant to real ‐ world practice • Determine results in a rapid and applicable way • Increase generalizability 1) Bakken S, Lantiqua RA, Busacca LV, et al. Barriers, enablers, and incentives for research participation: a report from the Ambulatory Care Research Network (ACRN). J Am Board Fam Med. 2009;22(4):436 ‐ 45. 2) Image from: Wikipedia. Amphiprioninae. Larry A. Green, MD and John Hickner, MD, MSc. A Short History of Primary Care Practice ‐ based Research Networks: From Concept to Essential Research Laboratories J Am Board Fam Med. 2006 Jan ‐ Feb;19(1):1 ‐ 10. Available from: [http://en.wikipedia.org/wiki/Clownfish#Symbiosis_and_mutualism]. 2

12/5/2018 Which is a benefit of PBRNs? A. PBRNs slow down the translation of research findings into clinical practice to protect patients from unproven therapies Clinicians in PBRNs are NOT passive data B. PBRN research is controlled by Universities, so the studies are grounded in collectors theory C. PBRN clinician members must participate in all research studies to increase generalizability D. PBRN research is clinician ‐ driven, to increase translatability into practice What does PBRN Stand for? Today: Agency for Healthcare Research and Quality A. Practice ‐ Based Research Network B. Physician ‐ Based Rapid Notetaking C. Patient ‐ Built Referral Network D. Pharmacist ‐ Based Rapid Notetaking Practice Based Research Networks in New England Types of Practice Based Research Networks Professional Regional Population Condition Images from: 1) National Dental Practice ‐ Based Research Network. Available from: [http://www.nationaldentalpbrn.org/]. 2) Greater Rochester Practice ‐ Based Research Network. Available from: [http://www.urmc.rochester.edu/gr ‐ pbrn]. 3)Stanley Manne Children's Research Institute. Avilable from: [http://www.luriechildrensresearch.org/pprg/]. 4) California Newborn Screening Program. Available from: [http://www.cdph.ca.gov/programs/nbs/Pages/NBSCFParents.aspx] 3

12/5/2018 CPRNs What Institution Registers PBRNS? • Community Pharmacy Based Research Networks (CPRNs) are a type A. Centers for Disease Control (CDC) of Practice Based Research Network (PBRN) • CPRNs are not Service Networks; they are NOT GPO’s: B. Agency for Healthcare Research and Quality (AHRQ) Service Networks CPRNs C. Food and Drug Administration (FDA) Purpose Help pharmacists deliver care to Help pharmacists IDENTIFY AND patients through various resources RESEARCH ways to deliver care to like patients D. Connecticut Commission of Pharmacy Examples Community Pharmacy Enhanced ACCP, RxSafeNet, UConn’s NE ‐ Services Network (CPESN) CPRN Why Research Community Pharmacies? % of patients age ≥ 65 on chronic medication by class Now that I know what a PBRN is, what does this have to do with Community Pharmacy? 1) Pharmacy Times. Pharmacists rank among most trusted professionals. Available from: [http://www.pharmacytimes.com/news/Pharmacists ‐ Rank ‐ Among ‐ Most ‐ Trusted ‐ Professionals]. 2) Dickerson LM Kraus CK, Kuo GM, et al. Formation of primary care pharmacist practice ‐ based research network. Am J Health ‐ Syst Pharm . 2007;64:2044 ‐ 49. 3) National Center for Health Statistics. Health, United States, 2013: With Special Feature on Prescription Drugs. Hyattsville, MD. 2014. PBRNs in Pharmacy Which of the following is True? A. You have to have research experience to be part of a PBRN B. You can’t be a part of a PBRN unless you’re a physician C. Community Pharmacy PBRNs exist, and community pharmacists are a part of them D. Community Pharmacy PBRNs only study insurance claims data : 1) ACCP Research Institute. ACCP PBRN Announces First Research Publication. Available at: [http://www.accp.com/docs/positions /research/MEDAP_Drug_Errors.pdf]. 2) College of Pharmacy ‐ The University of Tennessee Health Science Center. Available from: [http://www.uthsc.edu/pharmacy/] in Feb, 2014. 3) Minnesota Pharmacis Association. Available from: www.poha.org] in Feb, 2015. 4) University of Minnesota College of Pharmacy. Available from: [http://pharmacy.umn.edu] in Feb, 2015. 5) MN Pharmacy Practice Based Research Network. Available from: [http://www.mpha.org/associations/9746/files/PBRN/index.html] in Feb, 2015. 6) Medication Safety Research Network of Indiana. Available from: [http://www.pharmacy.purdue.edu/rx ‐ safenet] in Feb, 2015. 7) Center for the Advancement of Pharmacy Practice within the University of Kentucky College of Pharmacy. Available from: [http://pharmacy.mc.uky.edu/capp/files/CAPPNet_Info.pdf] in Feb, 2015 4