Pharmacy, Practice and Policy: Conducting and Translating OPEN

Research Welcome

We will begin shortly.

Please ensure your computer speakers are turned on.

• Welcome! • Housekeeping Notes • Polls • Speaker Introduction

Before we begin…

Fostering innovation and evaluating the effectiveness of Ontario pharmacist-led medication management programs

Kelly Grindrod, BScPhm, PharmD, MSc Co-Lead, Knowledge , Translation and Exchange Theme, OPEN Assistant Professor, School of Pharmacy University of Waterloo

Nancy Waite, PharmD, FCCP Co-Principal Investigator, OPEN Ontario College of Pharmacists Professor in Pharmacy Innovation Associate Director, Practice-Based Education and Professional Outreach Associate Professor School of Pharmacy, University of Waterloo

• What is OPEN? • What will OPEN do? • How can OPEN contribute to the

future of pharmacy and patient outcomes?

• OPEN’s website www.open-pharmacy-research.ca

OPEN Ontario Pharmacy Research Collaboration

OPEN overview • An umbrella organization • Formed to support

pharmacy practice research in Ontario

• Liaise with like-minded individuals across Canada and in other countries

Acknowledgements

OPEN’s current support • Government of Ontario • School of Pharmacy, University of Waterloo • Department of Family Medicine, McMaster

University

The views expressed in this presentation are those of the presenter and do not necessarily reflect those of the funders.

OPEN “Fostering innovation and evaluating the effectiveness of Ontario pharmacist-led

medication management programs”

• This first grant from the government of Ontario is for $5.77 million over 3 years

• Ministry of Health and Long-Term Care, Health System Research Fund Program

• Multi-institutional, interdisciplinary, knowledge-user engaged research

OPEN’s research sites • Approximately 50 interdisciplinary

researchers, staff and students from four Ontario universities and one research institution —

– University of Waterloo – McMaster University – University of Toronto – Western University – Bruyère Research Institute

OPEN’s leadership

• OPEN led by two co-Principal Investigators – Nancy Waite, School of Pharmacy,

University of Waterloo – Lisa Dolovich, Departments of Family Medicine,

Clinical Epidemiology and Biostatistics, and Medicine, McMaster University

• Responsible for OPEN program’s conceptual, scientific and administrative aims

Why this research is important now

• In the midst of healthcare system change and transformation

• Need to better understand value, not just in economic terms but also social

• Need to increase efficiency and coordination of healthcare system and health services

• Inclusion of pharmacy and pharmacists essential to health system integration efforts

• Provide evidence base for medication management policy decisions

• Improve quality of existing services

• Provide a platform to bring diverse stakeholders together

• Contribute expertise to local, regional, provincial, national and international initiatives

Why this research is important now

OPEN’s objectives 1. Provide evidence of the quality, outcomes

and value of recent and emerging medication management services provided by pharmacists

2. Train students and researchers in health services research

3. Foster knowledge translation and exchange between project members, knowledge users and public

4. Improve healthcare of Ontarians, including healthcare needs with respect to gender and vulnerable populations

OPEN – Personnel

• OPEN researchers – 29 www.open-pharmacy-research.ca/about/people/researchers

• OPEN research and administrative staff – 19 and growing www.open-pharmacy-research.ca/about/people/staff

• OPEN students – 16 and growing www.open-pharmacy-research.ca/about/people/staff

OPEN’s MOHLTC-funded research projects

1. Develop and assess a pharmacist services evaluation framework

2. Evaluate existing primary care pharmacist services

3. Evaluate emerging pharmacist services

4. Applied health research questions

1. Develop and assess pharmacist services evaluation framework

• Project lead – Lisa Dolovich • Develop using Delphi panel and

stakeholder consensus • Produce framework and toolkit

to measure pharmacist services outcomes

• To date: literature review, interviews almost complete, related AHRQ question underway

2. Evaluate existing primary care pharmacist services

a) MedsCheck, MedsCheck Diabetes and Pharmaceutical Opinion programs

• Project lead – Linda MacKeigan, U of T, co-lead – Lisa Dolovich, McMaster

Primary question: Impact • What has been the quality and impact of

MedsCheck (annuals and diabetes) and Pharmaceutical Opinion programs on patients, physicians, pharmacies and pharmacists?

Secondary question: Access • Are these services reaching those most

likely to benefit and what are the determinants of service uptake?

2. Evaluate existing primary care pharmacist services

• To date: REB approvals for stakeholder interviews, ICES descriptive database analysis, collaboration with other MedsCheck projects, literature search

b) Pharmacist renewal and adaptation of prescriptions

• Project lead – Lisa McCarthy, U of T

• Establish estimates of early uptake of pharmacist authority to renew and adapt prescriptions

• Inform future health system planning and associated costs

• Currently conducting provincial and national reviews to inform research questions

2. Evaluate existing primary care pharmacist services

c) Pharmacists as immunizers • Project lead – Eric Schneider,

co-lead – Nancy Waite, UW • Findings applied to increase

uptake of influenza immunization

• Pharmacist survey in March, ICES data analysis process started, literature review for patient survey and health care prof focus group, AHRQs started

2. Evaluate existing primary care pharmacist services

3. Evaluate emerging pharmacist services

a) Developing deprescribing guidelines for the elderly

• Project co-leads – Barbara Farrell and James Conklin, Bruyère Research Institute

• Evaluate development and implementation of deprescribing guidelines in long-term care and family health teams

• Development of first guideline for PPI’s in progress, Wikipedia

b) Chronic disease management, with a focus on chronic pain

• Project co-leads – Feng Chang and Tejal Patel, uWaterloo; Beth Sproule, U of T

• Train and evaluate community and family health team pharmacist provision of chronic pain management

• Stakeholder engagement workshop held, pharmacist survey Mar/April

3. Evaluate emerging pharmacist services

c) Pharmacists as prescribers for minor ailments

• Project co-leads – Lisa McCarthy, U of T; Nancy Waite, uWaterloo

• Summit with Ontario stakeholders to gain understanding of perspectives with respect to pharmacist prescribing

3. Evaluate emerging pharmacist services

4. Applied health research questions

• AHRQ lead – Lisa Dolovich, McMaster • 25% of program budget available for AHRQs • Address emerging research questions generated by

knowledge users and vetted by Ministry of Health and Long-Term Care

• Questions relevant to a variety of practice settings • A number of new projects will develop based on AHRQs • More info about AHRQ protocol and procedures at

open-pharmacy-research.ca/research-projects/ahrq

Applied health research questions • The role of outreach/practice facilitation in

pharmacy services – Knowledge user: Ned Pojskic, OPA

– Lead: Lisa Dolovich

• Pan-Canadian medication management planning – Knowledge user: Brent Fraser, MOHLTC

– Lead: Lisa Dolovich

• Smoking cessation – Knowledge user: Ned Pojskic, OPA

– Lead: Suzanne Cadarette

• Other AHRQs being developed and finalized

Cross-cutting program themes • OPEN research is conducted

in tandem with three cross-cutting themes – Knowledge translation

and exchange – Capacity building – Gender and vulnerable

populations

Knowledge translation & exchange • KTE leads – Kelly Grindrod, uWaterloo;

James Conklin, Bruyère Research Institute • Supporting OPEN researchers put research

findings into action through dynamic and iterative KTE strategy

• Develop KTE tools: toolkits, presentations, publications, newsletters, press releases, stakeholder meetings and conferences

Knowledge translation & exchange

• Inquire into facilitators and barriers to KTE using OPEN as a natural laboratory

• Examine impact of OPEN KTE components of Advisory Committee, and AHRQ process

• Encourage and help construct KTE research components of projects

• Work with other cross cutting theme groups to optimize impact

OPEN’s knowledge users Representatives of Ontario organizations that seek research evidence to inform their planning, provision of services, policy and/or program development in the health and healthcare system

• Ministry of Health and Long-Term Care • Ontario College of Pharmacists • Ontario Pharmacists Association • Ontario College of Family Physicians • Canadian Society of Hospital Pharmacists –

Ontario Branch

List of knowledge users will expand over time

Potential knowledge user activities • Partners in OPEN’s research projects

– Input incorporated into project design

• Assist OPEN researchers in project implementation – Recruit practice sites into research studies – Assist with survey development and delivery – Make suggestions to strengthen transferability of findings – Discuss policy and program planning implications – Suggest and implement strategies to disseminate results – Interpret results

• Members of OPEN Advisory Committee

Capacity building: Training & mentoring

• Capacity-building leads – Nancy Waite, uWaterloo, Beth Sproule, U of T

• Undergraduate and graduate students (9 current and 7 previous), postdoctoral fellows, research staff (19) and investigators (29)

• Online modules on orientation, health care systems, GVP and pharmacy practice research

• Webinars • Experiential opportunities

Gender & vulnerable populations • GVP leads – Martin Cooke and Nancy Waite,

uWaterloo • Support and measure the impact of the

incorporation of sex/gender, rural/urban, age, ethnicity/race considerations into data collection and analysis

• Lit review of sex/gender in pharmacy practice research

• Recommended GVP survey questions

OPEN’s administrative and operational structure

More information

Lisa Dolovich ldolovic@mcmaster.ca

(905) 525-9140, ext. 28509

Nancy Waite nmwaite@uwaterloo.ca

(519) 888-4485

OPEN program (519) 888-4412

open@uwaterloo.ca www.open-pharmacy-research.ca

Twitter: @open_pharmacy

Kelly Grindrod kgrindro@uwaterloo.ca

• Please type your questions into the Q&A pod on the right-side of your screen.

• Please contact Kristina Allsopp at research@pharmacists.ca

Questions

• Spring 2014 • Title, Date and Speaker: TBA

Upcoming Pharmacy Research Webinars

• This presentation will be available on the Canadian Pharmacists Association’s website at http://www.pharmacists.ca/index.cfm/education-practice-resources/pharmacy-practice-research/canadian-pharmacy-practice-research-group/cpprg-webinars/

• Thank you to Canadian Pharmacy Practice Research Group

(CPPRG) Executive Committee for hosting this pharmacy research webinar series.

Thank you!