1. Joint Commission of Pharmacy Practitioners (JCPP)
Dissemination and Implementation Sciences and Their Applications in Pharmacy: PART 2 Terry L. Seaton, Pharm.D., BCPS, FCCP
Joint Commission of Pharmacy Practitioners (JCPP)
Alexandria, Virginia
August 2, 2016

2. Applications of Implementation Science in Pharmacy Terry Seaton, PharmD, BCPS, FCCP President, ACCP Professor, St. Louis College of Pharmacy

3. Session Objectives
Propose practical applications of D&I science in pharmacy practice
Stimulate interest in D&I science and encourage professional pharmacy organizations to promote and support its integration (tremendous opportunity for inter-organizational collaboration)
Briefly list examples of pharmacy-related IS research

4. My Perspective Primary care clinician (family medicine) 14 years
Informatics researcher—clinical decision support using clinical prediction rules and guideline implementation—7 years
Sabbatical in dissemination and implementation research (DIR core in our CTSA with Washington University in St. Louis) in 2013
Clinical pharmacist with local ACO (Track 3) 3 years

5. A Blank Canvas—Opportunities Abound
Pharmacy
Practice
Implementation
Dissemination

6. Example
Objective: Identify barriers and facilitators to pharmacist integration into PACT (VA)
Methods:
Perspective—non-pharmacist team members
Qualitative—Semi-structured telephone interviews of clinicians and administrators from all 22 PCMH teamlets (n = 423) in a pilot Midwest launch
51 interviewed
27 a second time, 1 year later, focusing on pharmacy
Patterson. Res Social Adm Pharm 2014;11:85-95.

7. Example (Cont.) Results:
Roles and activities were influenced by previous experiences and attitudes
Coordination with pharmacists was hindered if communications were burdensome to team members
Integration ranged from “none” to “essential”
Reluctance attributed to knowledge deficits and lack of pharmacist participation in PACT training
Patterson. Res Social Adm Pharm 2014;11:85-95.

8. ACCP Grant Update CMM effectiveness and implementation
IRB approval, informed consent, and training
Aim 1: Assess baseline demographics, the state of CMM within each practice, and practitioner and organizational capacity for CMM service development, refinement, and expansion
Engaged a multidisciplinary team of implementation scientists (National Implementation Research Network)

9. Applying Research Principles to Practice

10. Online Model Selection

11. Consolidated Framework for Implementation Research (CFIR)
“Fostering implementation of health services research findings into practice: a consolidated framework for advancing implementation science”
Merges key theories and constructs to eliminate overlap
Standardizes terminology
Designed for multiple contexts
Five major domains and 29 constructs
Damschroder. Implementation Science 2009, 4:50

12. Online CFIR Guide

13. Research Priorities Pharmacy
Technology and the medication use system (e.g., clinical decision support, telepharmacy)
Clinical pharmacy services (e.g., impact on quality and cost in ACOs)
Pharmacogenomics
Care transitions and medication reconciliation
Education—starting from scratch (e.g., curricular revision and interprofessional education)
Many others!
June, 2016

14. Specific Contextual Frameworks
Developing and Assessing Contextual Frameworks for Research on the Implementation of Complex System Interventions
Patient-Centered Medical Home (PCMH)
Process Redesign
Care Transitions
Purpose: To guide research on how, why and where interventions succeed or fail to achieve intended outcomes
AHRQ Publication No. 14-EHC014-EF, March 2014

15. CF-Care Transitions

16. Grid-Enabled Measures (GEM)
Measures Database
Grid-Enabled Measures (GEM)

17. Health IT Surveys

18. Challenges to Implementation
Time
Documentation of progress
New information technology
Costs
Management of growth
Ignorance or push-back from providers and patients
Lack of leadership
Perceived lack of value by practice, clinicians, patients
Difficulty obtaining outcome data
Lack of organizational structure
Reimbursement is moving target
Measuring impact of complex interventions

19. Themed Issue—IS in Pharmacy
Papers due August 5, 2016
Guest Editors: Sarah J. Shoemaker, PhD, PharmD and Geoffrey Curran, PhD
Anticipated publication in May, 2017
Research in Social and Administrative Pharmacy (RSAP)

20. Call to Action! Professional Organizations in Pharmacy
D&I sciences are here to stay…
Time to act is now
Examine our organization’s Mission
Strategically plan to include SMART objectives that incorporate D&I principles
If have official journal, then ensure opportunities available to publish rigorous D&I research
Consider opportunities to foster and support professional development and research opportunities for members

21. Terry L. Seaton, PharmD, FCCP, BCPS
Contact Information
Terry L. Seaton, PharmD, FCCP, BCPS
Professor
St. Louis College of Pharmacy

22. Questions or Comments? Thank you!