1. Optimal Prescribing Update and Support (OPUS) Prototype Session 2 March 7, 2012

2. Session Opening Dr. Keith White, MD OPUS takes off and flies

3. 3  Session Opening (15 min)  Report out by Practices (75 min)  Break (15 min)  Feedback on Materials (30 min)  Facilitation Skills (60 min)  Lunch (60 min)  Break out: Presentations Skills, MOA (60 min)  Break (30 min)  Training Video Discussion (30 min)  Engagement Strategy (30 min)  Evaluation (15 min)  Closing Remarks (15 min) Agenda

4. 4  “What’s In It For Me?” (WIIFM) ––> What was “it” for you? Action Period Report Results

5. Report Out by Practices

6. Out of 8 physicians who reported…

7. 7 906 patients were identified How Many Patients were Identified? StatinsPPIs Patient Lists63137 EMR334372 Total397509

8. 8

9. 9 5 GPs reviewed patient charts before visit 4 GPs called in patients to discuss medications 4 GPs flagged charts to identify patients who required medication reviews on next visit Over half of patients were caught at their next regular visit Action Period Activities

10. 10 GPs had discussions about medication changes with 181 patients GPs changed medication in over 54 patients GPs succeeded in tapering or stopping medications in over 45 patients What happened? PPIsStatins 156125 PPIsStatins 35+19 PPIsStatins 26+19

11. 11

12. 12  Give a brief overview of what you did in the action period: › What went well? › What did not? › How did MOAs help? › Suggestions for improvements for your colleagues?  Summary Reports from tables: › Top 2-3 highlights of the action period. › Top 2-3 barriers. › Most common MOA supporting roles. › Suggestions for future action periods. Table Discussions

13. BREAK (15 minutes)

14. Feedback on Materials

15. 15  What worked well?  What didn't work at all?  What needs to be revised? How should it be revised?  What is missing or what would make things make things run more smoothly? Discussion questions

16. Facilitation Skills Helen Roberts, Clippe Communications helenvr@dccnet.com 604 788 9886

17. 17  To help you feel comfortable as a facilitator  To clarify the role of the pharmacy support Purpose

18. 18  The earlier the better  WIIFM - What's In It For Me  Open ended questions  Teaching attitude is different than teaching a skill ! Principle #1: Engage them

19. 19 Your Brain on Questions

20. 20  Engage them with questions  Review purpose and agenda  Your role: Share your story – what you liked  What’s in it for them  Recap Agenda

21. 21  Tell them what you are going to tell them  Then tell them  Then tell them what you told them Principle #2

22. 22  Put questions back to the group  Lean into your partner for help Principle #3: You never need to have all the answers

23. 23  7 + 2 Chunk your information  Attitudes are contagious Principle #4 and 5

24. 24  Presentation Skills – plenary  MOAs – Beijing Room, Second Floor Break out sessions

25. LUNCH (60 minutes)

27. BREAK (15 minutes)

28. Training Video Discussion Malcolm Maclure and Alan Cassels http://www.web.uvic.ca/~studies/

29. 29  Recruit GPs  Rehearse your presentation  Replace or supplement Academic Detailer  Reminders for Action Periods  Additional drugs classes. e4PROS project. Uses of Videos

30. 30  “What’s In It For Me?”  Special Authority Pre-Approval: other drug class?  Other motivators to engage GPs  e4PROS project: e-Education for Prescribing Review  Enabling remote GPs to participate  Option to extend OPUS to other drug classes Engagement Strategy

31. Evaluation Marcus Hollander, PhD & Helena Kadlec, PhD March 7, 2012 Hollander Analytical Services Ltd. 308 -895 Fort Street Victoria, BC V8W 1H7 Tel: (250) 384-2776 Fax: (250) 389-0105 E-Mail: marcus@hollanderanalytical.com helena@hollanderanalytical.com marcus@hollanderanalytical.com helena@hollanderanalytical.com

32. Our Evaluation Approach (Adapted to the Quarterly Learning Session model) Finalize Module Content Everyone in attendance: Session #1 Survey Everyone in attendance: Session #2 Survey Action Period Session #1 Prototyping a PSP Learning Module Session #2 ** TODAY ** Regional Roll-out Report to PSP

33. Findings from Session 1 Prototype Session 1 (Nov 2011)  23 participants who completed the survey (11 GPs, 3 MOAs, 6 Academic Detailers, 3 PSP RSTs)  response rate = 87% Make-up session (Jan 2012)  8 participants completed the survey (7 GPs and 1 Pharmacist)

34. Number and Percentage of Participants Rating their Understanding of Each Topic as “Very Good” or “Good” Topic Prototype Session 1 Make-up session N%N% The overall aims of the OPUS learning session. 12/1392.37 / 887.5 Information contained in an EQIP report. 12/1392.34 / 666.7 Special Authority Pre-approval Agreement. 9/1369.32 / 633.3 The model for improvement employed by PSP. 12/1392.37 / 887.5 Your role in the OPUS initiative. 10/1376.94 / 757.1 Your goals and expectations for the action period. 10/1376.95 / 862.5 Your plans for change during the action period. 9/1181.84 / 757.1 How to engage the local community pharmacist in patients’ care. 3/1323.12 / 825.0 How the new information/handouts will be used in the GP’s practice. 6/1250.05 / 771.4 How you will self-audit charts during the action period. 9/1369.24 / 757.1 How you will monitor changes during the action period. 11/1384.64 / 850.0 Overall level of preparedness for the action period. 9/1275.05 / 862.5

35. Session 1 (Nov 2011) Make-up (Jan 2012) The review of my personal EQIP portrait prior to the learning session, was: helpful to me..................... surprising to me.................. uncomfortable for me.............. 8 (100%) 5 (62.5%) 1 (12.5%) 3 (100%) 1 (33.3%) 0 The discussion of the data limitation (as influenced by a GP’s approach to MSP coding) was helpful to me. 9 (90.0%)3 (75.0%) My understanding of my prescribing patterns was improved by attending the session. 7 (70.0%)4 (80.0%) After attending the session, I understand how I can improve my patient lists 7 (70.0%)4 (57.1%) After attending the session, I feel more comfortable with collabo- rating with the community pharmacist in caring for my patients. 2 (20.0%)1 (14.3%) After attending the session, I feel more comfortable discussing changes in prescriptions with my patients, with regard to: a) Antihypertensives b) Statins c) Proton Pump Inhibitors d) Anticoagulants 9 (90.0%) 10 (100%) 4 (44.4%) -- 7 (100%) -- Number and % of GPs who Agreed or Strongly Agreed

36. The Evaluation Today Please complete the survey at the end of today’s session We appreciate your time and input into this process

37. Closing Comments Dr. Keith White, MD

38. 38

39. 39  Presentation to GPSC of OPUS prototype results  Data strategy approval  e-Education for Prescribing Review & Online Support (e4PROS)  Additional drugs classes may be explored  Evaluation of the provincial OPUS Next Steps