Community screening initiatives and use of pharmacy servicesCo-led by Lisa Dolovich and Roopinder Sandhu of the Cardiovascular Health Awareness Program (CHAP) and Jeff Healey of the Population Health Research Institute (PHRI)

Members: Alex Grinvalds (PHRI), Gina Agarwal (CHAP), Kimberly Begley (PHRI) and Nazneen Solkar (PHRI)

Master’s student: Karla Lancaster

The Community screening initiatives and use of pharmacy services project bridges the expertise of OPEN’s medication management researchers with that of two other research groups — the Cardiovascular Health Awareness Program and the Population Health Research Institute.

Its aim is to describe and analyze the use of pharmacy services after a community pharmacy screening initiative and to determine the cost of the screening intervention that community pharmacists provide.

Background and research goals

Community pharmacists are among the most accessible primary healthcare providers, so they are in an ideal position to counsel patients and provide them with expert advice about their medications and therapies.

During the winter of 2014–15, community pharmacists from 20 Rexall Pharmacies across Ontario and Alberta participated in the Program for the Identification of Actionable Atrial Fibrillation (PIAAF) pharmacy trial, an initiative in which patients were screened for atrial fibrillation, hypertension and type II diabetes — thee strong risk factors for stroke.

Using data from the screening trial, project researchers will —

  1. Determine the overall cost to implement and complete the full PIAAF pharmacy study, as analyzed through a discrete-event simulation budget impact model, from the perspective of the pharmacy chain
  2. Describe the use of enhanced professional pharmacy services after the PIAAF pharmacy study
  3. Predict whether at-risk patients are likely to receive pharmacy services based on their characteristics, risk level and screening results
  4. Describe and analyze the perceived effectiveness and feasibility of the in-pharmacy screening initiative from the perspective of community pharmacists

Methods

This project will analyze the overall cost of participating in the PIAAF pharmacy study, provide a descriptive analysis of pharmacy services used after participating in the PIAAF pharmacy trial, and create a multivariate logistic regression model to predict use of pharmacy services by patients at risk.

The project will also include a quantitative analysis and qualitative description of a semi-structured pharmacist questionnaire, which will be sent to participating pharmacists to elicit their opinions on the effectiveness and implementation of the PIAAF pharmacy study.

Implications

The study will investigate whether in-pharmacy screening initiatives such as PIAAF can be used as opportunities for pharmacists to provide pharmacy services to patients at risk for cardio-metabolic disease, and determine if patients who would benefit most from these pharmacist services are receiving them. It will also estimate the costs of such initiatives on community pharmacies, and review the feasibility and effectiveness of the PIAAF study from the perspective of participating pharmacists.