NACDS Foundation continues to prioritize forward-thinking, patient-centered projects that address gaps in healthcare access, especially in vulnerable and underserved communities. Exploration of new care delivery models to inform transformation of care for pressing public health issues continue to be at the forefront of the Foundation’s research portfolio.
Research Projects
Pharmacies Are Most Cost-Effective Options for Patients with Minor Ailments
Often, patients turn to accessible health care options – urgent care centers, emergency rooms, physicians’ offices, and pharmacies – as the first line of defense for minor ailments, such as an allergic reactions or abrasions. The goal of this project was to apply a physician-pharmacist collaborative practice model to evaluate quality of care, access to treatment and costs for treating patients for a narrow set of minor ailments in community pharmacies as compared to other healthcare settings.
Project Lifeline: A Community Partnership and Research Program to Address Substance Use Disorder
Project Lifeline aims to improve public health through the implementation of SBIRT (Screening, Brief Intervention, and Referral to Treatment), an evidence-based process that involves screening individuals for opioid use disorder (OUD) and substance use disorder (SUD) to determine the provision of appropriate intervention or linkage to care. This project extension in Allegheny County builds off the success of the initial Foundation Project Lifeline research in Blair County, which focused on the feasibility of implementing SBIRT in community pharmacies, while Allegheny County focuses on the sustainability of the model.
Innovative Care Models for Patients at Community Pharmacies
While some progress has been made in healthcare to address medication management through patient care pharmacy services, gaps exist in the current care delivery system to realize the potential of optimizing medications to improve public and population health. In collaboration with UNC Chapel Hill researchers, community pharmacies across the U.S. deliver one of four patient care services which were selected based on a data-driven process that prioritized gaps in population health coupled with solutions feasible to implement within the community pharmacy setting.
Advancing Medication Management
Comprehensive Medication Management (CMM) is a patient care approach to develop individualized medication care plans in collaboration with the patient and the healthcare team to help ensure optimal medication use and outcomes, while reducing avoidable public health and societal costs. This study aims to further analyze CMM, evaluating opportunities for sustainability and impact on patient outcomes, with the goal of allowing more patients to have access to enhanced, individualized, evidence-based care, with the additional goal of improving their medication use and ultimately, their health.
Tuberculosis Testing and Treatment in Community Pharmacies
Tuberculosis testing and latent tuberculosis infections (LTBI) treatments are important public health services, and have been the cornerstone of TB prevention in the United States. The goal of this research project is two-fold: (1) to survey patients and understand their perception of receiving TB testing in a community-based environment and (2) to evaluate patient outcomes and access to care when TB testing and treatment are provided in a community pharmacy setting. The study will also explore models to increase follow-up treatment in an effort to limit transmission.
Gaps in Diabetes Care and Cardiovascular Health
Millions of adults in the United States are living with diabetes, and more are diagnosed every year. With a diagnosis comes an increased risk for other medical conditions and complications, including cardiovascular disease, stroke, and heart attack. To decrease this risk, long-standing research and national guidelines support the addition of statin therapy for most patients with diabetes. Despite these research-based national recommendations, many patients still do not receive this important drug therapy. This project aims to close this care gap by utilizing community pharmacists to address patient needs and overall population health. Through a collaborative agreement, developed with a partnering physician, indicated patients receive community pharmacist-initiated and monitored statin therapy; thus, addressing the gap in statin care.
Pharmacogenomics Testing in the Community
Pharmacogenomics (PGx) and personalized medicine are rapidly growing areas of interest in medicine, and new connections are made every day as to how genes play a role in drug therapy. Many medications are directly influenced by an individual’s genes and effectiveness can vary between patients. PGx testing can have a significant impact on the efficacy of a patient’s medication treatment, but this patient care service is not widely available in the community setting. This project aims to address this issue by: (1) educating pharmacists and other healthcare providers on PGx and personalized medicine so they are prepared to provide this care for their patients, and (2) expanding access to PGx testing for patients.
Applying Pharmacogenomics in Dosing Buprenorphine in Pregnancy
Substance use disorder (SUD) in pregnant women continues to be a significant public health concern as this disease not only affects maternal health, but also the neonate’s health outcomes. Research suggests that using pharmacogenomics to personalize SUD treatment for an individual patient may lead to improved outcomes for both mother and baby. This study aims to expand on this existing research by analyzing: (1) the impact that a mother’s genes may have on dosing requirements for buprenorphine, a common treatment option, and (2) how the mother’s and/or neonate’s genetic composition may influence the baby’s outcomes, including severity of neonatal abstinence syndrome (NAS). Insights from this research may help with the development of a personalized medicine approach to SUD treatment for pregnant women and babies and predict if certain babies will require more intensive treatment for NAS.
Expanding Hepatitis C and HIV Services
Public health authorities continue to stress that early detection among high-risk groups is an essential component of disease management and improved patient outcomes in HIV (human immunodeficiency virus) and hepatitis C. This multi-state initiative evaluates the impact of providing community access to screening for at-risk patients. For patients with reactive tests, immediate linkage to care occurs through collaboration with local public health entities. The U.S. Centers for Disease Control and Prevention (CDC) is providing public health expertise and insight into study design and implementation.