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Table 5 Summary of themes describing “research use” in pharmacist prescriptive authority

From: Use of research evidence varied in efforts to expand specific pharmacist autonomous prescriptive authority: an evaluation and recommendations to increase research utilization

Framework sub-concept Theme in the context of prescriptive authority Quote
Purpose of research use Conceptual: To provide new ideas, understanding, or concepts Used to understand different considerations for prescriptive authority policy “…that our biggest concern, of course, is, you know, around safety… is this a practice that is going to be beneficial for women’s health and not hurt people. And the data is pretty clear with regards to that experience.”
“…one of the things, you know, that research shows us was that there are—one of the barriers for pharmacists actually being able to provide this service is the barrier of getting compensated for the service, reimbursement.”
Instrumental: To directly influence the content or wording of a policy Used to inform components of the policy itself “Our adult immunization rates in [our state] were horrible; I’d say they’re probably the best of the best in the nation now, because of the programme… And so we would basically take that same protocol that we had for immunizations and we would go in and insert in and put in naloxone therapy.”
“We did kind of look at that model as far as how that may work as far as the education, the training that we want to get pharmacists involved in.”
Tactical: To justify or lend weight to pre-existing ideas Used to advocate to healthcare providers and legislators “When we were meeting with some of the folks, in particular, [our state’s] medical association, we did have publications, you know, showing how pharmacists in different settings have helped patients with tobacco cessation.”
Imposed: To meet an organizational requirement Not used very often to motivate research use “We had to have documentation from department of health about what the problem was that was research from them, in terms of state demographics of overdose death rates and that it was being caused by prescription drugs.”
Timing of research use Agenda-setting Helped to assess the need and feasibility to prioritize policy “But we did find in [our state], that the bandwidth of the pharmacies, even to do that brief intervention, because it's not just conducting it, it’s privacy concerns… it’s documentation. It’s the whole process of logistics of actually doing the referral. And so it ended up kind of getting tabled.”
“…needed desperately to get out of being the worst in the country in overdose deaths…”
Policy development Helped to guide policy direction and wording “[the staff member who looked at research evidence for policy] did a lot of the research and a lot of the wordsmithing outside of the meetings, and he would bring us the final documents that we would review…”
Policy implementation, monitoring, and evaluation Helped to look at several metrics to understand impact of policy “And after we had done this, we looked at how many had been prescribed after hours on holidays or on weekends when prescribers are typically closed… But what we found was what we thought would be true. And we found that was that the pharmacists are the most accessible healthcare professional.”
“So the protocol for prescriptive authority was not deemed effective. It did not increase item movement. It did not decrease opioid death rates, opioid overdose death rates in New Mexico. So it was not statistically or clinically significant…. We did see, I don’t want to say, a statistically significant number in naloxone is given out at the pharmacy level, but an increase.”