(1342) Implementing the Medsma℞t Families Intervention Through Advanced Pharmacy Practice Experiences Student Pharmacists in Wisconsin Community Pharmacies

Objectives: The purpose of this study is to evaluate the reach, implementation, and adoption of the MedSMA℞T Families intervention through PharmD students using this patient-centered tool in community practice. Adolescents and their parents have demonstrated critical knowledge gaps and unsafe behaviors preventing them from appropriately managing prescription opioids in the home, particularly around storage and disposal. Given that pharmacists are uniquely prepared as both medication experts and the most accessible healthcare professionals to combat the growing opioid crisis, the MedSMA℞T Families intervention was developed to meet the needs of adolescents and families, as well as provide pharmacists with additional resources in community pharmacies. This intervention is comprised of a serious game on opioid prescription safety and a Family Medication Safety Plan (FMSP).

Methods: A total of 96 PharmD students will utilize the MedSMA℞T Families intervention during their Advanced Pharmacy Practice Experiences (APPEs), also known as clinical rotations, during the 2023-2024 cycle. APPEs are completed in regions throughout Wisconsin, primarily concentrated in the central, eastern, and northeastern areas. As a part of their community pharmacy APPEs rotation curriculum, all 4th year PharmD students are required to use the MedSMA℞T Families intervention to educate their patients on safe opioid medication use.

PharmD students offer the MedSMA℞T Families intervention to targeted patients via a flyer with a URL to the game and a printout of the FMSP worksheet. All students keep track of how many interventions were offered and how many patients accepted through weekly surveys. Reach is measured by the number of the ‘hits’ received by the unique URL at each site, with each ‘hit’ representing a patient accessing the MedSMA℞T Families site. Moreover, the study team collects site-specific in-game telemetry to track how patients interact with the game. All students attend weekly check-in meetings via Zoom with the study team. The study team will retain field notes from these meetings and email communications for qualitative analysis.

Qualitative and quantitative analysis is guided by the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework to elucidate implementation factors and reach. The primary quantitative outcome is reach, conceptualized as the proportion of interventions offered to patients to number of times the intervention is accepted by patients. Also, the Systems Engineering Initiative for Patient Safety 3.0 model was applied to understand pharmacy-specific socio-technical barriers and facilitators in qualitative data. Primary qualitative outcomes will include communication notes with students focusing on RE-AIM’s Reach, Implementation, and Adoption characteristics and reports of critical incidents delaying site implementation.

Results: To date 35 students have employed MedSMA℞T Families during their rotation at 22 unique pharmacy locations throughout Wisconsin. The community pharmacy locations are in health-system affiliated pharmacies and independent community pharmacies. Settings range from clinic integrated sites to a mail order pharmacy.

Preliminary results are based on the 2 completed rotations to date. Preliminary quantitative reach is currently 58% (126/215). A further 23% (29/126) of patients who accepted the intervention have accessed the game. Preliminary qualitative results demonstrate barriers related to Reach and Implementation aspects including aging participant populations, long-term previous opioid medication usage, and institutional buy-in from administration. Adoption characteristics include site preceptor consistency and rapid workflow changes in community pharmacies.

Conclusions: Preliminary mixed-methods analysis indicates positive impressions of implementing the intervention by students besides issues of patient demographics and pharmacy administration buy-in. Quantitative reach has demonstrated that patients are often willing to accept the intervention in pharmacy. In conjunction, these preliminary results suggest that most community pharmacy settings are acceptable locations to implement novel patient-centered education resources such as games and worksheets, which could provide patients with more robust medication knowledge, in addition to consultation.