PRISM Patient Communications and Understanding

Dr. Marie Smith’s consumer focus group research has shown that consumers generally have reservations about pharmacists as integral members of their healthcare teams. These reservations stem from the limited relationships many consumers have with dispensing pharmacists in community retail pharmacies. The consumers had no knowledge of or experience with clinical pharmacists working in non-dispensing roles (i.e., working with primary care physicians or on community-based health teams). Key factors to building consumer acceptance and enthusiasm for pharmacists as patient care providers are: (1) focusing on how pharmacists can be responsible for building or updating patient lists of all medications; (2) educating consumers about the types of advice and recommendations pharmacists can provide to patients and physicians; and (3) highlighting pharmacist-physician collaborations  to manage medications from multiple prescribers,  multiple pharmacies, and non-prescription medications (e.g., OTC drugs, herbal products, nutritional supplements).

Drs. Rachel Eyler and Nathaniel Rickles seek to improve pharmacist communication with patients.  Dr. Eyler has published on motivational interviewing at discharge to help increase patient understanding of and adherence to antibiotic regimens, and has developed a “spinner” decision aid to help describe the risks and benefits of medications, which has recently been published in Medical Decision.   Dr. Rickles has conducted several published studies to describe factors affecting pharmacist-patient communication among vulnerable populations and to evaluate interventions promoting various pharmacist education and monitoring activities in community pharmacies. Dr. Rickles has also explored new approaches to teaching a diverse set of communication skills to pharmacy students.   He has also developed communication models/frameworks that help inform relationships between the patient, the illness, the interaction with pharmacists and other healthcare providers, the treatments, and the outcomes.

Publications in this area include:

Eyler RF, Cordes S, Szymanski BR, Fraenkel L. Utilization of Continuous “Spinners” to Communicate Risk. Med Decis Making. 2017 May 1:272989X17707198.

Eyler R, Shvets K, Blakely ML. Motivational Interviewing to Increase Postdischarge Antibiotic Adherence in Older Adults with Pneumonia. Consult Pharm. 2016 Jan;31(1):38-43.

Young GA, Rickles NM, Benzer J, Dangi A. Management of Medicare Part D prescription drug benefits and medication adherence: a conceptual framework and empirical analysis.  Medical Care 2017 Jan;55(1):37-42.  DOI: 10.1097/MLR.0000000000000591

Rickles NM, Young GA, Hall JA, Noland C, Kim A, Peterson C, Hong M, Hale J. Medication adherence communications in community pharmacies: a naturalistic investigation. Patient Education and Counseling 2016;99:386-392. DOI: http://dx.doi.org/10.1016/ j.pec.2015.10.003

Rickles NM, Furtek K, Malladi R, Ng E, Zhou M. Pharmacy student attitudes and willingness to engage in care with people living with HIV/AIDs.  American Journal of Pharmaceutical Education.2016;80(3):Article 45.

Smith TW, Catney CM, Rickles NM, Hermansen-Kobulnicky CJ, Broeseker AE, Kimberlin CL.  Pharmacy student comfort in communicating with persons with disabilities. Currents in Pharmacy Teaching and Learning.

Rickles NM, Maclean LG, Hess K, Farmer KC, Yurkon AM, Ha CC, Schwartzman E, Law AV, Milani PA, Trotta K, Labella SR, Designor RJ. Teaching medication adherence in US Schools and Colleges of Pharmacy.  American Journal of Pharmaceutical Education. 2012;76(5): Article 79.

Rickles NM, Noland C, Tramontozzi A, Vinici MA. Pharmacy student knowledge and communication of medication errors.  American Journal of Pharmaceutical Education 2010;74:Article 60.

Rickles NM, Brown TA, McGivney MS, Snyder ME, White KA. Adherence: a review of education, research, practice, and policy in the United States. Pharmacy Practice 2010;8:1-17.

Rickles NM. A multi-theoretical approach to linking medication adherence levels and the comparison of outcomes. Research in Social and Administrative Pharmacy 2010;6:49-62.

Noland C, Rickles NM. Reflection and analysis of how pharmacy interns learn to communicate about medication errors.  Health Communication 2009; 4:351-360.

Rickles NM, Tieu P, Myers L, Galal S, Chung V. The impact of a standardized patient program on student learning of communication skills. American Journal of Pharmaceutical Education 2009;73: Article 4.

Smith M, Cannon-Breland M, Spiggle S. Consumer, physician, and payer perspectives on primary care medication management services with a shared resource pharmacists network. Research in Social and Administrative Pharmacy.2014; 10(3):539-553.

Funded grant projects in this area include:

American Foundation for Pharmacy Education (AFPE) Geriatric Fellowship. “A pharmacist-led motivational interviewing intervention to increase post-discharge antibiotic adherence in elderly patients admitted with pneumonia” July 2013.  Sponsor: American Foundation for Pharmacy Education  ($25,000); Primary Investigator: Rachel Eyler.

Tailoring Patient Options for Medication Adherence Action Plans in Community Pharmacies. Sponsor: Patient-Centered Outcomes Research Institute ($40,000 from May 2015 to present); Project Co-leaders: Nathaniel Rickles and David Johnson.

Building the case: changing consumer perceptions of the value of expanded community pharmacist services. Sponsor: Community Pharmacy Foundation ($29,000); Primary Investigator: Marie Smith, Co-Primary Investigator: Kate Steckowych