Assistant Professor University of Washington School of Pharmacy Seattle, Washington
Rationale: Epilepsy is a complex spectrum of seizure disorders. People with epilepsy often manage multiple health conditions, take antiseizure drugs with potential adverse effects affecting adherence, and experience fragmented healthcare and community services. Pharmacists are among the most accessible healthcare providers with extensive drug therapy knowledge and who regularly assess medication use patterns and patient outcomes to ensure appropriate medications use. Yet, no models exist for engaging community pharmacists in population health approaches to epilepsy care. The objective of this study was to identify the predisposing, enabling, and reinforcing factors influencing integration of community pharmacists in population health approaches to epilepsy care. Methods: Key informant interviews were conducted with stakeholders, including five people living with epilepsy, ten caregivers of people living with epilepsy, seven epileptologists, one neurologist, one epilepsy nurse, and seven community pharmacists in Washington State and Oregon from September 2019 to February 2020. Interviews were audio recorded, transcribed, and analyzed using a rapid content analysis approach guided by the PRECEDE framework to identify predisposing, enabling, and reinforcing factors influencing integration of community pharmacists in population health approaches to epilepsy care. Predisposing factors were defined as the characteristics or intervention features that would motivate a person to engage in epilepsy care provided by a community pharmacist; enabling factors as the skills, resources, and environment that support epilepsy care provided by a community pharmacist; and, reinforcing factors as the potential pros and cons of epilepsy care provided by a community pharmacist. Results: Four predisposing, four enabling, and five reinforcing factors emerged as influencing integration of community pharmacists in a population health approach to epilepsy care across all stakeholder groups. Predisposing factors included patient advocacy, medication adherence, medication monitoring, and medication education. Enabling factors were a shared vision, collaboration structure, efficient communication, and pharmacist attributes (knowledge, experience, and attitude). Positive reinforcing factors included a team approach, in-person support, and improved outcomes. Negative reinforcing factors were duplicate or discordant care and limited time and resources. Conclusions: Findings suggest there are several predisposing, enabling, and reinforcing factors influencing integration of community pharmacists in population health approaches to epilepsy care. These factors will inform the development of a community pharmacist integrated population health intervention. Funding: Please list any funding that was received in support of this abstract.: University of Washington Population Health Initiative and UCB, Inc.
