Electronic collection of medication adherence patient-reported outcomes data in community pharmacies: Pilot implementation outcomes.

BACKGROUND: Patient-reported outcomes (PROs) are used to assess a variety of patient experiences including medication nonadherence. Community pharmacists are well-positioned to address medication adherence. OBJECTIVES: The objectives of this study were to 1) determine the adoption, acceptability, feasibility, fidelity, appropriateness, and costs of piloting PatientToc, adapted to collect medication adherence PROs in community pharmacies, 2) pilot an initial implementation strategy for PatientToc including a resource toolkit and external facilitation plan, and 3) identify adaptations to consider for scaling PatientToc to pharmacies beyond this pilot. METHODS: Qualitative and quantitative data were collected, with data sources varying by outcome. Adoption, acceptability, fidelity and feasibility were evaluated with both quantitative (i.e., PatientToc administrative data and/or researcher records) and qualitative data (i.e., interviews and observations.) Appropriateness was evaluated with qualitative data. Costs were evaluated with quantitative data. Quantitative data were analyzed using descriptive statistics. Qualitative interview data were deductively coded. Intra- and inter-site summaries were created to synthesize quantitative and qualitative data to identify potential adaptations to make to PatientToc and/or the implementation plan. RESULTS: Three pharmacies implemented PatientToc for two to three months. Adoption by staff was lower than what had been requested by the study team, resulting in pharmacies using PatientToc with an average (standard deviation, SD) of 27 (14) patients. Moreover, pharmacies demonstrated varying fidelity in using PatientToc as pharmacists completed documentation in 21-100% of patient encounters. Implementation costs included a per-site average of $1280 for equipment, advertisement, and supplies, $290 per month in pharmacy staff time and $630 per month in research support staff time. Community pharmacy teams and patients overall found the use of PatientToc appropriate, acceptable, and feasible but six potential adaptations were identified. CONCLUSION: Implementing an electronic application for collecting and using PROs in community pharmacies was possible but challenging and staff adoption was lower than expected.