A Closer Look at the Health Outcomes PRN
Overview of the PRN
The Health Outcomes Practice and Research Network (PRN) is a small, but mighty PRN. We currently have 157 members, and they are a talented and diverse group. We have 26 trainees, 9 non-Pharm.D. members (excluding trainees), 11 with a Ph.D. degree, 31 with a Pharm.D. plus a master’s and/or Ph.D. degree, 1 with three (!) post-bachelor’s degrees, 58 with specialized training (e.g., board certification), and 6 outside the United States, and 26 of our members report working at academic institutions. We were first recognized as a PRN by the American College of Clinical Pharmacy (ACCP) in 1994. At that time, the PRN was called the Outcomes and Economics PRN and had 337 members. The PRN adopted its current name in 2007 to be more inclusive and to reflect the evolution of health outcomes in clinical pharmacy.
The PRN’s goals are as follows:
- Facilitate communication between ACCP members regarding developments in the application of outcomes and economics techniques in clinical practice, research, and educational environments
- Enhance the knowledge of ACCP members in the field of outcomes and economics
If you are doing a research project (we see you, residents and fellows), are interested in research, or don’t yet know if you’re interested in research, join our PRN! Research is a universal skill that will open doors of opportunity, even outside the world of pharmacy.
Opportunities and Resources
Our small membership means that we have lots of opportunities for leadership and involvement in our PRN. There are two committees, one for our Travel Awards and another that plans our yearly business/networking meeting and our research webinars. Our research webinars are an awesome resource and opportunity for trainees. Every few months, experts in our PRN speak about research methods and their research, or a trainee/investigator shares some research in progress in order to get feedback and direction from other PRN members. These also provide a space for membership to discuss ongoing research and collaboration opportunities. We’re also working on our social media presence and will be updating our PRN website with relevant data, including upcoming research webinars and other PRN-related news.
We routinely sponsor three travel awards to the ACCP Annual Meeting, where trainees can share the research they’ve been working on at our PRN business meeting. We also sponsor or co-sponsor a focus session every year at the Annual Meeting. This year, we will also be sponsoring our second annual Paper of the Year Award to highlight the amazing research and work of our members.
Current Clinical Issue – Opportunities for Expanding Pharmacist Practice Through Shared Decision-Making
As more clinical guidelines recommend shared decision-making (SDM) in practice – with notable examples being cancer screening and stroke prevention in atrial fibrillation – it is imperative that pharmacists understand what SDM is and how to implement and participate in SDM at their practice sites.1 SDM increases patient knowledge, patient confidence, and participation in care and may lead to lower costs through patients tending to choose more conservative treatments.2,3 For some areas of pharmacy where new medications are decreasing workload (i.e., direct oral anticoagulants and warfarin), SDM offers an opportunity for pharmacists’ future roles in these positions. SDM is becoming an increasing area of patient care improvement and research, with PCORI (Patient-Centered Outcomes Research Institute) currently funding 55 clinical effectiveness studies on SDM in a wide variety of practice areas. However, although many SDM interventions are aimed at physicians and mid-level providers, few are aimed at pharmacists.
So, what is SDM? It is a collaborative conversation between patients and their clinicians regarding health care decisions.4 SDM is particularly effective when decisions are complex and influenced by individual patient values and when there is a general level of clinical equipoise.4 An important aspect of SDM is sharing all risks and benefits of treatment options, including the option of no treatment. However, SDM does not place the decision entirely on the patient (Figure).5 Rather, it gives patients a chance to recognize how what is actually important to them affects the decisions that may be best for them. SDM is often supported by decision aids. These can be given to a patient before a visit or used during a visit with a clinician. One of the main barriers to SDM is time constraints from providers, even though studies have shown that decision aids and SDM do not add a significant amount of time to a visit.6,7 Pharmacists are provided an opportunity to partner with physicians, nurse practitioners, and physician assistants to assist in medication-focused decisions that may require SDM. Even without decision aids, however, the concepts behind SDM can make a huge difference and improve the way we communicate with our patients.
We believe that SDM is the future of health care and that pharmacists should be at the forefront of this change. If you want to learn more about SDM and how to implement it in your own practice, please check out our PRN-sponsored focus session at the ACCP Annual Meeting in October in San Francisco, where we will be learning from experts about SDM and implementation science. We hope to see you there!
- January CT, Wann LS, Alpert JS, et al. 2014 AHA/ACC/HRS guideline for the management of patients with atrial fibrillation: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the Heart Rhythm Society. Circulation 2014;130:e199-267.
- Haynes RB, McKibbon KA, Kanani R. Systematic review of randomised trials of interventions to assist patients to follow prescriptions for medications. Lancet 1996;348:383-6.
- Stacey D, Legare F, Col NF, et al. Decision aids for people facing health treatment or screening decisions. Cochrane Database Syst Rev 2014;1:CD001431.
- Elwyn G, Frosch D, Thomson R, et al. Shared decision making: a model for clinical practice. J Gen Intern Med 2012;27:1361-7.
- Kramb G. The Importance of Shared Decision Making. September 19, 2020. Available at https://www.rightdevice.com/blog/articles/the-importance-of-shared-decision-making.
- Scalia P, Durand MA, Berkowitz JL, et al. The impact and utility of encounter patient decision aids: systematic review, meta-analysis and narrative synthesis. Patient Educ Couns 2019;102:817-41.
- Kunneman M, Branda ME, Hargraves IG, et al. Assessment of shared decision-making for stroke prevention in patients with atrial fibrillation: a randomized clinical trial. JAMA Intern Med 2020;180:1215-224.
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