implementation of focus groups in a collaborative ... · background • focus groups increasingly...

Background• Focusgroupsincreasinglyutilizedbyhealthcareresearchers

tounderstandproviderandpatientperspectives• Advantagesoffocusgroups:opendialoguebetween

participants,anabilitytoexpandonanswersafterhearingothers’comments,cost-effectivenessincollectinginformationfrommultiplepeopleatonce

• Oklahoma’sMedicaidprogramoverseenbytheOklahomaHealthCareAuthority(OHCA)andfostercareprogramoverseenbytheDepartmentofHumanServices(DHS)

• ChildreninfostercarecoveredbyMedicaidmorelikelyprescribedpsychotropicmedications1-3

• Nationalorganizationsrecommendstatesdevelopcomprehensivepsychotropicmedicationmonitoringprogramsassessingefficacyandsafety4

• Potentialtoimpactalmost10,000childreninOklahomafostercare(OFC)program5

Methods• Researchteam:StakeholdersfromPharmacyManagement

Consultants(PMC),OHCA,andDHS• StudyDesign:Qualitativefocusgroupsconsistingof

participantsin5importantsegmentswithinOFC• Segments:Inpatienthospitalteams,outpatientproviders,

childwelfarestaff,legalpersonnel,andfosterfamilies• Coveragearea:Recruitmentfromeachofthe5DHSregions

forgeographicalrepresentation• Incentives:Fullmealandgiftcard• Execution: Tworesearchteammembersconductingfocus

groupswithinregions;sessionsaudiorecordedandtranscribed

• DataAnalysis:TranscriptsuploadedintoATLAS.ti®andanalyzedusingtheconstantcomparativemethod

FocusGroupDesign

Implications• IdentificationofcurrentsuccessesandproblemsintheOFCpsychotropicmedicationuseprocess

• ImprovementstoqualityofcareforOFCchildren• Informdevelopmentofpsychotropicmedicationmonitoringprograms

References1. Hoagwood KE,KelleherK,ZimaBT,PerrinJM,Bilder S,CrystalS.Ten-YearTrends

InTreatmentServicesForChildrenWithAttentionDeficitHyperactivityDisorderEnrolledInMedicaid.HealthAffairs.2016;35(7):1266-1270.

2. CrystalS,MackieT,FentonMC,etal.RapidGrowthOfAntipsychoticPrescriptionsForChildrenWhoArePubliclyInsuredHasCeased,ButConcernsRemain.HealthAffairs.2016;35(6):974-982.

3. Zito JM,SaferDJ,SaiD,etal.PsychotropicMedicationPatternsAmongYouthinFosterCare.Pediatrics.2008;121(1):e157-e163.

4. MackieTI,HydeJ,Rodday AM,etal.Psychotropicmedicationoversightforyouthinfostercare:Anationalperspectiveonstatechildwelfarepolicyandpracticeguidelines.ChildrenandYouthServicesReview.2011;33(11):2213-2220.

5. Statistics.OklahomaFostersInitiativewebsite.http://www.oklahomafosters.com/statistics/.AccessedMarch14,2017.

6. Tonna AP,EdwardsRM.Isthereaplaceforqualitativeresearchmethodsinpharmacypractice?Eur JHospPharm.2012;0:1–3.doi:10.1136/ejhpharm-2012-000184.

7. CreswellJW,PlanoClarkV.DesigningandConductingMixedMethodsResearch.2nded.ThousandOaks,CA:SAGEPublications,Inc.;2011.

Objectives• Developacomprehensivepsychiatricmedication

managementsystem• UnderstandlivedexperiencesofpartiesintheOFCprogram

toimprovecommunicationandresourceaccess

DisclosureStatementDrs.Tidmore,Lambert,Nesser,andShropshire havenoconflictsofinterest.Dr.Keast reportscontractualemploymentwiththeOklahomaHealthCareAuthority,anunrelatedresearchgrantfromGileadSciences,Inc,andanunrelatedresearchgrantfromPurduePharma.FundingforthisresearchwasreceivedbyCHIPHealthServicesInitiative.

Implementation of Focus Groups in a Collaborative Assessment of Medication Utilization in the Foster Care System

Laura Tidmore, Pharm.D.,1 Tammy Lambert, Pharm.D., Ph. D.,1,2 Shellie Keast, Pharm.D., Ph.D.,1,2

Nancy Nesser, Pharm.D, J.D.,3 Deborah Shropshire, M.D.41University of Oklahoma College of Pharmacy, 2Pharmacy Management Consultants, 3Oklahoma Health Care Authority 4Oklahoma Dept. of Human Services

Discussion• Notallresearchquestionsappropriatelyaddressedthroughquantitativemethods

• Understandinglivedexperiencesofindividualsaddressescomplexityofhealthcareproblemsandprovidesinsighttoimprovehealthcaredelivery5-6

• Focusgroupsbringtogetherparticipantswhoshareacommonalityandallowresearcherstostudyinteractionsbetweenthem

• Advantagesoversurveys:collectmorespecificinformationingreaterdepth,minimizedconfusionthroughclarificationofquestions,usesparticipants’ownwords,participantsempoweredtoassumeactiveroleinprogramimprovement

FocusGroupSegments

•InpatientPsychiatricTeams•OutpatientProviders•DHSSocialWorkers•LegalSystemProfessionals•FosterParents

Groups

•3- 4groupspersegment•N=15- 20groups

Participants

•6- 8participantspergroup•N=90- 160participants

OklahomaDHSRegions