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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