STEADI Focus Group Moderator Guide 18MAY2016

Attachment E – STEADI Focus Group Moderator’s Guide

Form Approved

OMB No. 0920-1009

Exp. Date: 3/31/2017

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What degree(s) do you hold? ______________________________

Did/do you hold a residency or other post-graduate appointment?

____ Yes, in the past

____ Yes, currently

____ No

How many years have you been practicing? _____ years

Do you have training or advanced certification in geriatric pharmacy? Please check all that apply.

____ Medication Therapy Management (MTM)

____ Board-Certified Pharmacotherapy Specialists (BCPS)

____ Certification in Geriatric Pharmacy (CGS)

____ Other __________________

Introduction Hello, my name is ______________. I will be moderating this focus group today. Thank you for agreeing to participate. I would also like to introduce _______________. He/she is here to take notes. He/she will not use any names; all responses will be kept confidential outside this room.

Provide basic description of project and project aims

I am a researcher at Altarum Institute. We are partners on a project funded by CDC called STEADI: Stopping Elderly Accidents Deaths and Injuries. The project has several goals. One of them is to develop training for pharmacists to support them in providing fall prevention services for patients 65 and older, who we will call “older adults”.

To do so effectively, it is important to have an accurate understanding of your education and training experiences and preferences, your daily workflow, and the challenges you are likely to encounter. These are the issues this focus group is designed to address.

I am looking forward to hearing your insights and opinions. What we learn from this focus group and others we are conducting will contribute directly to the training materials we develop, the ways in which the training is offered, and the development of tools to support pharmacists in conducting and promoting fall prevention in older adults.

Ask if participants understand the project and their role

Does anyone have any questions about the project?

Do any of you have any questions about your role in the focus group?

Explain how the focus group will operate, including guidelines

This focus group should take no more than 90 minutes.

I’d like to quickly go over some guidelines for how we’ll conduct this session. First, I value everyone’s input, and I hope to hear from each of you throughout the focus group. However, no one is required to speak.

If at any time you must leave the room, you are free to do so.

I encourage everyone to help maintain an open, polite, and orderly environment. Try not to speak over each other. Please, also, silence your cellphones and other electronic devices.

It is likely there will be varied experiences and opinions expressed today. This is actually what we are hoping to hear; we are not looking for everyone to agree.

The focus group will be centered on five main themes. I will introduce each theme by asking a question, and will take some time to ask follow-up questions before moving on to the next theme.

Does anyone have any questions about how the focus group will run?

[If recording: With your permission, we would also like to use an audio recorder for this session, so that we can go back to it as we analyze the information we learn today. Does anyone object to our recording this conversation?

Introductory activity

Great. First, I’m going to ask each of you to state your name, where you practice, and one observation, issue, or belief you have regarding older adults and falls.

Thematic and follow-up questions

Fall Prevention Processes

For the purpose of this focus group, every time we refer to Medication Therapy Management, or MTM, we are referring to the comprehensive medication review process that entails pharmacists making sure that all medications are right for the patient and their health conditions, and that the best possible outcomes from treatment are achieved. This process may be called MTM or medication review depending on your practice site.

The first question I’m going to ask you is, what sort of training have you received in MTM?

What about geriatric pharmacology?

How often do you conduct MTM? Do you have any assistance with this process?

Probe: Interns, pharmacy techs, pharmacy students

How often do you conduct MTM related to fall prevention? How frequently do you suggest medication changes specifically to decrease fall risks?

What medication classes do you associate with falls?

What challenges do you face in conducting MTM in general and for fall prevention?

Probe: Time, reimbursement, other?

What could help overcome these challenges or barriers?

Distribute the SAFE document for viewing by the focus group members

How would the SAFE document help you in conducting a medication review? What else could be included on the SAFE document?

How often do you talk about falls?

What prevents you from talking about falls?

Probe: Time, not comfortable doing it, lack of training

Vitamin D

Are you aware that Vitamin D can prevent falling? Would you willing to recommend Vitamin D in your practice if you receive training?

(If no, why not)

Probe: Feel comfortable (or not comfortable) recommending it, outside of scope of duties? Time prevents?

Fall prevention training

What formal or continuing professional development training on falls have you had?

Where do you go to find on-line training opportunities?

What ways of promoting an online training would you suggest?

CDC recommends that primary care providers ask older adults about falls, review their medications, and recommend vitamin D supplementation at 800 international units. What do you think about pharmacists addressing these three questions as part of fall prevention services?

What challenges would you foresee and what are some solutions to address those challenges?

What sort of training do you think would be helpful for supporting pharmacists in conducting fall prevention?

Communication with healthcare providers

Do you ever communicate with your patient’s prescribing health care provider (HCP) about the patient’s fall risk?

Probes: How frequently? What are the challenges?

What are successful techniques that increase the receptiveness of Healthcare providers to your input regarding concerns or medication changes?

Challenges and strategies

Can you describe for me any challenges or barriers you face in implementing MTM that we haven’t already discussed?

How about challenges in conducting fall prevention screening activities?

What administrative changes would increase adoption of fall risk prevention? How about support tools?

How can we inspire pharmacists to pursue training in this area or engage in regular fall prevention services?

Wrap-up

That was extremely informative. Does anyone have any additional comments or questions before we conclude?

Thank you again for giving us your time.