Pharmacist Intervention to Close Statin Gaps

Podcast Host Nick Dorich, PharmD, PQS Associate Director of Pharmacy Accounts, talks about pharmacist intervention to close statin gaps with Jennifer L. Bacci, PharmD, MPH, BCACP, Endowed Associate Professor in Innovative Pharmacy Practice at University of Washington School of Pharmacy. She's one of the co-authors of the JAMA article
Community Pharmacist Intervention to Optimize Statin Adherence in Diabetes Care.

In this episode Bacci explains why statin initiation is an important clinical gap for patients with diabetes and how pharmacist involvement can improve patient outcomes.

Transcript

00:00:00:20 - 00:00:23:05
Speaker 1
A one size fits all approach is not the best approach for closing gaps in care. What I mean by that is I think we need to give community pharmacies all the tools they may need to respond to each patient's needs. In some instances, that may be electronic health record connectivity coordinates that an initiation with other members of the care team.

00:00:23:07 - 00:00:35:20
Speaker 1
And in other instances, it may be a collaborative practice agreement to initiate the stand, particularly when patients don't have established primary care provider.

00:00:35:22 - 00:01:00:23
Speaker 2
Welcome to the Pharmacy Quality Solutions Quality corner show where quality measurement leads to better patient outcomes. This show will be your go to source for all things related to quality improvement and medication use and health care. We will hit on trending topics as they relate to performance measurements and find common ground for payers and practitioners. We will discuss how the platform can help you with your performance goals.

00:01:01:00 - 00:01:34:22
Speaker 2
We will also make sure to keep you up to date on pharmacy quality news. Please note that the topics discussed are based on the information available at the date and time of reporting. Information or guidelines are updated periodically and we will always recommend that our listeners research and review any guidelines that are newly published. Buckle up and put your thinking cap on the quality corner show starts now.

00:01:34:24 - 00:02:03:04
Speaker 3
Hello, Quality Corner Show listeners. Welcome to the PQS podcast, where we focus on medication, use quality improvement and how we can utilize pharmacists to improve patient health outcomes. I'm your host, Nick Dortch. Through this podcast series, we cover quite a bit regarding quality measures in health care, but more specifically, we also attempt to look at this through the lens of how pharmacists can be more fully utilized and recognized as a member of the health care team.

00:02:03:06 - 00:02:26:23
Speaker 3
There are barriers to pharmacist involvement often related to the scope of practice, which we know that differs by state or by region or maybe even practice, right. There are barriers related to workflow in pharmacy operations. There's also the hectic approach for a community pharmacy of running both a consumer or patient facing business while trying to manage the details on the back end behind the counter and on your computer.

00:02:27:00 - 00:02:46:02
Speaker 3
And then, of course, there are the difficulties around receiving sustainable reimbursement for the efforts by the pharmacy team. I call that out the pharmacy chain because it's not just the pharmacist, it's often the pharmacy technicians or the pharmacy interns. Those future pharmacists that may be involved with these patient care services. So that brings me to our topic today.

00:02:46:06 - 00:03:07:14
Speaker 3
And this actually starts with a story. A few months ago, as I was reviewing some items from the Journal of the American Pharmacists Association and a study that reviewed the pharmacist ability barriers to initiating and optimizing statin therapy. Now, this was an article that I, of course, had to read, and it just so happened that I'd previously met the lead author.

00:03:07:20 - 00:03:27:05
Speaker 3
So it was very easy for me to reach out to her and say, Hey, would you like to come and talk about this topic on a podcast? So with that, please allow me to introduce our guest for today's show. That is Dr. Jennie Baki, associate professor of pharmacy at the University of Washington School of Pharmacy. Jenny, how are you today?

00:03:27:07 - 00:03:28:23
Speaker 1
I'm great. Thanks for having me back.

00:03:29:04 - 00:03:44:20
Speaker 3
Excellent. Well, Jenny, as I mentioned, you and I have met previously through some ties in the University of Pittsburgh School of Pharmacy. So I know you, but many of our guests may not know you. So do you mind providing a brief background on what you've done in your career? And then what is it that you do today?

00:03:45:01 - 00:04:11:14
Speaker 1
Yeah, absolutely. My journey to where I am now really started as a student when I was working at a supermarket community pharmacy in Pittsburgh. I found a lot of satisfaction and meaning in the relationships that I was able to build with our patients. And then I was also very fortunate because I was a student when pharmacists in Pennsylvania gained the authority to administer vaccinations, which was really cool, and I wanted to get involved.

00:04:11:14 - 00:04:45:12
Speaker 1
So of course I volunteered to help implement the service at my pharmacy. And I think all those experiences really helped me clarify my vision for my career and and for community practice. And that is that I see community pharmacists having responsibility for the medication related needs in the communities in which they practice. So after graduating, I completed a community practice residency, which is I think around the time that you and I met and I did this, to gain the skill set that I would need to make my vision a reality beyond advancing my patient care skills.

00:04:45:12 - 00:05:09:14
Speaker 1
I learned how to implement patient care services in community pharmacy. I had the opportunity to get involved in the Pennsylvania project, which was led by Dr. Jan Pringle and was among one of the first kind of community pharmacy demonstration projects evaluating the impact of pharmacy based interventions on medication adherence. This is my first time really getting involved in practice based research.

00:05:09:16 - 00:05:35:23
Speaker 1
And through it, I learned that research and practice, advancement, practice transformation really go hand in hand. After my residency, I worked full time in Community pharmacy as a pharmacist. It was challenging, but very rewarding, and I got to learn from the many pharmacists and pharmacy technicians that I met along the way. And I kept hearing a similar message from them that they want to do more for their patients but struggled with the how.

00:05:36:00 - 00:06:03:16
Speaker 1
And I was really excited and wanted to help figured that part out. So I actually ended up going back to pharmacy and completing a community pharmacy research fellowship and a master's in public health to develop an expertise in implementation science. And I did that because I believe schools and colleges of pharmacy have a unique ability to convene. And I felt I could better partner and work across organizations to help community pharmacy practice.

00:06:03:18 - 00:06:28:01
Speaker 1
So fast forward to to my current position. As you as you said, I'm a faculty member at the University of Washington School of Pharmacy. My work here really focuses on the application of implementation science to evaluate and advance innovative patient care models and community pharmacy practice. And in other words, I really get to work with our community pharmacy partners to advance practice, which is a really cool job.

00:06:28:03 - 00:06:47:23
Speaker 3
Yeah, it absolutely is. And Jenny, going going back a few few moments, it's amazing how so many stories interconnect us in Pharmacy. You had mentioned your interest in this area started from pharmacist being able to immunize in your state. That's for me. It was that same exact thing. But in the state of Rhode Island, just a few hundred miles away, they got me interested.

00:06:47:23 - 00:07:07:02
Speaker 3
And then, yes, as you're mentioning it, the wheels are turning in my head. And you and I had met at the first initial project research project showing that was held at the University of Pittsburgh for the Pennsylvania project. I got to meet you, Dr. Mcgivney, Dean Crowe, both as well. So a lot of the great folks, Jan Pringle, who you had mentioned.

00:07:07:08 - 00:07:25:21
Speaker 3
So that was where we had originally met. And then life has taken us many different ways, but always great to be able to engage in opportunities like this and see pharmacies that continue to do great things in their career. So, Jennie, before we get into today's questions, I'm going to make sure that I cite or reference your article for our audience.

00:07:25:23 - 00:07:49:09
Speaker 3
So for those listening, if you are driving or doing something like that while listening to the episode, please don't pull up this article while driving. Make sure you pull over to the side, or wait until you are safely parked. But this is from the Journal of the American Pharmacists Association. It's an article titled Community Pharmacist Intervention to Optimize Statin Adherence and Diabetes Care.

00:07:49:11 - 00:08:09:23
Speaker 3
That guide study. So Jennie is listed as the lead author in that study as well, was published earlier this year. So we're going to be talking about this study here in just a moment. Again, I, I would I would recommend that you look that study up and because that's going to contain all the details, we don't have the time to cover all of them today, but definitely recommend that everyone give that a good read.

00:08:10:00 - 00:08:17:19
Speaker 3
So, Jennie, we're going to begin with our questions, but we're first going to hear a quick message from my teammates at PQS.

00:08:17:21 - 00:08:42:08
Speaker 2
Now. It's time for the breakdown as quality corner show host Nick will ask three main topic questions. Our guests will have a chance to respond and there will be some discussion to summarize the key points. This process worksheet for the second and third questions which will wrap up the primary content. So after that, it's next end on a closing summary, usually containing a bonus question.

00:08:42:10 - 00:08:49:12
Speaker 2
Now that we have the start of the process, let's jump into the questions.

00:08:49:14 - 00:09:11:21
Speaker 3
All right, Jenny, So we're ready to begin with the questions for today's episode, focusing on this studies, focusing on statin initiation for patients with diabetes. And there is a common saying that it starts with Y. So we're going to start with that. Why is stat an initiation an increasingly important clinical gap for patients with diabetes?

00:09:11:23 - 00:09:40:03
Speaker 1
I'm a strong believer in starting with Y, so I love this question. You know, statins are highly effective in a relatively low cost way to reduce cardiovascular risk in people with type two diabetes, but we also know that their use and then adherence to statins remains suboptimal, which really makes this an implementation science question What are the most effective techniques to improve statin uptake?

00:09:40:05 - 00:10:03:07
Speaker 1
And we, our team felt that community pharmacists could be one of the strategies to do so. We know that pharmacists have the opportunity to help resolve gaps in care because of their accessibility in the community. We also know that several studies have previously shown positive outcomes from community pharmacist led interventions to identify people with type two diabetes, not on a statin.

00:10:03:09 - 00:10:31:22
Speaker 1
However, in those previous studies, pharmacists were required to contact a prescriber via telephone or fax to get a prescription. I think any of us in community pharmacy are very used to that process, which is really not the most efficient process. So our study was among the first to evaluate a model for community pharmacists initiating statins using a collaborative practice agreement, or as we call them here in Washington state, a collaborative drug therapy agreement.

00:10:31:24 - 00:11:00:00
Speaker 3
Jenny, thanks for that information and introduction so far. I will note we've covered a little bit around pharmacist prescribing and collaborative practice, including with some of your other colleagues in Washington. So I will note that that makes it this study a little bit of a unique aspect that may not be possible in all states yet, but perhaps can I assume that the thought process behind looking at the study was maybe going to show could this be a road map for pharmacists in other states?

00:11:00:00 - 00:11:04:21
Speaker 3
And I see you nodding your head yes, but do you want to expand upon that for our listening audience?

00:11:04:23 - 00:11:39:19
Speaker 1
Yeah, absolutely. You know, we recognize in Washington state we're very fortunate with our progressive pharmacy laws. We've had the ability to intern to collaborative practice agreement sense, oh, 30 or 40 years ago. And we're able to do that at a population level. It's up to the clinicians to determine the care. And so our hope was should we show positive outcomes that this may be data that other states could use to advocate for collaborative practice agreements or other opportunities to optimize their scope of practice?

00:11:39:21 - 00:11:59:20
Speaker 3
Excellent. And before we go to our next question, I'll make sure to note one other item, because I've been very familiar with some of the other research that you mentioned, looking at this topic specifically for statin initiation, particularly in patients with diabetes. There is a quality measure. There is a star rating measure that is tied to this, and it's why this has become an important topic for pharmacists.

00:11:59:20 - 00:12:22:19
Speaker 3
This is a measure that also many pharmacists, if they're familiar with, checking their equip dashboard, they have seen this measure and in many cases have had questions, comments, complaints about this measure. And what we can do to help improve this measure performance. But I think what we've seen from some prior studies that we'll talk about it in a second is that pharmacists do have an ability to impact that measure performance.

00:12:22:21 - 00:12:44:23
Speaker 3
It may be a little bit different based on the state, based on the practice. So if you're good, I think we can get into our next question and and let's go ahead and let's address it. So you have studied this implementation or guidance for pharmacists working with prescribers and really with the patient just as much to close this stat and gap for patients with diabetes.

00:12:45:00 - 00:13:01:09
Speaker 3
So what have your results shown with this study? What's is this more of the same from what we've seen with other other studies in terms of the result or impact? Or is this something where we're seeing really new information that should be furthering additional research and opportunities for pharmacists, provided care?

00:13:01:11 - 00:13:31:21
Speaker 1
Yeah, I think it might be helpful to start by just briefly summarizing the intervention for the listeners. We had pharmacists in nine intervention pharmacies in Washington State proactively identifying patients with type two diabetes, not taking a stand, and they did this using an automated population health alert in their dispensing system. So that alert would pop up. It would give the pharmacist an opportunity to assess whether the patient might be eligible for a statin and then engage them in a conversation.

00:13:32:02 - 00:14:03:04
Speaker 1
If clinically appropriate. The pharmacist could prescribe statin therapy under a collaborative practice agreement, or they could facilitate acquisition of a statin prescription from the patient's preferred prescriber. And they could do this via telephone and via fact and in some instances, electronic health record connectivity. The pharmacist then followed up with patients for one year after statin initiation, and they had some flexibility to use their clinical judgment about when to follow up and how to follow up with patients.

00:14:03:04 - 00:14:32:02
Speaker 1
And they also had the ability within the Collaborative Practice agreement to make adjustments to the statin therapy if the patient was experiencing adherence barriers or experiencing side effects. So our study specifically looked at the impact of the intervention on Staton initiation and statin adherence. What we found was that the intervention resulted in more patients initiating statin therapy and having higher statin adherence as compared to usual care.

00:14:32:04 - 00:14:35:19
Speaker 1
However, the differences were not statistically significant.

00:14:35:21 - 00:14:54:18
Speaker 3
Thank you, Jenny. So looking at this or considering this information, it's this brings a lot of information that we at USC looking at this data. Some of the questions concerns that if pharmacists and pharmacy team members have brought up because you start a patient on a statin that can help with regards to one quality measure in the care for the patient.

00:14:54:20 - 00:15:19:09
Speaker 3
But once a patient starts a statin therapy, obviously they can then become eligible for that other other measure looking at cholesterol or statin adherence. So I really like that your team took the approach to covering not just one, but really both measures in this instance and seeing that, you know, from the standpoint there was a difference as as you mentioned here, looking at the looking at the data from a study perspective, not statistically significant.

00:15:19:09 - 00:15:42:13
Speaker 3
But I also look at this as an opportunity where this is an area requiring or looking at, hey, what's what is there not enough research, enough patient opportunities, As you mentioned, looking at nine pharmacies in a geographical area. So a lot of opportunities going forward. Now, the follow up question I have for you, Jenny, related to this, what did your team see with the pharmacist and with patients?

00:15:42:15 - 00:15:52:12
Speaker 3
What were considered as the most impactful barriers to the successful, successful initiation? What do you think could be changed to get better results?

00:15:52:14 - 00:16:18:17
Speaker 1
Yeah, So we actually also evaluated pharmacist perception of the intervention feasible and their fidelity to the intervention and the pharmacist perceived the intervention to be feasible. But as expected it was very common. The fidelity to the intervention decreased over time and these findings help us understand some of the barriers to continue to improve how we approach closing gaps in care and community pharmacy.

00:16:18:19 - 00:16:54:10
Speaker 1
One of the things that's a particular note too, is that 12 intervention patients or 2.7% of intervention patients initiated a statin prescribed by the pharmacist via a collaborative practice agreement. And so that's significantly lower than what we were hoping or even expecting to find. So of course we wanted to understand why, which gets at your barrier. QUESTION And based on the feedback from pharmacists, you know, it was easiest for them to reach out to the patient's primary care provider via the electronic health record when that option was available.

00:16:54:12 - 00:17:15:10
Speaker 1
And some of that probably comes down to the time involved in doing the prescribing. There may have been point of care testing involved in that versus sending a note in the electronic health record. And Mylan might take away from that is that I think a one size fits all approach is not the best approach for closing gaps in care.

00:17:15:12 - 00:17:42:05
Speaker 1
What I mean by that is I think we need to give community pharmacists all the tools they may need to respond to each patient's needs. In some instances that may be electronic health record connectivity to coordinate statin initiation with other members of the care team and in other instances, it may be a collaborative practice agreement to initiate the stand, particularly when patients don't have established primary care provider.

00:17:42:07 - 00:18:00:00
Speaker 3
Yeah, it's an excellent callout, Jenny, and I'll note I've heard a similar comment when we looked at other pharmacy community pharmacy based research. But even for pharmacy operators in that if a pharmacist or a pharmacy team, if they have one tool, in some ways they might as well have no tools, right? Because it becomes a very cookie cutter approach.

00:18:00:00 - 00:18:23:08
Speaker 3
And sometimes it could be like trying to fit that square peg in the round hole and it's simply not going to work. And if there's an expectation that it is supposed to work, everybody doesn't like that process. So giving the pharmacy team, I would say the autonomy and the education to assess the patient, assess how they need to work with this patient and the patient's provider, primary care provider, other prescribers as necessary.

00:18:23:12 - 00:18:42:15
Speaker 3
Those can be essential elements that are there to lend itself for an experience. It's better for the pharmacy team initiating that work, but then also the patient who is ultimately this is really ultimately for the patient. So speaking of doing things for the patient, Jenny, I'm going to move this to our third question, which in our new format for the Quality Corner show.

00:18:42:17 - 00:19:05:01
Speaker 3
Our third question always focuses on one topic, and that is will, how do we define patient outcomes in this sense? So for you today, I want to ask how does pharmacist involvement with prescribing, initiating or optimizing a medication regimen with with regards to statin therapy in particular, how does this improve patient health outcomes?

00:19:05:03 - 00:19:34:05
Speaker 1
Yeah, I think the long story short is it's one way to make an impact on patient outcomes. But I think that in order to get to our population level goals, we need to combine a variety of approaches. I think with this particular approach, some of the additional lessons learned that I think we could apply just in general to to targeted interventions in community practice.

00:19:34:07 - 00:20:03:14
Speaker 1
A couple of the other things we need to think about moving forward are how we structure patient care workflow in community pharmacies. Time was a challenge in this study, and so thinking about using workflows like the appointment based model or medication synchronization that could create some time in workflow to conduct targeted interventions, particularly when you're prescribing. And there may be a couple of steps involved in that process.

00:20:03:16 - 00:20:44:13
Speaker 1
I think that's an important lesson learned around that prescribing piece and using prescribing pharmacist prescribing to improve outcomes. I think the other thing is patients in our study appeared to desire a collaborative approach to pharmacist prescribing. And so I think that goes back to really thinking about how to better integrate the community pharmacists with the health care team for care coordination beyond faxing and using the telephone, but also increasing the public's awareness of pharmacists having the ability and the competence to prescribe medications.

00:20:44:13 - 00:21:08:00
Speaker 1
It's not something that they're used to seeing us do, particularly for chronic medications like it's done. They may be more used to seeing us do that for vaccines or a short, shorter term medication like an antibiotic or antiviral. And so really being thoughtful about how we engage the public and help them feel more comfortable with pharmacists acting in these in these ways.

00:21:08:02 - 00:21:29:21
Speaker 3
Excellent call outs, Jenny. And actually your mention of the facts, it reminds me of a discussion I had with a recent pharmacy graduate at this year's APA meeting where their comment to me was they've only seen faxes in their lifetime. As someone who's in their early to mid twenties that they see it in health care and they see it in movies set in the 1980s.

00:21:29:23 - 00:22:07:04
Speaker 3
So something there is probably not optimized when it comes to patient care and probably some takeaways that we can learn from that. But Jenny, one follow up question for you. And we are talking about optimizing care for patients with diabetes and the idea around this project was statin initiation, but thinking about improving health outcomes, this may have been involved with your study or there may have been other feedback from pharmacists, but working with this patient population, were there any key considerations from, you know, from the patients or maybe feedback from the pharmacist on, hey, we're discussing statin initiation, but are there other aspects of care for patients with diabetes that could be other key targets

00:22:07:09 - 00:22:19:17
Speaker 3
where we as the health care provider can help meet the patient in a different way? That is really focused on their priority for their health care? So were there any thoughts or considerations? Did that come up at all in this research project?

00:22:19:19 - 00:22:43:04
Speaker 1
It's a great question. We didn't evaluate that, so it didn't really come up in in this particular research project. But I think it's a really interesting future research question, right, Because the goals to be looking at the patient as a whole person in all their health care needs, not just one specific medication that they need. So I think that's a great idea for a research study.

00:22:43:06 - 00:23:00:22
Speaker 3
Well, Jenny, I think whether it's you or other colleagues at the University of Washington or maybe some of your friends that are still at the University of Pittsburgh, you can just send them this clip from this podcast episode. When they have residents, new residents that start in a couple of months. That's the idea for the new research topic, and they can run with it from there.

00:23:00:24 - 00:23:28:12
Speaker 3
Well, Jenny, thank you for the breakdown for the review of today's information. And I'll give us a little bit of summary before we kind of close or wrap up here. But really the idea and what we focused on today is pharmacist engagement, pharmacist intervention on initiating or starting a novel therapy for a patient. In this case, it's we're looking at, particularly for patients with type two diabetes, initiating a statin therapy, which is generally recommended based on clinical guidelines.

00:23:28:14 - 00:24:06:21
Speaker 3
As Jenny said, there has been research on this topic previously and that pharmacists have generally been considered to have a positive effect or positive impact in that regard. But Jenny's study, which again is published in the Journal of the American Pharmacists Association, this was unique compared to some other studies because it was specifically looking at approaching this intervention would be a collaborative practice agreement which may be limited in some states, but that is allowable in the state of Washington, and the results overall were positive in terms of both improving the rate of stat and initiation for those therapies, but then also improving or having a higher PDC rate proportion of days covered, having a higher

00:24:06:21 - 00:24:23:13
Speaker 3
adherence rate for those patients that were new initiated. So, Jenny, kudos to you and to the team. I know you're the lead author on the study, but as I can see, there's about five or six others. So kudos to you. The other authors, of course, the pharmacist that were actively involved with working on this study to improve patient health outcomes.

00:24:23:13 - 00:24:45:23
Speaker 3
So a lot of really great information here. And someone that is passionate about community pharmacy based research, I love to see this type of work. I love to see positive results. And this information really, as you said, we've got additional research topics that we can look at based on this. We'll look forward to more in the future. But Jenny, this takes us to the part of the show where we're going to have some rapid fire questions.

00:24:46:00 - 00:24:53:08
Speaker 3
These may or may not be related specifically to health care or pharmacy, but they may tie in a little bit here. Are you ready to begin?

00:24:53:10 - 00:24:54:23
Speaker 1
Yeah. Let's go.

00:24:55:00 - 00:24:59:20
Speaker 3
All right. First question. Are you a morning person or a night owl?

00:24:59:22 - 00:25:04:18
Speaker 1
Neither. But I guess if I have to pick maybe more. Morning.

00:25:04:20 - 00:25:14:05
Speaker 3
Now, follow up question for you. Have you found that that has changed in your life, being someone that used to live in the Eastern Time Zone and now living on specific time zone.

00:25:14:07 - 00:25:19:22
Speaker 1
I'll be honest, it more so changes with the time of year and whether I'm teaching a lot or not.

00:25:19:24 - 00:25:39:13
Speaker 3
That's a good call, but we haven't heard that answer before and that is one that's probably unique to folks that that are teaching, but definitely a unique answer. I'm sure it's not the last time we're going to We're going to hear that one. Next question for you. Do you prefer to read the book or watch the movie? And if you have any particular examples in mind, we would love to hear it.

00:25:39:15 - 00:25:48:00
Speaker 1
Definitely read the book first and then watch the movie. No particular examples coming to mind, though.

00:25:48:02 - 00:25:54:16
Speaker 3
Fair enough. All right. Next question. What is your number one recommendation to live a healthy life?

00:25:54:18 - 00:26:06:10
Speaker 1
Well, right now, I'm trying to be very intentional about unplugging from technology and taking breaks and really making sure to foster the relationships in my life.

00:26:06:12 - 00:26:24:15
Speaker 3
Excellent, excellent item. My my personal one, Jenny, about removing from technology is 30 minutes before I want to be going to bed. Go to sleep. No technology there. I will note it's more difficult when there are sports on that I really want to watch because you often go from finishing the game and if I want to wait 30 minutes, then it's a later bedtime.

00:26:24:19 - 00:26:33:01
Speaker 3
But it is what it is. I mean, last question here for you, Jenny. What is one goal, personal or professional that you are currently working on?

00:26:33:03 - 00:26:37:08
Speaker 1
Yeah, outside of pharmacy, I'm currently working on learning Italian.

00:26:37:10 - 00:26:45:13
Speaker 3
How is that health? So how far into this are you in? Is are you learning Italian with a specific travel goal in mind down the road?

00:26:45:15 - 00:26:57:12
Speaker 1
I'm still pretty early and I trying to refresh on what I knew as a child and I'm doing it because I'm working on dual citizenship but ineligible for citizenship in Italy.

00:26:57:14 - 00:27:14:14
Speaker 3
Excellent. Love to hear that. That's a great one. And I if I knew any Italian words, I would try to give you some great message right now. But I don't. So, Jenny, I thank you for being on the show today. And before we close, I do want to make sure we give everyone a chance to know where to find you or how to contact you.

00:27:14:20 - 00:27:31:05
Speaker 3
So if anyone has questions related to our topic today, your journal article or other research and work that you're doing at the University of Washington, or they may have questions as it relates to community pharmacy based research, which I know you're very passionate about. But where can folks find you? What's the best way to contact you?

00:27:31:08 - 00:27:41:08
Speaker 1
Yeah, so I invite listeners to reach out to me via email is probably the best way to get in touch with me about UW dot edu and I'm also on LinkedIn.

00:27:41:10 - 00:27:59:03
Speaker 3
Excellent. But Jenny, with that, we have wrapped up today's episode, so I thank you for joining as our guests did a wonderful job and again appreciate the research that you were sharing here with us. And for our listening audience, we thank you for joining us today and we hope you listen to our next episode of The Quality Corner Show.

00:27:59:05 - 00:28:02:07
Speaker 3
But before we go, we have one final message from the PQS team

00:28:02:12 - 00:28:25:03
Speaker 2
The Pharmacy Quality Solutions Quality Corner show has a request for you. Our goal is to spread the word about how quality measurement can help improve health outcomes. And we need your help in sharing this podcast to friends and colleagues in the health care industry. We also want you to provide feedback, ask those questions and suggest health topics you'd like to see covered.

00:28:25:05 - 00:28:47:10
Speaker 2
If you are a health expert and you want to contribute to the show or even talk on the show, please contact us. You can email info at pharmacyquality.com. Let us know what is on your mind, what we can address so that you are fully informed. We want you to be able to provide the best care for your patients and members, and we wish all of you listeners out there well.