February 4, 2021

Utilizing community pharmacists to provide a coordinated response to epilepsy care

Epilepsy is among the most common neurological diseases, affecting an estimated 50 million people worldwide. Within Washington state, approximately 75,000 live with epilepsy.

Though treatments exist, epilepsy care is often fragmented and uncoordinated. This directly impacts individual and population health outcomes, leading to significant health and socioeconomic disparities.

In recognition of this critical population health challenge, a team of University of Washington researchers has collaborated to design an intervention model that will engage community pharmacists in implementing population health-based approaches to epilepsy care.

The team combines expertise in pharmacy, neurology and global health and is led by Jennifer Bacci, assistant professor of pharmacy at the UW School of Pharmacy.

Other members of the research team include Steve White, professor and chair of the department of pharmacy at the UW School of Pharmacy; Sabra Zarâa, CHOICE Institute Ph.D. student and pharmacist; John Miller, emeritus professor of neurology at the UW School of Medicine; Edward Novotny, pediatric epileptologist and professor at the UW School of Medicine; and Bryan Weiner, professor at the UW School of Public Health.

The project began with a comprehensive analysis of existing literature on epilepsy care. The research team also conducted informant interviews with healthcare providers, as well as people living with epilepsy and their caregivers.

“This is truly a team effort,” Bacci said. “We have a strong and diverse research team, but also our approach is through stakeholders, bringing all the necessary groups, individuals and parties to the table.”

The project was supported by a Population Health Initiative pilot research grant that was awarded in March 2019. The project goals align with the Population Health Initiative’s vision of improving population health, and the research team exemplifies the merits of interdisciplinary collaboration.

From their analysis and interview findings, the researchers designed three potential interventions for people living with epilepsy that would involve community pharmacists.

Community pharmacists’ comprehensive pharmaceutical background enables them to serve as educators in epilepsy care, monitor dosing accuracy and drug interactions, and improve patient care continuity. Under these proposed intervention models, community pharmacists would maintain and improve the care that people living with epilepsy receive.

“It is a beautiful merging of a need and a group of providers that can meet that need, given community pharmacists’ [role] as drug experts [and] their location right in people’s neighborhoods where they live and work,” Bacci said.

Over 90% of Americans live within five miles of a community pharmacist, making them the most accessible healthcare providers in the country. This allows the proposed model to be cost-efficient and widely accessible.

“This is really important, especially in rural areas, which we’ve learned through our research [on] people living with epilepsy and their caregivers,” Bacci said. “They often don’t have access to the great tertiary epilepsy centers that we have here in Seattle.”

A report of the project outcome was shared earlier this month, highlighting the researchers’ progress and the future of their proposed intervention model.

“[This project] has opened up a new awareness of the relationship between patient and pharmacist, and also increased awareness of the importance of the pharmacist as a team member,” White said.

Through additional funding from global biopharmaceutical company UCB, the research team is now preparing to conduct an initial pilot of their intervention model in several community pharmacies in Washington state.

The team will analyze the acceptability and feasibility of their intervention model, working to refine their design and aiming to expand their intervention model to a national scale in the future.

“Our major goal is to see something positive come out of this for the patient and the caregiver,” White said. “It’s all about making a better life for them.”