Preparing Pharmacists to Care for Patients Experiencing Domestic Abuse

AACP Article

Dr. Marie Barnard, recipient of an Academy on Violence and Abuse Scholars Award, advocates for pharmacists to be trained to spot domestic violence and play a bigger role in intervention.

By Emily Jacobs

Intimate partner violence is a serious health issue that affects as many as 27.3 percent of women and 11.5 percent of men in their lifetimes, according to the Centers for Disease Control and Prevention. Domestic violence and abuse can cause both physical and mental health effects, ranging from injuries to worsening chronic conditions to post-traumatic stress disorder. The Academy on Violence and Abuse (AVA), a nonprofit academic organization, aims to advance health education and research on violence and abuse. The AVA Scholars Program is a mentorship program established to help junior researchers conduct high-quality research focused on understanding and limiting the health effects of violence and abuse.

Dr. Marie Barnard, assistant professor of pharmacy administration and research assistant professor in the Research Institute of Pharmaceutical Sciences at the University of Mississippi School of Pharmacy, received a 2020–21 AVA Scholars Award and became the first pharmacy educator to do so. Here she discusses her research on domestic violence and why this is an important but underserved concern for pharmacists.

How did you get involved with this work?

I earned a master's degree in epidemiology at the University of Tennessee Health Sciences Center. My thesis project focused on pregnant victims of domestic violence in Shelby County, Tennessee, and their birth outcomes. I did not intend to work on domestic violence in my doctoral program, but when I started my Ph.D. in pharmacy administration, I realized that no one in pharmacy talks about intimate partner violence. So I began to dig a little bit and learned that pharmacists are the only healthcare provider group that doesn't have some kind of mandatory training [on domestic violence].

This raised some important questions. For example, is training not required for pharmacists because patients never disclose abuse to them? Have any pharmacists received training related to domestic violence? My dissertation project surveyed practicing community pharmacists across the country. We learned that many pharmacists had had a patient disclose abuse, but none of the pharmacists reported that they had received any training about domestic violence.

Ultimately, what I hope to do is to develop an effective [domestic violence] educational intervention for both the pharmacy school environment and continuing education for those who are out of pharmacy school and in practice.

What is the AVA Scholars Program?

AVA offers what they call the Scholars Program every other year. [Recipients] get support from a more senior researcher in the field. They provide mentoring to support you as you conduct a research project. My Scholar Award will support qualitative research to conduct interviews with pharmacists, as well as interviews with victims to examine how could the pharmacy environment best serve these patients.



Ultimately, what I hope to do is to develop an effective [domestic violence] educational intervention for both the pharmacy school environment and continuing education for those who are out of pharmacy school and in practice.

Dr. Marie Barnard

Why does domestic abuse need more attention in the pharmacy setting?

[Pharmacists are] the most accessible healthcare providers there is in many communities. You can walk up to the counter of a pharmacy without an appointment. Pharmacists need to know how to safely respond to a patient who discloses abuse and then how to make what we call a ‘warm referral’ to a community resource that can help the victim.

Domestic violence negatively impacts medication adherence, and it can show up in other ways in the pharmacy environment. For example, it's especially interesting in relation to opioid prescriptions, because victims may appear to be doctor shopping. They may come with opioid prescriptions from multiple hospitals and physicians and this may be because they're moving around providers to try to hide the abuse.

What other support has your work received?

I received an AACP New Investigator Award a year ago. That funding supported the development of a continuing education module and the first implementation and evaluation of the module. I also have a mentor, Dr. Pat Chase, through the AACP Women’s Faculty SIG Cabinet mentoring program. Dr. Chase is fantastic and was really instrumental in me getting the AVA scholar work. She encouraged me to lay out a research agenda with discrete steps, which was a great piece of advice. Everyone thinks, ‘I'm going to get a grant.’ You have to do a lot of work to get ready to apply for a grant, and one piece of that is collecting pilot data. The AVA Scholars Program forced me to put together a proposal about how I could collect pilot data.

I had to have letters of recommendation for this award and [Dr. Chase] wrote one of those letters for me. These kinds of mentorship programs target junior faculty, so they rely on letters of recommendation from another person in the field to say, ‘Yes, this person has the potential to be successful.’ It was really great that I could reach out to her.

What happens next for you?

I will be attending the 2020 AVA Global Health Summit Program virtually Oct. 22–23. I’ll get to meet my mentor. We’ll work through what I propose to do, get feedback and then begin to execute the project. At the same time, I will begin to identify larger funding opportunities for work in this area. I will report on the progress and the project’s outcomes in 2021.

One of the challenges for me is that there really aren't any senior faculty in the academic pharmacy community to serve as a mentor for my work because there are not many others working on this topic. I'm hoping to be matched with a senior faculty member who is experienced in this area and has conducted research and been funded at the federal level in this work.

Emily Jacobs is a freelance writer based in Toledo, Ohio.