Designing an Intervention to Reduce Stigma and Bias in Clinical Pharmacist Documentation (ReSPect-2 Study)

Stigmatizing and biased language is prevalent in electronic health record (EHR) documentation. The literature suggests that stigmatizing language has a negative impact on providers' perceptions of patients and patients' health care experiences. Although many health care antistigma campaigns and behaviour change frameworks exist, no strategy has been proven to reduce stigmatizing and biased language in pharmacy documentation.

To design, implement, and evaluate an evidence-based intervention to enhance hospital pharmacists' knowledge of stigmatizing and biased language in EHR documentation and to develop skills to avoid use of such language.

This interventional pre-post study was based on a synchronous interactive workshop on reducing the use of stigmatizing or biased language in clinical documentation offered to pharmacists at 2 acute care hospitals in late 2024. Participants were invited to complete knowledge assessments and surveys before and after the workshop.

Of the 46 eligible clinical pharmacists and best possible medication history pharmacists, 41 (89%) participated in the study. The mean knowledge assessment score improved from 74.1% before to 87.0% after the workshop (increase of 13 percentage points). The proportion of participants selecting "strongly agree" increased from before to after the workshop with regard to topic awareness (30% [12/40] vs 53% [21/40]) and confidence in avoiding stigmatizing or biased language (10% [4/40] vs 30% [12/40]). Most participants strongly agreed that the workshop was engaging (74% [29/39]) and helped them gain a better understanding of the topic (79% [31/39]).

This multimodal knowledge translation strategy improved pharmacists' knowledge about avoiding stigmatizing and biased language in written documentation. Participants described an increase in topic awareness and confidence, with an overall positive learning experience.