Considerations of Australian community pharmacists in the provision and implementation of cognitive pharmacy services: a qualitative study
Abstract Background Australian federally-funded cognitive pharmacy services (CPS) (e.g. medication management and reconciliation services) have not been translated into practice consistently. These health services are purportedly accessible across all Australian community pharmacies, yet are not del...
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| Format: | Article |
| Language: | English |
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BMC
2021-09-01
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| Series: | BMC Health Services Research |
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| Online Access: | https://doi.org/10.1186/s12913-021-06838-x |
| _version_ | 1818716423631929344 |
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| author | Faith R. Yong Su-Yin Hor Beata V. Bajorek |
| author_facet | Faith R. Yong Su-Yin Hor Beata V. Bajorek |
| author_sort | Faith R. Yong |
| collection | DOAJ |
| description | Abstract Background Australian federally-funded cognitive pharmacy services (CPS) (e.g. medication management and reconciliation services) have not been translated into practice consistently. These health services are purportedly accessible across all Australian community pharmacies, yet are not delivered as often as pharmacists would like. There are international indicators that pharmacists lack the complete behavioural control required to prioritise CPS, despite their desire to deliver them. This requires local investigation. Objective To explore Australian pharmacists’ perspectives [1] as CPS providers on the micro level, and [2] on associated meso and macro level CPS implementation issues. Methods Registered Australian community pharmacists were recruited via professional organisations and snowball sampling. Data were collected via an online demographic survey and semi-structured interviews until data saturation was reached. Interview transcripts were de-identified then verified by participants. Content analysis was performed to identify provider perspectives on the micro level. Framework analysis using RE-AIM was used to explore meso and macro implementation issues. Results Twenty-three participants across Australia gave perspectives on CPS provision. At the micro level, pharmacists did not agree on a single definition of CPS. However, they reported complexity in interactional work and patient considerations, and individual pharmacist factors that affected them when deciding whether to provide CPS. There was an overall deficiency in pharmacy workplace resources reported to be available for implementation and innovation. Use of an implementation evaluation framework suggested CPS implementation is lacking sufficient structural support, whilst reach into target population, service consistency and maintenance for CPS were not specifically considered by pharmacists. Conclusions This analysis of pharmacist CPS perspectives suggests slow uptake may be due to a lack of evidence-based, focused, multi-level implementation strategies that take ongoing pharmacist role transition into account. Sustained change may require external change management and implementation support, engagement of frontline clinicians in research, and the development of appropriate pharmacist practice models to support community pharmacists in their CPS roles. Trial registration This study was not a clinical intervention trial. It was approved by the University of Technology Sydney Human Research Ethics Committee (UTS HREC 19–3417) on the 26th of April 2019. |
| first_indexed | 2024-12-17T19:19:02Z |
| format | Article |
| id | doaj.art-fe27add6533644c69b114a6793ef3dc7 |
| institution | Directory Open Access Journal |
| issn | 1472-6963 |
| language | English |
| last_indexed | 2024-12-17T19:19:02Z |
| publishDate | 2021-09-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Health Services Research |
| spelling | doaj.art-fe27add6533644c69b114a6793ef3dc72022-12-21T21:35:40ZengBMCBMC Health Services Research1472-69632021-09-0121112610.1186/s12913-021-06838-xConsiderations of Australian community pharmacists in the provision and implementation of cognitive pharmacy services: a qualitative studyFaith R. Yong0Su-Yin Hor1Beata V. Bajorek2Discipline of Pharmacy, Graduate School of Health, Faculty of Health, University of Technology SydneyCentre for Health Services Management, Faculty of Health, University of Technology SydneyDiscipline of Pharmacy, Graduate School of Health, Faculty of Health, University of Technology SydneyAbstract Background Australian federally-funded cognitive pharmacy services (CPS) (e.g. medication management and reconciliation services) have not been translated into practice consistently. These health services are purportedly accessible across all Australian community pharmacies, yet are not delivered as often as pharmacists would like. There are international indicators that pharmacists lack the complete behavioural control required to prioritise CPS, despite their desire to deliver them. This requires local investigation. Objective To explore Australian pharmacists’ perspectives [1] as CPS providers on the micro level, and [2] on associated meso and macro level CPS implementation issues. Methods Registered Australian community pharmacists were recruited via professional organisations and snowball sampling. Data were collected via an online demographic survey and semi-structured interviews until data saturation was reached. Interview transcripts were de-identified then verified by participants. Content analysis was performed to identify provider perspectives on the micro level. Framework analysis using RE-AIM was used to explore meso and macro implementation issues. Results Twenty-three participants across Australia gave perspectives on CPS provision. At the micro level, pharmacists did not agree on a single definition of CPS. However, they reported complexity in interactional work and patient considerations, and individual pharmacist factors that affected them when deciding whether to provide CPS. There was an overall deficiency in pharmacy workplace resources reported to be available for implementation and innovation. Use of an implementation evaluation framework suggested CPS implementation is lacking sufficient structural support, whilst reach into target population, service consistency and maintenance for CPS were not specifically considered by pharmacists. Conclusions This analysis of pharmacist CPS perspectives suggests slow uptake may be due to a lack of evidence-based, focused, multi-level implementation strategies that take ongoing pharmacist role transition into account. Sustained change may require external change management and implementation support, engagement of frontline clinicians in research, and the development of appropriate pharmacist practice models to support community pharmacists in their CPS roles. Trial registration This study was not a clinical intervention trial. It was approved by the University of Technology Sydney Human Research Ethics Committee (UTS HREC 19–3417) on the 26th of April 2019.https://doi.org/10.1186/s12913-021-06838-xHealth servicesImplementationTranslationRolePharmacist |
| spellingShingle | Faith R. Yong Su-Yin Hor Beata V. Bajorek Considerations of Australian community pharmacists in the provision and implementation of cognitive pharmacy services: a qualitative study BMC Health Services Research Health services Implementation Translation Role Pharmacist |
| title | Considerations of Australian community pharmacists in the provision and implementation of cognitive pharmacy services: a qualitative study |
| title_full | Considerations of Australian community pharmacists in the provision and implementation of cognitive pharmacy services: a qualitative study |
| title_fullStr | Considerations of Australian community pharmacists in the provision and implementation of cognitive pharmacy services: a qualitative study |
| title_full_unstemmed | Considerations of Australian community pharmacists in the provision and implementation of cognitive pharmacy services: a qualitative study |
| title_short | Considerations of Australian community pharmacists in the provision and implementation of cognitive pharmacy services: a qualitative study |
| title_sort | considerations of australian community pharmacists in the provision and implementation of cognitive pharmacy services a qualitative study |
| topic | Health services Implementation Translation Role Pharmacist |
| url | https://doi.org/10.1186/s12913-021-06838-x |
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