@misc{10481/64888,
year = {2020},
month = {8},
url = {http://hdl.handle.net/10481/64888},
abstract = {Objectives To evaluate an implementation programme of
a community pharmacy medication review with follow-up
(MRF) service using a hybrid effectiveness-implementation
study design, and to compare the clinical and humanistic
outcomes with those in a previously conducted cluster
randomised controlled trial (cRCT).
Setting Community pharmacies in Spain.
Participants 135 community pharmacies and 222
pharmacists providing MRF to polymedicated patients
aged 65 or over.
Intervention The intervention was an implementation
programme for the MRF service. A national level group was
established, mirrored with a provincial level group. A series
of interventions were defined (1) to engage pharmacy
owners with the implementation model and (2) to provide
training to pharmacists consisting of clinical case studies,
process of MRF, communication skills and data collection
methods and (3) practice change facilitators.
Primary and secondary outcome measures The
primary outcomes for the implementation programme
were progress, reach, fidelity and integration. The
secondary outcomes were number of medications,
non-controlled
health problems, emergency visits,
hospitalisations and health-related
quality of life, which
were compared with a previous 6-month
cluster RCT.
Results 55% of pharmacies reached the implementation
phase and 35.6% remained in the testing phase at 12
months. A reach of 89.3% (n=844) was achieved. Fidelity
average score was 8.45 (min: 6.2, max: 9.3) out of 10. The
integration mean score was 3.39 (SD: 0.72) out of 5. MRF
service outcomes were similar to the cluster RCT study;
however, the magnitude of the outcomes was delayed.
Conclusions The implementation of pharmacy services is
a complex multifactorial process, conditioned by numerous
implementation factors. In the absence of remuneration,
the implementation of the MRF service is a slow process,
taking at least 12 months to complete.
Trial registration number CGFTRA-2017-01.},
publisher = {10.1136/bmjopen-2019-036669},
title = {Varas-Doval, R., Gastelurrutia, M. A., Benrimoj, S. I., Zarzuelo, M. J., Garcia-Cardenas, V., Perez-Escamilla, B., & Martínez-Martínez, F. (2020). Evaluating an implementation programme for medication review with follow-up in community pharmacy using a hybrid effectiveness study design: translating evidence into practice. BMJ open, 10(9), e036669. [doi:10.1136/bmjopen-2019-036669]},
doi = {10.1136/ bmjopen-2019-036669},
author = {Varas Doval, Raquel and Gastelurrutia, Miguel Ángel and Benrimoj, Shalom I and Zarzuelo Romero, María José and Pérez Escamilla, Beatriz and Martínez Martínez, Fernando},
}