Qualitative study on the implementation of professional pharmacy services in Australian community pharmacies using framework analysis
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Show full item recordEditorial
Biomed Central
Materia
Health services Health plan implementation Communication Health services research Health services administration Pharmaceutical services
Date
2016Referencia bibliográfica
Moullin, J. C.; Sabater Hernández, D.; Benrimoj, S. I. Qualitative study on the implementation of professional pharmacy services in Australian community pharmacies using framework analysis. BMC Health Services Research, 16: 439 (2016). [http://hdl.handle.net/10481/49912]
Sponsorship
The study was funded as part of a University of Technology Sydney (UTS) Research Excellence Scholarship (RES), comprising of an Australian Postgraduate Award (APA) Scholarship funded by the Australian Government, plus a Top-up funded by the University of Technology Sydney, received from the primary author (JCM).Abstract
Background: Multiple studies have explored the implementation process and influences, however it appears there
is no study investigating these influences across the stages of implementation. Community pharmacy is attempting
to implement professional services (pharmaceutical care and other health services). The use of implementation
theory may assist the achievement of widespread provision, support and integration. The objective was to investigate
professional service implementation in community pharmacy to contextualise and advance the concepts of a generic
implementation framework previously published.
Methods: Purposeful sampling was used to investigate implementation across a range of levels of implementation in
community pharmacies in Australia. Twenty-five semi-structured interviews were conducted and analysed using a
framework methodology. Data was charted using implementation stages as overarching themes and each stage
was thematically analysed, to investigate the implementation process, the influences and their relationships. Secondary
analyses were performed of the factors (barriers and facilitators) using an adapted version of the Consolidated
Framework for Implementation Research (CFIR), and implementation strategies and interventions, using the
Expert Recommendations for Implementing Change (ERIC) discrete implementation strategy compilation.
Results: Six stages emerged, labelled as development or discovery, exploration, preparation, testing, operation
and sustainability. Within the stages, a range of implementation activities/steps and five overarching influences
(pharmacys' direction and impetus, internal communication, staffing, community fit and support) were identified.
The stages and activities were not applied strictly in a linear fashion. There was a trend towards the greater the
number of activities considered, the greater the apparent integration into the pharmacy organization. Implementation
factors varied over the implementation stages, and additional factors were added to the CFIR list and definitions
modified/contextualised for pharmacy. Implementation strategies employed by pharmacies varied widely.
Evaluations were lacking. Conclusions: The process of implementation and five overarching influences of professional services implementation
in community pharmacy have been outlined. Framework analysis revealed, outside of the five overarching influences,
factors influencing implementation varied across the implementation stages. It is proposed at each stage, for
each domain, the factors, strategies and evaluations should be considered. The Framework for the Implementation of
Services in Pharmacy incorporates the contextualisation of implementation science for pharmacy.
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