Abstract
BackgroundAustralian 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.ObjectiveTo explore Australian pharmacists’ perspectives [1] as CPS providers on the micro level, and [2] on associated meso and macro level CPS implementation issues.MethodsRegistered 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.ResultsTwenty-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.ConclusionsThis 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 registrationThis 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.
Highlights
Introduction and general participant informationResearcher will provide an overview of the goals and min purpose of the discussion
Pharmacists did not agree on a single definition of cognitive pharmacy services (CPS)
Yong et al BMC Health Services Research (2021) 21:906. This analysis of pharmacist CPS perspectives suggests slow uptake may be due to a lack of evidencebased, focused, multi-level implementation strategies that take ongoing pharmacist role transition into account
Summary
Introduction and general participant informationResearcher will provide an overview of the goals and min purpose of the discussion. In Australia, pharmacists practising in a pharmacy in a community setting (e.g. shopping centres, retail strips, etc.) are considered ‘community pharmacists’ During their practice, they are required to gather clinical information about their patients through interviewing and counselling processes. As accessible primary care health professionals, community pharmacists are ideally placed to provide medication and health management services that complement general practitioner and allied health service offerings. The resultant health services are known generally as ‘services’ within the Australian community pharmacy sector (as opposed to dispensing and related activities), with several terms and definitions used in the industry (see Table 1) [6] These newer health services will be referred to in this paper as ‘cognitive pharmacy services’ (CPS)
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