Evaluation approaches, tools and aspects of implementation used in pharmacist interventions in residential aged care facilities: A scoping review.

Abstract

The medication expertise of pharmacists is widely acknowledged and there is ongoing interest in their potential role to reduce medication-related harm amongst residents living in residential aged care facilities (RACFs). An increased understanding of how these interventions are evaluated could support adoption of these interventions in the real world. To systematically explore the application of evaluation approaches, evaluation tools and aspects of implementation (implementation factors i.e. barriers and facilitators, and assessing implementation fidelity) used in pharmacist intervention in RACF peer-reviewed literature. A search strategy was applied to MEDLINE, CINAHL, Cochrane Library and Web of Science databases for publications between 1 January 2000 and 27 August 2020 based on defined inclusion and exclusion criteria. Articles that reported on evaluated pharmacist interventions impacting residents in RACFs or which outlined study participant perspectives in relation to these interventions were included. 2003 published articles were identified, out of which 56 articles met the inclusion criteria. Fifty-three articles reported on outcome evaluations. Four articles used evaluation guidance with 1 article explicitly guided by an evaluation framework. Relationships, trust and respect between pharmacists and RACF health care team members were one of the most reported factors influencing intervention success. None of the 56 articles used a theory or model, assessed implementation fidelity or employed a logic model. To date there appears to be sparse utilisation of available evaluation approaches, evaluation tools and implementation aspects in pharmacist intervention in RACF peer-reviewed literature. By embracing these evaluation approaches, evaluation tools and aspects of implementation, pharmacy practice researchers have an opportunity to contribute to evaluation research in RACFs and beyond.