Abstract
Aim: The aim of this study is to explore pharmacist perspectives of the implementation of a community pharmacy-based ear health service in rural communities. Method: A community pharmacy-based health service model was designed and developed to provide an accessible ear care service (LISTEN UP—Locally Integrated Screening and Testing Ear aNd aUral Program) and pharmacist’s perspectives of the implementation of LISTEN UP were explored. Thematic analysis was conducted and data coded according to the Consolidated Framework for Implementation Research. Results: A total of 20 interviews were conducted with 10 pharmacists, averaging 30 min. Visualistion of the ear canal was reported as the greatest advantage of the service, whilst the time required for documentation reported as a complexity. The number of pharmacists working at one time and the availability of a private consultation room were identified as the two limiting factors for execution. On reflection, the need for government funding for service viability and sustainability was highlighted. Discussion/Conclusion: Expanded pharmacy practice is emerging for the Australian pharmacy profession. Rural community pharmacists are recognised as integral members of healthcare teams, providing accessible medication supply and health advice to seven million people in Australia who call rural and remote regions home. However, there are no structured models supporting them to provide expanded services to improve health outcomes in their communities. This study provides lessons learnt to guide future design and development of expanded models of pharmacy practice.
Highlights
Rural pharmacists are integral members of the healthcare team and are at times the only permanent health professionals in small remote communities [1]
Consumers and health professionals have reported some resistance to expanded practice, when focusing on rural Australia, pharmacists, consumers, health professionals and stakeholders are all supportive of expanded practice for rural and remote areas with an expected improvement in health for their local communities [3,15,16,17,18,24]
This study has reported pharmacist perspectives of various constructs connected to the Consolidated Framework for Implementation Research (CFIR) framework of implementation [13]
Summary
Rural pharmacists are integral members of the healthcare team and are at times the only permanent health professionals in small remote communities [1]. Rural community pharmacists provide accessible healthcare including medication supply, stewardship and safety and are often the first point of call for health advice for seven million rural and remote Australians [1,2]. They are dedicated health professionals who provide pharmaceutical services to local communities, the full scope of their practice is not well utilised or understood (ref HP article) [3,4]. In Australia, despite rural community pharmacists’ knowledge and embedded role in their community, pharmacists are unable to access structured or funded models of care to provide these expanded services, aside from a limited schedule of immunisations [1]. This, together with a poorly defined role with ambiguous boundaries of their recognised scope of practice has rural pharmacists challenged to provide appropriate care to these vulnerable and complex populations [4]
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