The implementation of a new service is often challenging when translating research findings into routine clinical practices. This paper presents the results of the implementation study of a pilot project for a diabetes and cardiovascular diseases risk-assessment service in Belgian community pharmacies. To evaluate the implementation of the service, a mixed method was used that follows the RE-AIM framework. During the testing stage, 37 pharmacies participated, including five that dropped out due to a lack of time or COVID-19-related temporary obligations. Overall, 502 patients participated, of which 376 (74.9%) were eligible for according-to-protocol analysis. Of these, 80 patients (21.3%) were identified as being at high risk for the targeted diseases, and 100 (26.6%) were referred to general practice for further investigation. We presented the limited effectiveness and the key elements influencing optimal implementation. Additional strategies, such as interprofessional workshops, a data-sharing platform, and communication campaigns, should be considered to spread awareness of the new role of pharmacists. Such strategies could also promote collaboration with general practitioners to ensure the follow-up of patients at high risk. Overall, this service was considered easy to perform and feasible in practice but would require financial and external support to ensure its effectiveness, sustainability, and larger-scale implementation.
There is an increasing motivation to implement pharmacist-led screening services in community pharmacies. This study aims to develop tools to support the pharmacist in the context of a diabetes and cardiovascular disease risk assessment service. Our development involved a multistep process using a user-centred approach, including a need assessment phase (14 patients, 17 pharmacists) and a creative design phase, followed by the evaluation of the materials (10 patients, 16 pharmacists). Three following themes covering educational needs emerged from stakeholders’ discussions: “content”, “layout”, and “form”, with three additional themes regarding the practical organisation: “software”, “awareness”, and “referral”. Based on the need assessment, tools for patient education purposes and awareness campaigns were created. During the development, special attention was paid to the writing style and structure with less text and more graphical colourful elements to suit patients with different health literacy and educational levels. The evaluation phase allowed researchers to observe participants engaging with the materials. Overall, participants were satisfied with the tools. The contents were considered valuable and relevant. However, adaptations were necessary to ensure their understanding and long-term usability. Finally, future research is required to evaluate the materials’ impact on patients’ behaviour towards their identified risk factors and ensure their effectiveness.
Background Diagnostic self-tests in Belgian pharmacies are a recent phenomenon. While considered a way to empower patients to take informed decisions, self-tests also challenge the relationship between patients and health professionals and between pharmacists and general practitioners. This study explored how the introduction of diagnostic self-tests in pharmacies influences the health care relationships. Methods A qualitative study, part of the Care-test research program, was conducted using semi-structured interviews with 18 patients, 25 doctors, and 16 pharmacists from Brussels. Data collection ended after data saturation. Reflexive thematic analysis was performed. Results Mutual partnership approaches were not mainstreamed and mainly intuitive when existing, with patients being often more in demand for a partnership with their doctors than what their doctors offered. This perceived lack of dialogue led some patients to autonomous behaviours, qualified as “non-adherence” by professionals (self-medication with medicinal herbs, unilateral adaptation of therapies including those for HIV-infection and for orphan disease, etc.). Not all the patients, however, were in demand for a more active role. Some deferred to the doctor's choice, but they did not experience another kind of relationship. The doctor-pharmacist collaboration mainly entailed factual information exchange, although more collaborative relationships exist. Current collaborations related to self-tests were limited due to their novelty and controversial nature. While patients were generally in favour of diagnostic self-tests, professionals had divided opinions about them. Conclusions The study reveals divergent views between patients and health professionals and amongst professionals, about self-tests and the need for a partnership between patients and professionals. This suggests a need for health professionals to be better skilled in dealing with participative approaches. Key messages Mutual partnership and Interprofessional collaboration are not mainstreamed in health care. Patients, doctors and pharmacists had divergent views about diagnostic self-tests and about the need for partnership.
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