A theory-informed approach to mental health care capacity building for pharmacists

Abstract

BackgroundPharmacists are knowledgeable, accessible health care professionals who can provide services that improve outcomes in mental health care. Various challenges and opportunities can exist in pharmacy practice to hinder or support pharmacists’ efforts. We used a theory-informed approach to development and implementation of a capacity-building program to enhance pharmacists’ roles in mental health care.MethodsTheories and frameworks including the Consolidated Framework for Implementation Research, the Theoretical Domains Framework, and the Behaviour Change Wheel were used to inform the conceptualization, development, and implementation of a capacity-building program to enhance pharmacists’ roles in mental health care.ResultsThe More Than Meds program was developed and implemented through an iterative process. The main program components included: an education and training day; use of a train-the-trainer approach from partnerships with pharmacists and people with lived experience of mental illness; development of a community of practice through email communications, a website, and a newsletter; and use of educational outreach delivered by pharmacists. Theories and frameworks used throughout the program’s development and implementation facilitated a means to conceptualize the component parts of the program as well as its overall presence as a whole from inception through evolution in implementation. Using theoretical foundations for the program enabled critical consideration and understanding of issues related to trialability and adaptability of the program.ConclusionsTheory was essential to the underlying development and implementation of a capacity-building program for enhancing services by pharmacists for people with lived experience of mental illness. Lessons learned from the development and implementation of this program are informing current research and evolution of the program.

Combined use of the Consolidated Framework for Implementation Research (CFIR) and the Theoretical Domains Framework (TDF): a systematic review

“…1). We identified 12 CFIR + TDF articles; the final list of included studies comprised five protocols for empirical studies (Gould [22], Prior [23], Manca [24], Graham-Rowe [25], Sales [26]) and seven completed empirical studies (Murphy [27], English [28], Bunger [29], Moullin [30], Newlands [31], Templeton [32], Elouafkaoui [33]).

Fig. 1PRISMA flow diagram

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“…Two completed studies and two protocols described intervention design and/or implementation plans (Gould [22], Sales [26], Murphy [27], English [28]); one protocol described a comparison of the effectiveness of an intervention relative to standard care (Prior [23]), and two protocols and five completed studies evaluated interventions (Manca [24], Sales [26], Bunger [29], Moullin [30], Newlands [31], Templeton [32], Elouafkaoui [33]). Several of the included studies had multiple objectives (e.g., effectiveness study and concurrent qualitative process evaluation [23, 33]).…”

“…Two completed studies and two protocols (Gould [22], Sales [26], Murphy [27], English [28]) used the frameworks in the intervention design phase. One of these protocols (Gould [22]) also planned to apply CFIR + TDF in the feasibility/piloting phase to identify current practice of healthcare professionals within the intervention target healthcare setting and identify barriers and facilitators to performing the target behavior.…”

“…Two studies’ (Murphy [27], English [28]) sole objective was intervention design, using environmental scans, a priori knowledge about context, and a theory-informed approach. One study was quantitative (Bunger [29]), and two completed studies and four protocols were mixed-method (Gould [22], Prior [23], Manca [24], Sales [26], Templeton [32], Elouafkaoui [33]) including interviews, questionnaires, observation, comparative effectiveness, framework analysis, and network analysis.…”

“…Two completed studies (Murphy [27], English [28]) designed interventions; their data sources included results from authors’ previous and ongoing research (Murphy [27], English [28]), the published literature (Murphy [27], English [28]), authors’ cumulative tacit knowledge and experience (Murphy [27], English [28]), and informal discussions with stakeholders (English [28]); notably, both intervention development studies’ authors described CFIR + TDF as data sources. A third completed study (Bunger [29]) applied neither the CFIR nor the TDF during data collection.…”