Development of a pharmacy practice intervention: lessons from the literature

Hughes, Carmel; Cadogan, Cathal; Ryan, Cristí­n

doi:10.1007/s11096-015-0180-6

Cited by 16 publications

(10 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In other words, disregarding the input of these stakeholders (or considering only the views of pharmacists) may lead to an incomplete and biased understanding of the implementation context which, in turn, can result in service underutilisation, unsuccessful implementation and limited service impact. 59 Generally, involving relevant stakeholders throughout the development, implementation and evaluation of health programmes is crucial to increase the chances of any of those initiatives being effective and successfully implemented. 6 29 30 60 Indeed, this is equally relevant to CPS planning.…”

Section: Discussionmentioning

confidence: 99%

Qualitative meta-synthesis of barriers and facilitators that influence the implementation of community pharmacy services: perspectives of patients, nurses and general medical practitioners

Hossain

Fernández-Llimós

Luckett³

et al. 2017

BMJ Open

View full text Add to dashboard Cite

ObjectivesThe integration of community pharmacy services (CPSs) into primary care practice can be enhanced by assessing (and further addressing) the elements that enable (ie, facilitators) or hinder (ie, barriers) the implementation of such CPSs. These elements have been widely researched from the perspective of pharmacists but not from the perspectives of other stakeholders who can interact with and influence the implementation of CPSs. The aim of this study was to synthesise the literature on patients’, general practitioners’ (GPs) and nurses’ perspectives of CPSs to identify barriers and facilitators to their implementation in Australia.MethodsA meta-synthesis of qualitative studies was performed. A systematic search in PubMed, Scopus and Informit was conducted to identify studies that explored patients’, GPs’ or nurses’ views about CPSs in Australia. Thematic synthesis was performed to identify elements influencing CPS implementation, which were further classified using an ecological approach.ResultsTwenty-nine articles were included in the review, addressing 63 elements influencing CPS implementation. Elements were identified as a barrier, facilitator or both and were related to four ecological levels: individual patient (n=14), interpersonal (n=24), organisational (n=16) and community and healthcare system (n=9). It was found that patients, nurses and GPs identified elements reported in previous pharmacist-informed studies, such as pharmacist’s training/education or financial remuneration, but also new elements, such as patients’ capability to follow service's procedures, the relationships between GP and pharmacy professional bodies or the availability of multidisciplinary training/education.ConclusionsPatients, GPs and nurses can describe a large number of elements influencing CPS implementation. These elements can be combined with previous findings in pharmacists-informed studies to produce a comprehensive framework to assess barriers and facilitators to CPS implementation. This framework can be used by pharmacy service planners and policy makers to improve the analysis of the contexts in which CPSs are implemented.

show abstract

Section: Discussionmentioning

confidence: 99%

Qualitative meta-synthesis of barriers and facilitators that influence the implementation of community pharmacy services: perspectives of patients, nurses and general medical practitioners

Hossain

Fernández-Llimós

Luckett³

et al. 2017

BMJ Open

View full text Add to dashboard Cite

show abstract

“…[ 51 ] It has been advocated that a formative, theory-based approach be taken in conducting evaluations of initiatives in pharmacy practice. [ 52 , 53 ] This includes recommendations that evaluations account for the iterative nature of health care improvement work and are undertaken prospectively, generating learning applicable to ongoing improvement efforts and enabling midcourse adjustment to the initiative. Moreover, it has been recommended that such initiatives are resourced to include a trained programme evaluation researcher to conduct this work.…”

Section: Discussionmentioning

confidence: 99%

A systematic review of the outcome data supporting the Healthy Living Pharmacy concept and lessons from its implementation

Nazar¹,

Nazar²,

White³

et al. 2019

PLoS ONE

View full text Add to dashboard Cite

BackgroundThe Healthy Living Pharmacy (HLP) project, launched in England, UK in 2009 was a novel approach of introducing public health services within community pharmacy to tackle local health inequalities. A national roll-out followed a reported successful pilot; subsequent local evaluations ensued.ObjectivesTo summarise reported outcomes and investigate contextual factors that indicate the presence, absence and maturity of implementation determinants, thus offering useful lessons to stakeholders in implementing future initiatives to achieve successful outcomes.MethodsA systematic review was conducted to identify all publications reporting on the HLP project. All HLP articles and conference abstracts were considered for inclusion and were assessed for methodological quality. The Consolidated Framework for Implementation Research (CFIR) was utilised to identify potential implementation determinants reported. Each article was then analysed to identify reported economic, humanistic or clinical outcomes.ResultsThe review included six peer-reviewed journal articles and 12 conference abstracts. Joanna Briggs Institute Qualitative Assessment and Review Instrument indicated deficiencies in methodological quality. Through adoption of the CFIR framework, the implementation determinants relevant to the implementation of HLP into community pharmacy were identified. A resonating issue emerged in that the absence of adopting an evidence-based implementation process limited the ability to capture meaningful outcome data. This resulted in a lack of evidence to support sustainability and the failure to address many of the well cited barriers, e.g. lack of awareness amongst patients, public and other healthcare professionals, and weak support for future investment in resource for training and dissemination.ConclusionsHealthcare systems are increasingly called on to adopt evidence‐based interventions that improve quality, control costs, and maximize value, thus offering opportunity to accelerate the implementation of clinical pharmacy services and programs aimed at improving patient care. Interventions, such as the HLP project require focused efforts on implementation and evaluation of those implementation efforts to produce effective and lasting changes in complex health care systems.

show abstract

“…Based on the Medical Research Council (MRC) guidance on complex interventions [ 6 , 7 ], a theory-based intervention has been developed to improve appropriate polypharmacy in older people in primary care [ 8 , 9 ]. The intervention was developed in Northern Ireland (NI) following Theoretical Domains Framework (TDF)-based semi-structured interviews with General Practitioners (GPs) and community pharmacists [ 10 , 11 ].…”

Section: Introductionmentioning

confidence: 99%

An external pilot cluster randomised controlled trial of a theory-based intervention to improve appropriate polypharmacy in older people in primary care (PolyPrime): study protocol

Rankin

Cadogan

Barry

et al. 2021

Pilot Feasibility Stud

Self Cite

View full text Add to dashboard Cite

Background The use of multiple medications (polypharmacy) is a concern in older people (≥65 years) and is associated with negative health outcomes. For older populations with multimorbidity, polypharmacy is the reality and the key challenge is ensuring appropriate polypharmacy (as opposed to inappropriate polypharmacy). This external pilot cluster randomised controlled trial (cRCT) aims to further test a theory-based intervention to improve appropriate polypharmacy in older people in primary care in two jurisdictions, Northern Ireland (NI) and the Republic of Ireland (ROI). Methods Twelve GP practices across NI (n=6) and the six counties in the ROI that border NI will be randomised to either the intervention or usual care group. Members of the research team have developed an intervention to improve appropriate polypharmacy in older people in primary care using the Theoretical Domains Framework of behaviour change. The intervention consists of two components: (1) an online video which demonstrates how a GP may prescribe appropriate polypharmacy during a consultation with an older patient and (2) a patient recall process, whereby patients are invited to scheduled medication review consultations with GPs. Ten older patients receiving polypharmacy (≥4 medications) will be recruited per GP practice (n=120). GP practices allocated to the intervention arm will be asked to watch the online video and schedule medication reviews with patients on two occasions; an initial and a 6-month follow-up appointment. GP practices allocated to the control arm will continue to provide usual care to patients. The study will assess the feasibility of recruitment, retention and study procedures including collecting data on medication appropriateness (from GP records), quality of life and health service use (i.e. hospitalisations). An embedded process evaluation will assess intervention fidelity (i.e. was the intervention delivered as intended), acceptability of the intervention and potential mechanisms of action. Discussion This pilot cRCT will provide evidence of the feasibility of a range of study parameters such as recruitment and retention, data collection procedures and the acceptability of the intervention. Pre-specified progression criteria will also be used to determine whether or not to proceed to a definitive cRCT. Trial registration ISRCTN, ISRCTN41009897. Registered 19 November 2019. ClinicalTrials.gov, NCT04181879. Registered 02 December 2019.

show abstract

Development of a pharmacy practice intervention: lessons from the literature

Cited by 16 publications

References 24 publications

Qualitative meta-synthesis of barriers and facilitators that influence the implementation of community pharmacy services: perspectives of patients, nurses and general medical practitioners

Qualitative meta-synthesis of barriers and facilitators that influence the implementation of community pharmacy services: perspectives of patients, nurses and general medical practitioners

A systematic review of the outcome data supporting the Healthy Living Pharmacy concept and lessons from its implementation

An external pilot cluster randomised controlled trial of a theory-based intervention to improve appropriate polypharmacy in older people in primary care (PolyPrime): study protocol

Contact Info

Product

Resources

About