Factors influencing the implementation of pharmaceutical care in outpatient settings: A systematic review applying the Consolidated Framework for Implementation Research

Pereira, Carlos Eugênio; Bambirra, Eduardo Henrique Ferreira; Fernandes, Brígida Dias; Sousa, Maria C.V.B.; Mendonça, Simone Araújo Medina; Chemello, Clarice

doi:10.1016/j.sapharm.2021.06.011

Cited by 7 publications

(7 citation statements)

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“…Além disso, para que a capacitação profissional ocorra de maneira fluida, é necessário definir quais são os profissionais interessados em ofertar o serviço de GTM. Como estratégia, pode-se aplicar questionários com a finalidade de conhecer mais o interesse e o conhecimento prévio desses profissionais sobre o serviço 16 . • Padronização de linguagem em comum A filosofia de prática também possibilita a utilização de uma linguagem comum entre os profissionais farmacêuticos, assegurando consistência à prática clínica estabelecida, conforme destacado por Blanchard et al (2017) 20 .…”

Section: Gtm: Gerenciamento Da Terapia Medicamentosaunclassified

“…• Padronização de linguagem em comum A filosofia de prática também possibilita a utilização de uma linguagem comum entre os profissionais farmacêuticos, assegurando consistência à prática clínica estabelecida, conforme destacado por Blanchard et al (2017) 20 . Além disso, a utilização de uma linguagem comum permite maior troca de conhecimento, informações e opiniões entre profissionais, cria um clima de pertencimento, aumenta a confiança do processo e permite que a comunicação seja feita de maneira mais eficaz, obtendo-se melhores resultados clínicos 16 .…”

Section: Gtm: Gerenciamento Da Terapia Medicamentosaunclassified

“…Para permitir a padronização de documentação, é necessário a presença de um suporte operacional e de uma equipe de tecnologia da informação capacitada e que esteja integrada a prática realizada pelos farmacêuticos na instituição. Ressalta-se que é grande a quantidade de dados e informações coletadas durante a consulta farmacêutica, sendo conhecimentos imprescindíveis para a continuidade do tratamento, o sucesso do plano farmacoterapêutico e o alcance de metas terapêuticas definidas para cada paciente 16 . sustentabilidade do serviço de GTM20.…”

Section: Sistema De Documentaçãounclassified

“…O processo de implementação de serviços clínicos pode ser dividido nas seguintes etapas: pré-implementação, implementação em andamento e pós-implementação. A pré-implementação é a etapa antes da oferta do novo serviço; a implementação em andamento é a etapa em que se inicia a oferta do novo serviço; e a pós-implementação compreende a etapa de continuidade na oferta do serviço, após ações de melhorias, garantindo o atendimento das exigências que atestam que o processo de implementação foi finalizado 16 .…”

Section: Introductionunclassified

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Implementação de serviços de gerenciamento da terapia medicamentosa: revisão de literatura

et al. 2023

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O estudo teve como objetivo identificar e descrever a literatura científica sobre a implementação de serviços clínicos farmacêuticos que embasem a oferta de serviços de gerenciamento da terapia medicamentosa (GTM) nos sistemas de saúde. Realizou-se uma revisão narrativa de literatura com busca de artigos em revistas científicas especializadas na área. Após a seleção dos artigos, realizou-se a extração manual de informações relativas à implementação de serviços de GTM. Os dados foram agrupados segundo as fases de implementação de serviços clínicos: pré-implementação, implementação e pós-implementação. Para cada fase, foram identificados fatores que influenciam o processo de implementação de serviços clínicos. Espera-se que a partir deste trabalho novas pesquisas possam ser realizadas sobre a implementação do serviço de GTM, área ainda pouco explorada.

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Section: Gtm: Gerenciamento Da Terapia Medicamentosaunclassified

Section: Sistema De Documentaçãounclassified

Section: Introductionunclassified

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Implementação de serviços de gerenciamento da terapia medicamentosa: revisão de literatura

et al. 2023

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“…Strategies and interventions that would facilitate this collaboration would include factors such as mutual acceptance and readiness of team members towards collaboration, performing as a team rather than an individual; communication strategies among clinicians and shared decision-making, and care coordination ( Mustafa Sirimsi et al, 2022 ). Further, pharmacist-led deprescribing strategies would need to be conceptualized and guided by implementation science (IS) ( Pereira et al, 2021 ; Ailabouni et al, 2022 )—the study of the incorporation of evidence-based findings into practice, to improve healthcare—( Bauer et al, 2015 ; Ronquillo et al, 2018 ). One framework that has shown promise in implementing medication regimen optimization services in practice is the Consolidated Framework for Implementation Research (CFIR) ( Shoemaker et al, 2017 ; Baumgartner et al, 2020 ).…”

Section: Introductionmentioning

confidence: 99%

A pharmacist-led medication review service with a deprescribing focus guided by implementation science

et al. 2023

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Background: Little research addressed deprescribing-focused medication optimization interventions while utilizing implementation science. This study aimed to develop a pharmacist-led medication review service with a deprescribing focus in a care facility serving patients of low income receiving medications for free in Lebanon followed by an assessment of the recommendations’ acceptance by prescribing physicians. As a secondary aim, the study evaluates the impact of this intervention on satisfaction compared to satisfaction associated with receiving routine care.Methods: The Consolidated Framework for Implementation Research (CFIR) was used to address implementation barriers and facilitators by mapping its constructs to the intervention implementation determinants at the study site. After filling medications and receiving routine pharmacy service at the facility, patients 65 years or older and taking 5 or more medications, were assigned into two groups. Both groups of patients received the intervention. Patient satisfaction was assessed right after receiving the intervention (intervention group) or just before the intervention (control group). The intervention consisted of an assessment of patient medication profiles before addressing recommendations with attending physicians at the facility. Patient satisfaction with the service was assessed using a validated translated version of the Medication Management Patient Satisfaction Survey (MMPSS). Descriptive statistics provided data on drug-related problems, the nature and the number of recommendations as well as physicians’ responses to recommendations. Independent sample t-tests were used to assess the intervention’s impact on patient satisfaction.Results: Of 157 patients meeting the inclusion criteria, 143 patients were enrolled: 72 in the control group and 71 in the experimental group. Of 143 patients, 83% presented drug-related problems (DRPs). Further, 66% of the screened DRPs met the STOPP/START criteria (77%, and 23% respectively). The intervention pharmacist provided 221 recommendations to physicians, of which 52% were to discontinue one or more medications. Patients in the intervention group showed significantly higher satisfaction compared to the ones in the control group (p < 0.001, effect size = 1.75). Of those recommendations, 30% were accepted by the physicians.Conclusion: Patients showed significantly higher satisfaction with the intervention they received compared to routine care. Future work should assess how specific CFIR constructs contribute to the outcomes of deprescribing-focused interventions.

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Implementation of medication reviews in community pharmacy: reaching consensus on stakeholders’ recommendations for mechanisms of change using the nominal group technique

Michel,

Tonna,

Dartsch

et al. 2024

Int J Clin Pharm

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Background Since 2022, patients with five or more medicines are eligible for a medication review (MR) in a community pharmacy remunerated by the German health system. However, implementation has been slow, with few pharmacies providing MRs. Stakeholders’ input is necessary to detail how implementation strategies can be executed effectively on a national level. Prior research identified “external facilitation” and “altering incentives” as crucial strategies to achieve implementation outcomes. Aim To gather stakeholders’ recommendations for, and obtain consensus on, mechanisms of change that allow implementation strategies to work in practice. Method The consensus method used was the nominal group technique (NGT) with NGT-discussions held separately with pharmacy owners and pharmacy chambers employees. Votes were summed and the relative importance (rI) calculated, defined as (score achieved for a mechanism)/(maximum possible score) × 100. Content analysis provided context for the highest ranked mechanisms and allowed linking to implementation outcomes. Results Four NGT-discussions were held in 2023 (n = 2 owners; n = 2 chamber employees) with a total of 17 participants. The overall highest ranked mechanisms were fit-for-purpose software (rI = 154.7) detailed process support (rI = 104.9) and an expert support line (rI = 77.7). These together with financial viability (rI = 40.0) were prioritised by both participant groups. Three mechanisms were favoured for both implementation strategies, namely software, process support and materials (rI = 34.3). Conclusion This study identified stakeholders’ priorities for mechanisms of change to implement MRs in community pharmacies. Focusing efforts on the prioritised mechanisms is likely to significantly advance a national implementation plan for countries which are at an early implementation stage.

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Factors influencing the implementation of pharmaceutical care in outpatient settings: A systematic review applying the Consolidated Framework for Implementation Research

Cited by 7 publications

References 50 publications

Implementação de serviços de gerenciamento da terapia medicamentosa: revisão de literatura

Implementação de serviços de gerenciamento da terapia medicamentosa: revisão de literatura

A pharmacist-led medication review service with a deprescribing focus guided by implementation science

Implementation of medication reviews in community pharmacy: reaching consensus on stakeholders’ recommendations for mechanisms of change using the nominal group technique

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