The complexity of implementation factors in professional pharmacy services

García-Cárdenas, Victoria; Pérez-Escamilla, Beatriz; Fernández-Llimós, Fernando; Benrimoj, Shalom I.

doi:10.1016/j.sapharm.2017.05.016

Cited by 42 publications

(56 citation statements)

References 22 publications

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“…[ 84 , 87 , 98 ]. For Garcia-Cardenas et al [ 25 ], several factors can contribute to the lack of time, such as lack of priority, commitment, and poor distribution of activities. In this way, it is fundamental to understand the specific causes that contribute to the lack of time, so that measures are developed to remedy this problem.…”

Section: Discussionmentioning

confidence: 99%

“…In this scenario, it is highlighted the implementation science, since it is responsible for investigating and understanding the multiple factors that influence the implementation processes [ 24 ]. The literature has emphasized that the complexity of the CPS implementation process, especially in health systems [ 25 , 26 ]. This complexity is characterized by interrelated stages, and influenced by multiple factors [ 27 , 28 ].…”

Section: Introductionmentioning

confidence: 99%

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Facilitators and strategies to implement clinical pharmacy services in a metropolis in Northeast Brazil: a qualitative approach

Ramos

Júnior

Pereira

et al. 2018

BMC Health Serv Res

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BackgroundClinical Pharmacy Services (CPS) are a reality in many health systems around the world. However, there are few studies that discuss the facilitators and the strategies to implement CPS in healthcare systems. In this way, the objective of this study was to identify the facilitators and strategies involved in the CPS implementation process in some public health units in a metropolis in the Northeast Brazil.MethodsA qualitative study was carried out with health-system pharmacists and managers who experienced the implementation of CPS. Therefore, focus groups were conducted with pharmacists, and the interviews with the managers. The discussions were carried out through semi-structured scripts and were recorded in audio and videos, after the signature of the consent form. The recordings were transcribed and analyzed independently through content analysis, followed by consensus meetings between researchers.ResultsTwo focus groups were conducted, with an average of seven pharmacists per group, and five interviews with local health managers. Participants reported 39 facilitators who were related to the categories: local healthcare network, healthcare team, pharmacists and implementation process of the CPS. And 21 strategies attributed to the following categories: local healthcare network, pharmacists and implementation process of the CPS.ConclusionsThis study identified facilitators and strategies of the implementation of CPS. Most of the positive experiences were related to the clinical skills and proactive attitudes of pharmacists. These findings may support pharmacists and health managers to implement CPS in health systems.Electronic supplementary materialThe online version of this article (10.1186/s12913-018-3403-4) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Facilitators and strategies to implement clinical pharmacy services in a metropolis in Northeast Brazil: a qualitative approach

Ramos

Júnior

Pereira

et al. 2018

BMC Health Serv Res

View full text Add to dashboard Cite

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“…Our review highlighted the lack of a common definition of medication adherence, and the lack of standard method used to measure it. This lack of standardized methods and guidelines impedes on the sharing of good practices and thus the ability to improve the quality of healthcare services, with cost-effective care, and dealing with professional pharmacy services without losing the typical socio-economic organizational characteristics of healthcare entities [62].…”

Section: Discussionmentioning

confidence: 99%

Scoping review and bibliometric analysis of Big Data applications for Medication adherence: an explorative methodological study to enhance consistency in literature

Pirri

Lorenzoni

Turchetti

2020

BMC Health Serv Res

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Background: Medication adherence has been studied in different settings, with different approaches, and applying different methodologies. Nevertheless, our knowledge and efficacy are quite limited in terms of measuring and evaluating all the variables and components that affect the management of medication adherence regimes as a complex phenomenon. The study aim is mapping the state-of-the-art of medication adherence measurement and assessment methods applied in chronic conditions. Specifically, we are interested in what methods and assessment procedures are currently used to tackle medication adherence. We explore whether Big Data techniques are adopted to improve decision-making procedures regarding patients' adherence, and the possible role of digital technologies in supporting interventions for improving patient adherence and avoiding waste or harm. Methods: A scoping literature review and bibliometric analysis were used. Arksey and O'Malley's framework was adopted to scope the review process, and a bibliometric analysis was applied to observe the evolution of the scientific literature and identify specific characteristics of the related knowledge domain. Results: A total of 533 articles were retrieved from the Scopus academic database and selected for the bibliometric analysis. Sixty-one studies were identified and included in the final analysis. The Morisky medication adherence scale (36%) was the most frequently adopted baseline measurement tool, and cardiovascular/hypertension disease, the most investigated illness (38%). Heterogeneous findings emerged from the types of study design and the statistical methodologies used to assess and compare the results. Conclusions: Our findings reveal a lack of Big Data applications currently deployed to address or measure medication adherence in chronic conditions. Our study proposes a general framework to select the methods, measurements and the corpus of variables in which the treatment regime can be analyzed.

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“…Although there is no validated tool to assess the readiness of pharmacists to implement a change in practice, there have been models developed to describe factors that hinder or facilitate the implementation of a new pharmacy service. Such a model was developed by Garcia-Cardenas and colleagues, who described five domains under which these factors can be categorised, namely professional service, pharmacy staff, pharmacy, local environment, and system (Garcia-Cardenas et al, 2018). In the present study, these domains were used to group survey questions to enable readiness to be evaluated.…”

Section: Introductionmentioning

confidence: 99%

Peer Review #3 of "Managing migraine with over-the-counter provision of triptans: the perspectives and readiness of Western Australian community pharmacists (v0.1)"

Edwards¹

2019

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Background. Down-scheduling one or more triptans to Schedule 3 (Pharmacist Only Medicine) from Schedule 4 (Prescription Only Medicine) has been debated in Australia for a decade. This study aimed to evaluate the perspectives and readiness of Western Australian (WA) community pharmacists to manage migraine including over-the-counter (OTC) provision of triptans. Methods. Data were collected using a self-administered paper-based questionnaire, posted to a random sample of 178 metropolitan and 97 regional pharmacies in WA. Respondent pharmacists were surveyed regarding: knowledge of optimal migraine treatment as per current guidelines, resources required to appropriately recommend triptans, and attitudes and perspective toward down-scheduling. Data were analysed using descriptive statistics and multivariate regression analysis. Pharmacist/pharmacy characteristics influencing readiness were evaluated by assigning respondents a score based on responses to Likert scale questions. These questions were assigned to five domains based on an implementation model, and these scores were used in a general linear model (GLM) to identify demographic characteristics associated with readiness across each domain. Results. A total of 114 of the 275 pharmacies returned useable questionnaires (response rate: 41.5%). The two most commonly recommended first line OTC agents were a combined paracetamol/non-steroidal anti-inflammatory drugs and aspirin (44/104; 42.3% and 22/104; 21.2%, respectively) which provided context to the respondents' knowledge of optimal migraine treatment. Responses to questions in relation to triptans and the warning signs requiring referral were in line with current guidelines, demonstrating respondents' knowledge in these areas. Nevertheless, most respondents demonstrated uncertainty in relation to the pathogenesis of migraine. If triptans were available OTC, 66/107 (61.7%) would recommend them first-line. The majority (107/113; 94.7%) agreed that down-scheduling would improve timely access to effective migraine medication, and 105/113 (92.9%) agreed that if triptans were downscheduled, pharmacists may be better able to assist people in the treatment of migraine.

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The complexity of implementation factors in professional pharmacy services

Cited by 42 publications

References 22 publications

Facilitators and strategies to implement clinical pharmacy services in a metropolis in Northeast Brazil: a qualitative approach

Facilitators and strategies to implement clinical pharmacy services in a metropolis in Northeast Brazil: a qualitative approach

Scoping review and bibliometric analysis of Big Data applications for Medication adherence: an explorative methodological study to enhance consistency in literature

Peer Review #3 of "Managing migraine with over-the-counter provision of triptans: the perspectives and readiness of Western Australian community pharmacists (v0.1)"

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