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Experiences of key stakeholders with the implementation of medication reviews in community pharmacies: a systematic review using the Consolidated Framework for Implementation Research (CFIR).

Michel, Dorothee E.; Tonna, Antonella P.; Dartsch, Dorothee C.; Weidmann, Anita E.

Authors

Dorothee C. Dartsch

Anita E. Weidmann



Abstract

Background: Though medication reviews have shown positive patient outcomes, they are still not widely implemented in community pharmacies. Published reviews on their implementation often include several other pharmacy services, making them non-specific. Using the Consolidated Framework for Implementation Research (CFIR) to focus solely on the experiences of different stakeholders with the implementation of medication reviews will help to better understand relevant facilitators and barriers. Objectives: To critically appraise, synthesise and present the available evidence on experiences of key stakeholders with the implementation of medication reviews and to identify barriers and facilitators to its implementation in community pharmacies. Methods: A systematic literature search was conducted in four databases for studies published in English, Spanish or German. Key search terms included: implementation, pharmac*, medication review, facilitator, barrier. Study selection, quality assessment and data extraction were performed by two independent reviewers. Findings were mapped directly against the constructs of the CFIR. Results: Out of 924 retrieved records 24 articles from 9 countries met the inclusion criteria. Key facilitators identified included pharmacists' openness to practice change and a high degree of patient satisfaction post medication review. Attracting patients to the service was stated as challenging due to an unawareness of the scope and potential benefit of a medication review. The dominant barrier was inadequate remuneration, as it impacted all additional resourcing and ultimately the viability of the service. Further barriers included difficult professional relationships with doctors and little mandate from health authorities. Most reports were from the employed pharmacists’ perspective and concerned the inner setting, other perspectives were under-reported. Conclusions: Results of this systematic review illustrate different stakeholders' experiences and add to the understanding of challenges in the implementation process. Nevertheless, findings also highlight how scarce reporting of external stakeholders’ views is and that filling this gap can unveil hidden barriers and facilitators. Registration: PROSPERO register (CRD 42019122836).

Citation

MICHEL, D.E., TONNA, A.P., DARTSCH, D.C. and WEIDMANN, A.E. 2021. Experiences of key stakeholders with the implementation of medication reviews in community pharmacies: a systematic review using the Consolidated Framework for Implementation Research (CFIR). Research in social and administrative pharmacy [online], In Press. Available from: https://doi.org/10.1016/j.sapharm.2021.07.017

Journal Article Type Article
Acceptance Date Jul 16, 2021
Online Publication Date Jul 21, 2021
Deposit Date Aug 6, 2021
Publicly Available Date Jul 22, 2022
Journal Research in social and administrative pharmacy
Print ISSN 1551-7411
Publisher Elsevier
Peer Reviewed Peer Reviewed
DOI https://doi.org/10.1016/j.sapharm.2021.07.017
Keywords Medication review; Implementation; Community pharmacy; CFIR; Facilitator; Barrier
Public URL https://rgu-repository.worktribe.com/output/1391513
Related Public URLs https://rgu-repository.worktribe.com/output/354106
Additional Information Supplementary data is provided at the end of the full-text file.