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Facilitating implementation of medication reviews in the community pharmacy setting: an application of the implementation research logic model.

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

Authors

Dorothee C. Dartsch

Anita E. Weidmann



Abstract

Previous research has identified both determinants and potential strategies to facilitate implementation of medication reviews (MR). A conceptual model which links determinants, strategies to support implementation and mechanisms of change to execute implementation, with projected outcomes is helpful to plan the approach and facilitate MR-implementation. The aim of this research was to apply the Implementation Research Logic Model (ILRM) for the implementation of medication reviews in the German community pharmacy setting, and thus illustrate the links between determinants, strategies, and implementation outcomes. The resulting map is meant to inform and facilitate MR-implementation. The IRLM was populated with determinants (barriers and facilitators structured using the Framework for Implementation of Services in Pharmacy, FISpH), proposed strategies (according to the Expert Recommendations for Implementing Change, ERIC) and mechanisms of change which were identified in an interview study with 21 German pharmacy owners. The research team linked these with 8 implementation outcomes derived from Proctor: acceptability, adoption, appropriateness, cost, feasibility, fidelity, penetration, sustainability. Twenty strategies from the interview study were mapped against 32 determinants. All strategies were hypothesised to impact on one or several of the 8 implementation outcomes. Depending on pharmacies' implementation stage (exploration, preparation, implementation, and sustainment) the importance of strategies was expected to vary. Strategies such as educational meetings and learning collaboratives can increase perceived appropriateness and boost adoption of MRs which is particularly important for pharmacies in the early exploration stage. Strategies such as receiving support from external implementation advisors as well as recruiting and training internal implementation leaders were deemed particularly important for pharmacies at the preparation stage to strengthen feasibility and fidelity. In later stages (implementation and sustainment) pharmacies were thought to benefit from provision of clinical feedback, obtaining and using patient feedback and re-examining implementation to achieve high fidelity, penetration, and sustainability of MR-provision. Some strategies such as fixed payment and stable delivery contracts were deemed pre-requisites for implementation irrespective of the stage the pharmacy was at. The application of the Implementation Research Logic Model illustrated the relations between determinants, strategies, mechanisms, and implementation outcomes. Future research is needed to ascertain that strategies work as planned and achieve the projected implementation outcomes.

Citation

MICHEL, D.E., TONNA, A.P., DARTSCH, D.C. and WEIDMANN, A.E. 2023. Facilitating implementation of medication reviews in the community pharmacy setting: an application of the Implementation Research Logic Model. Presented at the 13th PCNE (Pharmaceutical Care Network Europe) working conference: pharmacies' new roles in pharmaceutical care: bridging research and practice, 8-11 February 2023, Hillerod, Denmark.

Presentation Conference Type Poster
Conference Name 13th PCNE (Pharmaceutical Care Network Europe) working conference: pharmacies' new roles in pharmaceutical care: bridging research and practice
Conference Location Hillerod, Denmark
Start Date Feb 8, 2023
End Date Feb 11, 2023
Deposit Date Sep 11, 2023
Publicly Available Date Sep 18, 2023
DOI https://doi.org/10.1007/s11096-023-01576-y
Keywords Medication reviews (MR); Implementation research logic model (IRLM); Implementation outcomes
Public URL https://rgu-repository.worktribe.com/output/2072287
Additional Information Abstract published as:
MICHEL, D.E., TONNA, A.P., DARTSCH, D.C. and WEIDMANN, A.E. 2023. Facilitating implementation of medication reviews in the community pharmacy setting: an application of the Implementation Research Logic Model. International journal of clinical pharmacy [online] 45(2), PCNE abstract number 585, pages 520-521. Available from: https://doi.org/10.1007/s11096-023-01576-y

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