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

Authors

Dorothee C. Dartsch

Anita E. Weidmann



Abstract

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. To gather stakeholders’ recommendations for, and obtain consensus on, mechanisms of change that allow implementation strategies to work in practice. 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. 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). 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.

Citation

MICHEL, D.E., TONNA, A.P., DARTSCH, D.C. and WEIDMANN, A.E. 2024. Implementation of medication reviews in community pharmacy: reaching consensus on stakeholders’ recommendations for mechanisms of change using the nominal group technique. International journal of clinical pharmacy [online], Latest Articles. Available from: https://doi.org/10.1007/s11096-024-01708-y

Journal Article Type Article
Acceptance Date Jan 24, 2024
Online Publication Date Mar 15, 2024
Deposit Date Mar 26, 2024
Publicly Available Date Mar 26, 2024
Journal International journal of clinical pharmacy
Print ISSN 2210-7703
Electronic ISSN 2210-7711
Publisher Springer
Peer Reviewed Peer Reviewed
DOI https://doi.org/10.1007/s11096-024-01708-y
Keywords Community pharmacy services; Implementation; Mechanism of change; Medication review; Nominal group technique
Public URL https://rgu-repository.worktribe.com/output/2279563
Additional Information This article has been published with separate supporting information. This supporting information has been incorporated into a single file on this repository and can be found at the end of the file associated with this output.

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