‘Illuminating determinants of implementation of non-dispensing pharmacist services in home care: a qualitative interview study’

Abstract

AbstractObjectives Medication errors are leading causes of hospitalization and death in western countries and WHO encourages health care providers to implement non-dispensing pharmacist services in primary care to improve medication work. However, these services struggle to provide any impact on clinical outcomes. We wanted to explore health care professionals’ views on medication work to illuminate determinants of the implementation success. The research was designed to inform and adapt implementation strategies for non-dispensing pharmacist services.Design Semi-structured interview study with nine healthcare professionals.Setting Four Norwegian home care wards.Subjects Nine healthcare professionals working at different wards within one home care unit.Main outcome measures Determinants of implementation outcomes.Results Contextual determinants of the implementation process were mainly related to characteristics of the setting such as poorly designed information systems, work overload, and chaotic work environments. The identified barriers question the innovation’s appropriateness related to the setting’s needs but also provide possibilities for tailoring pharmacist services to local medication work issues. The observable positive effects and the perceived advantage of the pharmacist services are likely to facilitate the implementation process.Conclusion Our study provided information on contextual elements that influence the implementation process of non-dispensing pharmacist services. Awareness of these factors can help develop strategies to help the organization succeed in in achieving program outcomes.

Keywords

• Clinical pharmacists
• implementation science
• patient care management
• Norway
• home care services
• qualitative research