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Linking implementation factors and targeted strategies for optimal implementation of community pharmacy services

  • At: PPR 2022 (2022)
  • Type: Poster
  • Poster code: PM-16
  • By: GRAHAM, Emma L. (Pharmaceutical Care Research Group (University of Granada))
  • Co-author(s): Emma L. Graham, PhD Student, Pharmaceutical Care Research Group (University of Granada), Spain
    Noelia Amador-Fernández, Spanish Society of Community Pharmacy (SEFAC), Spain
    Vicente J. Baixauli, MICOF (Valencia), Spain
    Shalom I. Benrimoj
    Vicente Colomer-Molina
    Ricardo Fuertes-González
    Óscar García-Agudo
    Victoria García-Cárdenas
    Jesús C. Gómez-Martínez
    Elena Pérez-Hoyos
    Fernando Martínez-Martínez



  • Abstract:

    Background: The implementation of evidence-based practices is complex, with multiple implementation factors (IFs) that can impede (barriers) or reinforce (facilitators) this process. Change Agents (CAs) can design and apply targeted implementation strategies (TIS) with the intention of optimising the implementation process. However, there is a methodological gap linking IFs to TIS, particularly for community pharmacy services. This research is being undertaken as part of an implementation study of a Minor Ailments Service (MAS), “INDICA+PRO”, in Spanish community pharmacies (CPs).

    Purpose: The objective is to develop a standardised classification system for IFs and discrete or multifaceted TIS based on implementation science theory, thus potentially measuring their effectiveness. Secondly, to design a software tool so that INDICA+PRO CAs can document their activity during the facilitation process.

    Method: A search of implementation science journals was conducted in order to identify frameworks, classification systems, compilations and menus for IFs and TIS and to apply them within the INDICA+PRO implementation study. The INDICA+PRO implementation study is a type 3 hybrid effectiveness-implementation design trial which will be carried out in Spanish CPs between October 2020 and December 2022.

    Results: For the standardised classification system of identified IFs, the Consolidated Framework for Implementation Research (CFIR) menu of constructs was derived and adapted. For the TIS, Dogherty’s compilation of discrete, practical facilitation activities was selected and adapted. These two classification systems, consisting of 62 categories of IFs, together with 56 discrete TIS were incorporated into a software tool located on the SEFAC eXPERT® platform. This tool enables the selection, description, linking and the reporting of outcomes of IFs and TIS by the INDICA+PRO study’s CAs.

    Conclusion: Addressing the existing gap in the literature and linking standardised IFs to TIS will play a vital role in in the improvement of the selection, combination and effectiveness of TIS when implementing an evidence-based practice in CP. The information documented in the software tool will be used to continuously monitor and facilitate the implementation of a MAS in Spanish CPs, aiding the INDICA+PRO CAs in facilitating change.

Last update 28 September 2023

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