title: Understanding practice change in community pharmacy: a qualitative study in Australia.
abstract: BACKGROUND
  Much of the research on cognitive pharmaceutical services has focused on understanding or changing community pharmacist behaviour, with few studies focusing on the pharmacy as the unit of analysis or considering the whole profession as an organisation.
  
  
  OBJECTIVE
  To investigate practice change and identify facilitators of this process in community pharmacy, with specific focus on the implementation of cognitive pharmaceutical services (CPS) and related programs.
  
  
  METHODS
  Thirty-six in-depth, semistructured interviews were conducted with participants from 2 groups, community pharmacies and pharmacy "strategists," in Australia. The interview guide was based on a framework of organizational theory, with 5 subject areas: roles and goals of participants in relation to practice change; experiences with CPS; change strategies used; networks important to the change process; and business impacts of CPS. Interviews were transcribed verbatim and thematically content analyzed, using NVivo software for data management.
  
  
  RESULTS
  Five key themes relating to the change process were derived from the interviews: change strategies (process- and behaviorally oriented); social networks (within and beyond the pharmacy); drivers of change (eg, government policy); motivators (eg, professional satisfaction); and facilitators of practice change (remuneration for implementation or service delivery, communication and teamwork, leadership, task delegation, external support or assistance, and reorganization of structure and function).
  
  
  CONCLUSIONS
  The use of an organizational perspective yielded rich data from which an understanding of the practice change process in relation to CPS implementation was gained. Current programs for the implementation and delivery of CPS have not taken into account all of the factors that have the ability to facilitate change in community pharmacy. Not only do future programs need to be underpinned by these elements, but policy makers must include them when planning remuneration and dissemination strategies.
authors.affiliation: Pharmacy Practice Research, Faculty of Pharmacy, University of Sydney, NSW 2006, Australia. alison@pharm.usyd.edu.au
authors.forename: Alison S
authors.initials: AS
authors.lastname: Roberts
authors.forename: S I Charlie
authors.initials: SI
authors.lastname: Benrimoj
authors.forename: Timothy F
authors.initials: TF
authors.lastname: Chen
authors.forename: Kylie A
authors.initials: KA
authors.lastname: Williams
authors.forename: Trine R
authors.initials: TR
authors.lastname: Hopp
authors.forename: Parisa
authors.initials: P
authors.lastname: Aslani
mesh_terms: D001315:Australia; D009936:Organizational Innovation; D010594:Pharmacies / Q000458:organization & administration*; D036301:Qualitative Research