title: Evaluation of the implementation process and outcomes of a professional pharmacy service in a community pharmacy setting. A case report.
abstract: Pharmacist-led medication review services are recognized as a key to medicines management. This case study describes the implementation process of a medication review with follow-up service in a community pharmacy setting and evaluates its initial outcomes. An implementation-effectiveness hybrid study was undertaken in a community pharmacy setting. The implementation process was divided into four different phases: Exploration and adoption, program installation, initial implementation, and full operation. A core set of implementation outcomes was measured, including penetration, implementation costs, feasibility, fidelity, acceptability, appropriateness and efficiency. The penetration rate of the service was nearly 62.5%, and the implementation costs were 57,359.67€. There was a high retention-participation rate of patients. For every month of service provision, there was a 1.27 increase in the number of patients requesting the service, compared to the number of patients being offered the service. The time spent on service provision was 171.7 min per patient. Average patient satisfaction with the service was 4.82 (SD: 0.39, scale 1-5), and the acceptance rate of care plans by patients and general medical practitioners were 96.99% and 96.46%, respectively. There were 408 negative outcomes associated with the use of medications were identified during the study (3.09 per patient), of which 96.3% were resolved. The average time per patient spent on service provision significantly decreased along the 18 months of service provision. This case report can assist individual pharmacists and professional organizations interested in implementing evidence-based services by offering an example on how to approach the implementation process in a systematic way.
authors.affiliation: Graduate School of Health, University of Technology Sydney, P.O. Box 123 Broadway, New South Wales 2007, Sydney, Australia. Electronic address: Victoria.garciacardenas@uts.edu.au.
authors.forename: Victoria
authors.initials: V
authors.lastname: Garcia-Cardenas
authors.affiliation: Graduate School of Health, University of Technology Sydney, P.O. Box 123 Broadway, New South Wales 2007, Sydney, Australia.
authors.forename: Shalom I
authors.initials: SI
authors.lastname: Benrimoj
authors.affiliation: Pharmaceutical Care Research Group, University of Granada, Facultad de Farmacia, Campus de Cartuja s/n. 18071, Granada, Spain.
authors.forename: Carla Castrillon
authors.initials: CC
authors.lastname: Ocampo
authors.affiliation: Gipuzkoa College of Pharmacists, Spain.
authors.forename: Estíbaliz
authors.initials: E
authors.lastname: Goyenechea
authors.affiliation: Pharmaceutical Care Research Group, University of Granada, Facultad de Farmacia, Campus de Cartuja s/n. 18071, Granada, Spain.
authors.forename: Fernando
authors.initials: F
authors.lastname: Martinez-Martinez
authors.affiliation: Pharmaceutical Care Research Group, University of Granada, Facultad de Farmacia, Campus de Cartuja s/n. 18071, Granada, Spain.
authors.forename: Miguel Angel
authors.initials: MA
authors.lastname: Gastelurrutia
mesh_terms: D003157:Community Pharmacy Services / Q000458:organization & administration*; D006801:Humans; D054539:Medication Therapy Management / Q000458:organization & administration*; D017060:Patient Satisfaction; D010595:Pharmacists / Q000458:organization & administration*; D024382:Professional Role; D016730:Program Development; D015397:Program Evaluation; D013997:Time Factors
keywords: Community pharmacy; Implementation; Implementation framework; Implementation outcome; Medication review; Professional pharmacy service