title: Stakeholder analysis for the development of a community pharmacy service aimed at preventing cardiovascular disease.
abstract: Participatory approaches involving stakeholders across the health care system can help enhance the development, implementation and evaluation of health services. These approaches may be particularly useful in planning community pharmacy services and so overcome challenges in their implementation into practice. Conducting a stakeholder analysis is a key first step since it allows relevant stakeholders to be identified, as well as providing planners a better understanding of the complexity of the health care system.
  
  
  
  The main aim of this study was to conduct a stakeholder analysis to identify those individuals and organizations that could be part of a leading planning group for the development of a community pharmacy service (CPS) to prevent cardiovascular disease (CVD) in Australia.
  
  
  
  An experienced facilitator conducted a workshop with 8 key informants of the Australian health care system. Two structured activities were undertaken. The first explored current needs and gaps in cardiovascular care and the role of community pharmacists. The second was a stakeholder analysis, using both ex-ante and ad-hoc approaches. Identified stakeholders were then classified into three groups according to their relative influence on the development of the pharmacy service. The information gathered was analyzed using qualitative content analysis.
  
  
  
  The key informants identified 46 stakeholders, including (1) patient/consumers and their representative organizations, (2) health care providers and their professional organizations and (3) institutions and organizations that do not directly interact with patients but organize and manage the health care system, develop and implement health policies, pay for health care, influence funding for health service research or promote new health initiatives. From the 46 stakeholders, a core group of 12 stakeholders was defined. These were considered crucial to the service's development because they held positions that could drive or inhibit progress. Secondary results of the workshop included: a list of needs and gaps in cardiovascular care (n = 6), a list of roles for community pharmacists in cardiovascular prevention (n = 12) and a list of potential factors (n = 7) that can hinder the integration of community pharmacy services into practice.
  
  
  
  This stakeholder analysis provided a detailed picture of the wide range of stakeholders across the entire health care system that have a stake in the development of a community pharmacy service aimed at preventing CVD. Of these, a core group of key stakeholders, with complementary roles, can then be approached for further planning of the service. The results of this analysis highlight the relevance of establishing multilevel stakeholder groups for CPS planning.
authors.affiliation: Graduate School of Health, University of Technology Sydney, Level 4, Building 7, 67 Thomas Street, Ultimo, NSW 2007 (P.O. Box 123), Australia; Academic Centre of Pharmaceutical Care, University of Granada, Faculty of Pharmacy, Campus Universitario Cartuja S/N, 18071 Granada, Spain. Electronic address: Lucia.FrancoTrigo@student.uts.edu.au.
authors.forename: L
authors.initials: L
authors.lastname: Franco-Trigo
authors.affiliation: Graduate School of Health, University of Technology Sydney, Level 4, Building 7, 67 Thomas Street, Ultimo, NSW 2007 (P.O. Box 123), Australia.
authors.forename: L N
authors.initials: LN
authors.lastname: Hossain
authors.affiliation: Graduate School of Health, University of Technology Sydney, Level 4, Building 7, 67 Thomas Street, Ultimo, NSW 2007 (P.O. Box 123), Australia.
authors.forename: D
authors.initials: D
authors.lastname: Durks
authors.affiliation: Institute for Sustainable Futures, University of Technology Sydney, Level 11, Building 10, 235 Jones Street, Ultimo, NSW 2007 (P.O. Box 123), Australia.
authors.forename: D
authors.initials: D
authors.lastname: Fam
authors.affiliation: Faculty of Health, University of Technology Sydney, Level 3, Building 10, 235 Jones Street, Ultimo, NSW 2007 (P.O. Box 123), Australia.
authors.forename: S C
authors.initials: SC
authors.lastname: Inglis
authors.affiliation: Graduate School of Health, University of Technology Sydney, Level 4, Building 7, 67 Thomas Street, Ultimo, NSW 2007 (P.O. Box 123), Australia.
authors.forename: S I
authors.initials: SI
authors.lastname: Benrimoj
authors.affiliation: Graduate School of Health, University of Technology Sydney, Level 4, Building 7, 67 Thomas Street, Ultimo, NSW 2007 (P.O. Box 123), Australia; Academic Centre of Pharmaceutical Care, University of Granada, Faculty of Pharmacy, Campus Universitario Cartuja S/N, 18071 Granada, Spain.
authors.forename: D
authors.initials: D
authors.lastname: Sabater-Hernández
mesh_terms: D001315:Australia; D002318:Cardiovascular Diseases / Q000517:prevention & control*; D003157:Community Pharmacy Services / Q000458:organization & administration*; D003695:Delivery of Health Care / Q000458:organization & administration; D006291:Health Policy; D006302:Health Services Research; D006801:Humans; D010595:Pharmacists / Q000458:organization & administration*; D024382:Professional Role
keywords: Australia [MeSH]; Cardiovascular diseases [MeSH]; Community pharmacy services [MeSH]; Health planning [MeSH]; Stakeholder analysis; Stakeholder mapping