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      Implementation of pharmacist-led services in primary care: A mixed-methods exploration of pharmacists’ perceptions of a national educational resource package

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          Abstract

          Background:

          To help alleviate the global pressure on primary care, there has been an increase in the number of clinical pharmacists within primary care. Educational resources are necessary to support this workforce and their development within this role. An educational resource package was developed in Scotland to support the General Practice Clinical Pharmacists (GPCPs), containing a hard copy Competency and Capability Framework (CCF), an online platform (TURAS) and both clinical and educational supervisors in 2016.

          Objective:

          To examine the implementation of a competency-based educational resource package through the exploration of pharmacists’ perceptions of its adoption, acceptability, appropriateness, and feasibility.

          Methods:

          Participants were GPCPs who had been part of a national training event between 2016 and 2018. The participants were given the opportunity to complete an online questionnaire or a semi-structured telephone interview. Both data collection tools were based on Proctor’s model of implementation outcomes: adoption, acceptability, appropriateness and feasibility. Areas covered included GPCPs’ perceptions and level of adoption of the educational resource package developed to support them in their role.

          Results:

          Of a potential 164 participants, 52 (31.7%) completed the questionnaire and 12 (7.3%) completed the interview. GPCPs indicated widespread adoption and were accepting of the resources; however, it was suggested that its value was undermined, as it was not associated with a qualification. The appropriateness and feasibility of the resources depended on GPCPs’ individual situation (including current role, previous job experience, time available, support received from peers and supervisors, and perceptions of resources available).

          Conclusions:

          The suitability of the CCF was evidenced by participants’ adoption and acceptance of the resource, indicating the necessity of a competence-based framework to support the GPCPs’ role. However, its suitability was hindered in terms of varied perceptions of appropriateness and feasibility. Despite the limited sample size, the results indicate that the value of these resources should be promoted across primary care; nevertheless further facilitation is required to allow GPCPs to fully engage with the resources.

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          Most cited references52

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          The qualitative content analysis process.

          This paper is a description of inductive and deductive content analysis. Content analysis is a method that may be used with either qualitative or quantitative data and in an inductive or deductive way. Qualitative content analysis is commonly used in nursing studies but little has been published on the analysis process and many research books generally only provide a short description of this method. When using content analysis, the aim was to build a model to describe the phenomenon in a conceptual form. Both inductive and deductive analysis processes are represented as three main phases: preparation, organizing and reporting. The preparation phase is similar in both approaches. The concepts are derived from the data in inductive content analysis. Deductive content analysis is used when the structure of analysis is operationalized on the basis of previous knowledge. Inductive content analysis is used in cases where there are no previous studies dealing with the phenomenon or when it is fragmented. A deductive approach is useful if the general aim was to test a previous theory in a different situation or to compare categories at different time periods.
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            Using the framework method for the analysis of qualitative data in multi-disciplinary health research

            Background The Framework Method is becoming an increasingly popular approach to the management and analysis of qualitative data in health research. However, there is confusion about its potential application and limitations. Discussion The article discusses when it is appropriate to adopt the Framework Method and explains the procedure for using it in multi-disciplinary health research teams, or those that involve clinicians, patients and lay people. The stages of the method are illustrated using examples from a published study. Summary Used effectively, with the leadership of an experienced qualitative researcher, the Framework Method is a systematic and flexible approach to analysing qualitative data and is appropriate for use in research teams even where not all members have previous experience of conducting qualitative research.
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              Outcomes for Implementation Research: Conceptual Distinctions, Measurement Challenges, and Research Agenda

              An unresolved issue in the field of implementation research is how to conceptualize and evaluate successful implementation. This paper advances the concept of “implementation outcomes” distinct from service system and clinical treatment outcomes. This paper proposes a heuristic, working “taxonomy” of eight conceptually distinct implementation outcomes—acceptability, adoption, appropriateness, feasibility, fidelity, implementation cost, penetration, and sustainability—along with their nominal definitions. We propose a two-pronged agenda for research on implementation outcomes. Conceptualizing and measuring implementation outcomes will advance understanding of implementation processes, enhance efficiency in implementation research, and pave the way for studies of the comparative effectiveness of implementation strategies.
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                Author and article information

                Contributors
                Journal
                Pharm Pract (Granada)
                Pharm Pract (Granada)
                Pharmacy Practice
                Centro de Investigaciones y Publicaciones Farmaceuticas
                1885-642X
                1886-3655
                Jul-Sep 2021
                13 September 2021
                : 19
                : 3
                : 2440
                Affiliations
                BA (Hons), MSc. Strathclyde Institute of Pharmacy and Biomedical Science, University of Strathclyde . Glasgow (United Kingdom). kate.preston@ 123456strath.ac.uk
                MPharm, PhD. Strathclyde Institute of Pharmacy and Biomedical Science, University of Strathclyde . Glasgow (United Kingdom). natalie.m.weir@ 123456strath.ac.uk
                MPharm (equiv), MPH, PhD. Strathclyde Institute of Pharmacy and Biomedical Science, University of Strathclyde . Glasgow (United Kingdom). tanja.muller@ 123456strath.ac.uk
                BA (Hons), MRes, PhD. Strathclyde Institute of Pharmacy and Biomedical Science, University of Strathclyde . Glasgow (United Kingdom). rosemary.e.newham@ 123456strath.ac.uk
                BSc, MSc (Clin Pharm). Strathclyde Institute of Pharmacy and Biomedical Science, University of Strathclyde . Glasgow (United Kingdom). marion.bennie@ 123456strath.ac.uk
                Author notes

                Conceptualization: NMW, TM, RN, MB. Formal analysis: KP, NMW. Funding acquisition: RN, MB. Investigation: KP, NMW. Methodology: KP, NMW, TM, RN. Writing – original draft: KP, RN. Writing – review & editing: KP, NMW, TM, RN, MB.

                Author information
                https://orcid.org/0000-0002-3771-0802
                https://orcid.org/0000-0003-1422-9415
                https://orcid.org/0000-0002-0418-4789
                https://orcid.org/0000-0001-6816-3111
                https://orcid.org/0000-0002-4046-629X
                Article
                pharmpract-19-2440
                10.18549/PharmPract.2021.3.2440
                8456343
                71609af8-965d-405e-80cf-57efa53acaa7
                Copyright: © Pharmacy Practice

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY-NC-ND 4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 26 May 2021
                : 12 September 2021
                Categories
                Original Research

                pharmacists,general practice,primary health care,pharmaceutical services,delivery of health care,regional health planning,perception,program evaluation,surveys and questionnaires,qualitative research,scotland

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