TY - JOUR
T1 - Barriers and facilitators for the implementation of the CombiConsultation by general practitioners, pharmacists and practice nurses
T2 - a qualitative interview study
AU - Meijvis, Valérie A.M.
AU - Heringa, Mette
AU - Kwint, Henk Frans
AU - de Wit, Niek J.
AU - Bouvy, Marcel L.
N1 - Funding Information:
This work was supported by ZonMw GGG-STIP grant number 848023004. ZonMw is the Dutch national organization for health research and healthcare innovation.
Funding Information:
The CombiConsultation has been developed by the pharmacists of cooperating pharmacies ‘Rijn en Gouwe’. We, the authors, thank all pharmacists, general practitioners and practice nurses for their participation in this study. We also thank the pharmacy master students Warsha Nanhoe (WN), Fleur van Gelder and Ivona Brozina.
Publisher Copyright:
© 2023, The Author(s).
PY - 2023/8
Y1 - 2023/8
N2 - Background: The CombiConsultation is a consultation with the pharmacist for patients with a chronic condition, aligned with the periodic consultation with the practice nurse or general practitioner. Implementation requires adjustments in the working methods of these healthcare providers and therefore behavioural changes. Aim: The aim of this study was to identify the barriers and facilitators that determine the behavioural changes by pharmacists, general practitioners and practice nurses required for the implementation of the CombiConsultation. Method: Ten community pharmacists, 5 practice nurses and 5 general practitioners were sampled from practices enrolled in the CombiConsultation study. Their views regarding the implementation of this clinical pharmacy service were explored using interviews based on the 14 domains of the Theoretical Domains Framework (TDF), which are linked to the Capability-Opportunity-Motivation-Behaviour-model. Barriers and facilitators in the domains were assessed by content analysis. Results: Twelve barriers and 23 facilitators were found within 13 TDF domains with high agreement between the healthcare providers. Important facilitators for implementation were the pharmacists’ expertise in pharmacotherapy (capability), access to medical data and physical proximity between professional practices (opportunity). Barriers were pharmacists’ insufficient consultation- and clinical-reasoning skills (capability), insufficient staff (opportunity) and reimbursement and lack of coordination among all involved healthcare providers (motivation). Conclusion: All healthcare providers are motivated to implement the CombiConsultation. An existing collaborative practice, with a clear and accepted professional role of the pharmacist is essential. Training of pharmacists in consultation and clinical-reasoning skills can be beneficial, as well as arrangements on the consultation logistics, and reimbursement.
AB - Background: The CombiConsultation is a consultation with the pharmacist for patients with a chronic condition, aligned with the periodic consultation with the practice nurse or general practitioner. Implementation requires adjustments in the working methods of these healthcare providers and therefore behavioural changes. Aim: The aim of this study was to identify the barriers and facilitators that determine the behavioural changes by pharmacists, general practitioners and practice nurses required for the implementation of the CombiConsultation. Method: Ten community pharmacists, 5 practice nurses and 5 general practitioners were sampled from practices enrolled in the CombiConsultation study. Their views regarding the implementation of this clinical pharmacy service were explored using interviews based on the 14 domains of the Theoretical Domains Framework (TDF), which are linked to the Capability-Opportunity-Motivation-Behaviour-model. Barriers and facilitators in the domains were assessed by content analysis. Results: Twelve barriers and 23 facilitators were found within 13 TDF domains with high agreement between the healthcare providers. Important facilitators for implementation were the pharmacists’ expertise in pharmacotherapy (capability), access to medical data and physical proximity between professional practices (opportunity). Barriers were pharmacists’ insufficient consultation- and clinical-reasoning skills (capability), insufficient staff (opportunity) and reimbursement and lack of coordination among all involved healthcare providers (motivation). Conclusion: All healthcare providers are motivated to implement the CombiConsultation. An existing collaborative practice, with a clear and accepted professional role of the pharmacist is essential. Training of pharmacists in consultation and clinical-reasoning skills can be beneficial, as well as arrangements on the consultation logistics, and reimbursement.
KW - CombiConsultation
KW - Community pharmacist
KW - General practice
KW - Pharmaceutical care
KW - Primary care
UR - http://www.scopus.com/inward/record.url?scp=85160618520&partnerID=8YFLogxK
U2 - 10.1007/s11096-023-01597-7
DO - 10.1007/s11096-023-01597-7
M3 - Article
C2 - 37253951
AN - SCOPUS:85160618520
SN - 2210-7703
VL - 45
SP - 970
EP - 979
JO - International journal of clinical pharmacy
JF - International journal of clinical pharmacy
IS - 4
ER -