Introduction

Community pharmacists are increasingly providing a range of professional health services. Whilst research provides evidence of their benefits, knowledge translation into practice has been challenging both in Australia and internationally. An opportunity to develop a granular understanding of factors driving successful implementation was presented by the Pharmacy Diabetes Screening Trial (PDST), a clustered Randomised Controlled Trial (RCT) implemented in a random sample of 339 Australian community pharmacies. Its aim was to compare the clinical and cost effectiveness of three pharmacy-based diabetes screening interventions.

Objective

To investigate the experiences of Australian community pharmacists in the implementation of the PDST and factors influencing implementation success.

Methods

Semi-structured telephone interviews were conducted with a stratified sample of pharmacist trial participants based on screening performance (number screened relative to target), location, and trial arm. All interviews were audio-recorded and transcribed ad verbatim. Interviews were continued until saturation. Initial thematic analysis was followed by in-depth analysis to test the extent to which the data fitted with three previously described overarching themes driving successful national implementation of innovation in community pharmacy.

Results

From August 2017 to October 2017, 21 interviews were conducted; 12 with high-performing and 9 with low-performing pharmacists. The key enablers and barriers were qualities of a pharmacy champion and active staff engagement, ease of implementation related to the number of working pharmacists and other staff, the external context including engagement with consumers and doctors, and consumer demand. It was also identified that attitudes/emphasis towards implementation planning and conscious prioritisation of service delivery by pharmacists may have been key differences between high- and low-performing pharmacies.

Conclusion

Insights into the interaction between individual, organisational, and external factors influencing successful implementation of community pharmacy innovations highlighted in this study should inform the design of future innovations to ensure their success and sustainability.

中文翻译：

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社区药房糖尿病筛查的实施——影响成功实施的因素

介绍

Community pharmacists are increasingly providing a range of professional health services. Whilst research provides evidence of their benefits, knowledge translation into practice has been challenging both in Australia and internationally. An opportunity to develop a granular understanding of factors driving successful implementation was presented by the Pharmacy Diabetes Screening Trial (PDST), a clustered Randomised Controlled Trial (RCT) implemented in a random sample of 339 Australian community pharmacies. Its aim was to compare the clinical and cost effectiveness of three pharmacy-based diabetes screening interventions.

Objective

To investigate the experiences of Australian community pharmacists in the implementation of the PDST and factors influencing implementation success.

Methods

半结构化电话访谈是根据筛选表现（相对于目标筛选的人数）、地点和试验组对药剂师试验参与者的分层样本进行的。所有采访都被录音并逐字转录。采访一直持续到饱和。最初的主题分析之后是深入分析，以测试数据与之前描述的三个总体主题相吻合的程度，推动了国家社区药学创新的成功实施。

结果

2017年8月至2017年10月，共进行了21次访谈；12 名高绩效药剂师和 9 名低绩效药剂师。关键的推动因素和障碍是药房冠军的素质和积极的员工参与度、与在职药剂师和其他员工数量相关的实施容易程度、包括与消费者和医生的接触在内的外部环境以及消费者需求。还确定了对实施计划的态度/重点和药剂师对服务提供的有意识的优先排序可能是高绩效药房和低绩效药房之间的主要区别。

结论

深入了解影响本研究中强调的社区药学创新成功实施的个人、组织和外部因素之间的相互作用，应该为未来创新的设计提供信息，以确保其成功和可持续性。