Analysing the capacity of the community pharmacy setting for providing healthcare services : a collaborative stakeholder approach

Hossain, Lutfun Nahar

Analysing the capacity of the community pharmacy setting for providing healthcare services : a collaborative stakeholder approach

Hossain, Lutfun Nahar

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Publication Type:: Thesis
Issue Date:: 2017

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Field	Value	Language
dc.contributor.author	Hossain, Lutfun Nahar
dc.date.accessioned	2018-04-06T04:21:41Z
dc.date.available	2018-04-06T04:21:41Z
dc.date.issued	2017
dc.identifier.uri	http://hdl.handle.net/10453/123263
dc.description	University of Technology Sydney. Graduate School of Health.	en_AU
dc.description.abstract	Background: Primary Health Networks (PHNs) are independent organisations that aim to improve the effectiveness and efficiency of health services at a primary care level. The integration of community pharmacy services (CPSs) into primary care practice can be enhanced by developing suitable implementation programs. Two key steps are implicated in this process: (1) identify determinants of practice that can hinder (i.e., barriers) or enable (i.e., facilitators) CPS implementation (2) prioritise the determinants that should be primarily addressed. These determinants have been widely researched from the perspective of community pharmacists but not from the perspectives of other key stakeholders. Objectives: To identify the determinants of implementation of CPSs in Australia using a collaborative stakeholder approach, and prioritise the key determinants to be addressed to enhance the implementation of CPSs in a PHN in Australia. Methods: A systematic review of qualitative studies was conducted to identify determinants of CPS implementation based on the perspectives of key stakeholders i.e., patients, nurses and general practitioners (GPs) (Chapter 3). A qualitative study was conducted in the Western Sydney PHN in two phases. (1) Semi-structured interviews were conducted with ground-level stakeholders i.e., patients, pharmacists, GPs and a practice manager, to identify determinants relevant to this setting. Framework analysis methodology was used to analyse the data. (2) A stakeholder workshop was conducted with ground-level and system-level (i.e., PHN) stakeholders to prioritise key determinants to be addressed, using a four-quadrant priority matrix. Results: Sixty-three determinants of CPS implementation were identified in the systematic review (Chapter 3) across six ecological levels: (1) the patient; (2) individual healthcare professionals; (3) relationships between individuals; (4) community pharmacy setting; (5) community pharmacy service; and (6) community and healthcare system. This list of determinants was combined with previous pharmacist-centred literature to create an overarching framework of determinants that was applied in the qualitative study (Chapter 4). Twenty-two key determinants were selected in the qualitative study based on the importance and feasibility of addressing them in practice. The stakeholders agreed upon three determinants to address initially (Chapter 4). Conclusion: A comprehensive list of determinants of practice that influence the implementation of CPSs in Australia was created by combining the results of the systematic review with previous pharmacist-centred literature. This list can be used to identify determinants of practice to CPS implementation in other settings. To enhance the implementation of CPSs in the Western Sydney PHN, first implementation efforts should be directed towards the twenty-two key determinants of pharmacy practice, focusing initially on the three determinants agreed upon by the stakeholders. Importantly, future research must continue to engage stakeholders in the development evaluation of strategies to enhance CPS implementation.	en_AU
dc.format	Thesis (MPharm)
dc.language.iso	en_AU	en_AU
dc.relation	https://opus.lib.uts.edu.au/bitstream/10453/123263/7/02whole.pdf
dc.rights	The author owns the copyright in this thesis including all reproduction and reuse rights for the work. The work may not be altered without the permission of the copyright owner. Attribution is essential when quoting or paraphrasing from this thesis.
dc.rights	au.edu.uts.lib/ppc
dc.rights	info:eu-repo/semantics/openAccess
dc.title	Analysing the capacity of the community pharmacy setting for providing healthcare services : a collaborative stakeholder approach	en_AU
dc.type	Thesis	en_AU
utslib.copyright.status	open_access

Abstract:

Background: Primary Health Networks (PHNs) are independent organisations that aim to improve the effectiveness and efficiency of health services at a primary care level. The integration of community pharmacy services (CPSs) into primary care practice can be enhanced by developing suitable implementation programs. Two key steps are implicated in this process: (1) identify determinants of practice that can hinder (i.e., barriers) or enable (i.e., facilitators) CPS implementation (2) prioritise the determinants that should be primarily addressed. These determinants have been widely researched from the perspective of community pharmacists but not from the perspectives of other key stakeholders. Objectives: To identify the determinants of implementation of CPSs in Australia using a collaborative stakeholder approach, and prioritise the key determinants to be addressed to enhance the implementation of CPSs in a PHN in Australia. Methods: A systematic review of qualitative studies was conducted to identify determinants of CPS implementation based on the perspectives of key stakeholders i.e., patients, nurses and general practitioners (GPs) (Chapter 3). A qualitative study was conducted in the Western Sydney PHN in two phases. (1) Semi-structured interviews were conducted with ground-level stakeholders i.e., patients, pharmacists, GPs and a practice manager, to identify determinants relevant to this setting. Framework analysis methodology was used to analyse the data. (2) A stakeholder workshop was conducted with ground-level and system-level (i.e., PHN) stakeholders to prioritise key determinants to be addressed, using a four-quadrant priority matrix. Results: Sixty-three determinants of CPS implementation were identified in the systematic review (Chapter 3) across six ecological levels: (1) the patient; (2) individual healthcare professionals; (3) relationships between individuals; (4) community pharmacy setting; (5) community pharmacy service; and (6) community and healthcare system. This list of determinants was combined with previous pharmacist-centred literature to create an overarching framework of determinants that was applied in the qualitative study (Chapter 4). Twenty-two key determinants were selected in the qualitative study based on the importance and feasibility of addressing them in practice. The stakeholders agreed upon three determinants to address initially (Chapter 4). Conclusion: A comprehensive list of determinants of practice that influence the implementation of CPSs in Australia was created by combining the results of the systematic review with previous pharmacist-centred literature. This list can be used to identify determinants of practice to CPS implementation in other settings. To enhance the implementation of CPSs in the Western Sydney PHN, first implementation efforts should be directed towards the twenty-two key determinants of pharmacy practice, focusing initially on the three determinants agreed upon by the stakeholders. Importantly, future research must continue to engage stakeholders in the development evaluation of strategies to enhance CPS implementation.

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