Participatory Research for the Development of Community Pharmacy Services = Investigación Participativa para el Desarrollo de Servicios Farmacéuticos en Farmacia Comunitaria
- Publication Type:
- Thesis
- Issue Date:
- 2019
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The early involvement of key stakeholders (with various roles and perspectives) in the planning process of a community pharmacy service (CPS), increases the potential of such services to respond to real needs and to be integrated in practice. Participatory development of CPSs was explored in this thesis by reviewing the applicability of stakeholder analysis within planning processes, then putting into practice the initial steps of the development of a cardiovascular disease-prevention CPS.
A systematic scoping review was performed to investigate the use of stakeholder analyses in health innovation planning processes and revealed that stakeholder analyses were applied to all phases of the process. High heterogeneity was found in the steps to carry out stakeholder analysis, in the methods used, the stakeholder attributes analysed and the descriptions of the analyses. A tool to guide future reporting of stakeholder analyses (the RISA tool) resulted from this review.
The first step of the planning process that was put into practice was the identification and initial engagement of stakeholders. Two stakeholder analyses were performed using different methodologies (one in Australia, the other in Spain). In Australia, 46 stakeholders were identified, with 12 of them considered 饾槵饾槮饾樅 饾槾饾樀饾槩饾槵饾槮饾槱饾槹饾槶饾槬饾槮饾槼饾槾 because of their potential to drive or hinder the development of the service. Needs and gaps in cardiovascular care (饾槸 = 6), roles for community pharmacists in cardiovascular prevention (饾槸 = 12) and potential factors that can hinder the integration of CPSs into practice (饾槸 = 7) were also identified. In Spain, the stakeholder analysis revealed 217 stakeholders belonging to 10 groups and a collaboration network between the 96 stakeholders participating in the study. Out of the 217 stakeholders, 57 were considered critical because of having high influence and interest in the collaborative initiative to develop the CPS, being highly ranked key stakeholders, having most collaborations with other stakeholders or being most strategically situated in the network. The initiative was supported by stakeholders and could be put into effect by combining their capacities and willingness to contribute.
The second step was the development of a stakeholder-shared vision in Australia to establish common ground among stakeholders and focus planning efforts. Additionally, 24 initiatives to achieve such a vision were identified. As a result, a preliminary model for chronic care that stipulates which stakeholder groups to consider, seven principles for advanced care and six environmental factors that may influence the implementation of these principles (the NSW-MCC) was proposed.
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En el proceso de planificaci贸n de servicios profesionales farmac茅uticos asistenciales (SPFA), la participaci贸n temprana de actores clave, con distintos roles y perspectivas, aumenta el potencial de estos servicios para responder a necesidades reales e integrarse en la pr谩ctica. En esta tesis se explor贸 el desarrollo participativo de los SPFA revisando la aplicabilidad del an谩lisis de actores a lo largo de los procesos de planificaci贸n y llevando a la pr谩ctica los pasos iniciales del desarrollo de un SPFA orientado a la prevenci贸n de la enfermedad cardiovascular.
Se realiz贸 una 饾槾饾槫饾槹饾槺饾槳饾槸饾槰 饾槼饾槮饾樂饾槳饾槮饾樃 sistem谩tica para investigar el uso de los an谩lisis de actores en los procesos de planificaci贸n de innovaciones sanitarias que revel贸 que estos an谩lisis se aplicaban en todas las fases del proceso. Se encontr贸 mucha heterogeneidad en los pasos para realizar an谩lisis de actores, en los m茅todos utilizados, los atributos de los actores que se analizaban y las descripciones de los an谩lisis. Como resultado de esta revisi贸n, se propuso una gu铆a para reportar futuros an谩lisis de actores (la gu铆a RISA).
El primer paso del proceso de planificaci贸n que se llev贸 a cabo fue la identificaci贸n e involucraci贸n inicial de actores. Se realizaron dos an谩lisis de actores utilizando distintas metodolog铆as (uno en Australia, el otro en Espa帽a). En Australia, se identificaron 46 actores, de los que 12 se consideraron actores clave debido a su potencial para impulsar o dificultar el desarrollo del servicio. Tambi茅n se identificaron necesidades y carencias en el cuidado cardiovascular actual (n = 6), papeles que podr铆an jugar los farmac茅uticos comunitarios en la prevenci贸n cardiovascular (n = 12) y factores que potencialmente podr铆an dificultar la integraci贸n de SPFAs en la pr谩ctica (n = 12). En Espa帽a, el an谩lisis de actores revel贸 217 actores que pertenec铆an a 10 grupos y una red de colaboraci贸n entre los 96 actores que participaron en el estudio. De los 217 actores identificados, 57 se consideraron cr铆ticos por tener alta influencia e inter茅s en la iniciativa colaborativa para desarrollar el SPFA, puntuar alto como actores clave, ser de los que ten铆an m谩s colaboraciones con otros actores o estar m谩s estrat茅gicamente situados en la red. En general, los actores apoyaron la iniciativa y, combinando sus capacidades y voluntad de contribuir, 茅sta se podr铆a poner en marcha.
El segundo paso consisti贸 en el desarrollo de una visi贸n conjunta de los actores en Australia para establecer un punto de partida com煤n y centrar los esfuerzos de planificaci贸n. Adem谩s, se identificaron 24 iniciativas para alcanzar dicha visi贸n. Como resultado, se propuso un modelo preliminar para el cuidado cr贸nico (el NSW-MCC) en el que se estipulan los grupos de actores a considerar, siete principios para un cuidado de calidad y seis factores ambientales que pueden influir en la implantaci贸n de estos principios.
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