Implementation evaluation of a pharmacist prescribing service for the management of dermatological conditions: a study protocol.
- Publisher:
- BMC
- Publication Type:
- Journal Article
- Citation:
- BMC Health Serv Res, 2025, 25, (1), pp. 1333
- Issue Date:
- 2025-10-08
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BACKGROUND: The scope of practice for community pharmacists is evolving globally. Policy drivers are to increase access to primary care, due to the lack of accessibility to general medical practitioners or inappropriate demand on emergency departments. Most implementation studies in this space have reported on determinants for pharmacist prescribing services. There is a lack of comprehensive evaluations including investigation of the implementation process and outcomes. METHODS: A cohort design hybrid type 2 effectiveness-implementation study, applying mixed methods will be carried out between 19th July 2024 and 31st August 2025. This paper is focussed on implementation evaluation components. Pharmacists who participated in either of two previous trials will invite consecutive patients with symptoms suggestive of impetigo, mild to moderate atopic dermatitis, mild plaque psoriasis or herpes zoster to participate. The intervention is a pharmacist-patient consultation utilising codesigned clinical guidelines. Following pharmacist training, the primary implementation strategy will be facilitation, with tailored implementation strategies delivered by implementation facilitators (IFs) based on individual pharmacy and pharmacist level barriers. IFs will be trained and will receive regular feedback from the research team. The assessment of the implementation impact will include the identification of implementation determinants (Consolidate Framework of Implementation Research, CFIR) and their link to strategies (Expert Recommendations for Implementing Change, ERIC). The evaluation of the implementation process will measure the progression of implementation stages (Exploration, Preparation, Implementation, Sustainment, EPIS). The analysis of implementation outcomes will follow Proctor et al. recommendations (acceptability, adoption, appropriateness, feasibility, fidelity and reach). Practical tools for IFs will be used including a checklist to guide the identification, evaluation and documentation of implementation determinants to guide problem-solving solutions and to collect implementation outcomes during encounters with pharmacists. Three reports will be used to provide feedback to IFs. Semi-structured interviews with patients, pharmacists and other key parties will be used to evaluate acceptability, appropriateness and feasibility and sustainment will be explored by using normalisation process theory. DISCUSSION: This study will contribute to the literature by generating new data on the implementation of pharmacist prescribing services with a detailed facilitation process to support implementers and a detailed process to assess tailored implementation strategies. TRIAL REGISTRATION: The trial was registered on 18 July 2024 with the Australian New Zealand Clinical Trials Registry (ANZCTR): ACTRN12624000877583 (Protocol Version 7, 10 July 2024). SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12913-025-13128-3.
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