Exploring long term implementation of cognitive services in community pharmacies - a qualitative study

Area of Science:

• Pharmacy Practice
• Health Services Research
• Implementation Science

Background:

• Implementing cognitive services in community pharmacies presents significant challenges.
• A staged approach to implementation requires specific initiatives for each phase.
• Understanding later-stage implementation factors is crucial for sustained service delivery.

Purpose of the Study:

• To gain insight into factors affecting the later stages of cognitive service implementation in community pharmacies.
• To identify barriers and facilitators for long-term adoption of new services.

Main Methods:

• A qualitative study involving semi-structured interviews with 12 Danish pharmacy staff.
• Exploration of implementation barriers and coping strategies for the Inhaler Technique Assessment Service (ITAS).
• Analysis using content analysis, critical common sense, and Rogers' Diffusion of Innovation theory.

Main Results:

• The primary long-term barrier was differential staff adoption rates of the ITAS.
• Low self-efficacy, rather than lack of competence, hindered laggard adoption.
• Lack of time, insufficient attention, and inadequate senior support were also significant issues.

Conclusions:

• Long-term implementation requires simultaneous individual and collective actions.
• The implementation process should be viewed as interrelated stages, not a linear progression.
• Pharmacy staff need support to overcome self-efficacy barriers and integrate services effectively.