Implementation of diabetes screening in community pharmacy - factors influencing successful implementation

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.

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

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.

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.

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.