ReflACTION framework: A proposed model for implementation of clinical pharmacy services

Area of Science:

• Health Services Research
• Implementation Science
• Social Pharmacy

Background:

• Clinical pharmacy services (CPS) implementation is expanding globally.
• Few studies utilize models or frameworks for CPS implementation, especially in low and middle-income countries.
• Existing implementation frameworks have limitations in their application.

Purpose of the Study:

• To propose and describe the ReflACTION framework for facilitating CPS implementation.
• To systematize CPS implementation based on established theoretical references.
• To address limitations in current implementation framework usage.

Main Methods:

• The ReflACTION framework was developed from extensive experience implementing CPS in Brazil.
• It integrates theoretical references from Paulo Freire, the Maguerez Arc, and the Apoteca framework.
• The framework comprises five cyclical steps: observation, key-point gathering, theorization, solution hypothesis, and application.

Main Results:

• The ReflACTION framework operationalizes CPS implementation through five distinct steps.
• Key determinants such as the implementation team, stakeholder involvement, dialogue, and awareness are emphasized.
• The framework provides a structured process for guiding CPS implementation.

Conclusions:

• The ReflACTION framework offers a practical approach to describing and guiding CPS implementation.
• It contributes to implementation science knowledge, aiming for improved patient outcomes.
• The framework is particularly relevant for resource-limited settings and diverse healthcare systems.