The Aged Care Onsite Pharmacist (ACOP) program in Australia: a qualitative study to examine key considerations for...

The Aged Care Onsite Pharmacist (ACOP) program was recently launched in Australia to enable pharmacists to deliver clinical governance, clinical pharmacy and education services on the ground in residential aged care homes (RACHs). As the program is now being scaled up nationally, it is crucial to understand the complex interactions between various factors at the individual and organisational levels to ensure the program is successfully implemented and achieves its ultimate goal of improving the quality use of medicines in RACHs.

This qualitative study aimed to explore stakeholders' perspectives on medication management, perceived value of onsite pharmacists, and key considerations for successful program implementation in RACHs.

We employed a qualitative approach and conducted semi-structured interviews (n = 61) with residents/families, pharmacists, medical practitioners, RACH staff, and individuals involved in policy and planning. Participants with experience working in both metropolitan and rural areas were included. The interviews were audio-recorded, transcribed, and thematically analysed, both inductively and deductively. The Consolidated Framework for Implementation Research informed the design of the study, developing interview schedules and data analysis.

Factors influencing the program implementation were grouped into five themes: (1) Individuals: factors concerning individuals involved in the program; (2) Innovation: factors related to the program design; (3) Process: implementation process actions; (4) Inner setting: factors relating to the organisational context; and (5) Outer setting: factors pertaining to the policy context. Most participants valued the potential contribution of onsite pharmacists. Program flexibility was noted as essential to increase its acceptability, uptake and adoptability. A desire for implementation strategies was evident. Workforce, organisational leadership, infrastructure and resources, and broader policy support were noted as critical for the program's success.

The ACOP program represents a promising strategy to enhance medication management in RACHs. However, implementation on a large scale necessitates a thoughtful consideration of various interconnected factors at the individual, organisation and policy levels that may affect its uptake, adoptability, and long-term sustainability. This has implications for policymakers and providers at the scale up phase to ensure the program achieves its ultimate goal of enhancing residents' health outcomes.