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Implementation of statewide protocols for community-based pharmacist services in Virginia: A qualitative study using
Journal of the American Pharmacists Association : Japha
|October 31, 2025
Summary
Virginia pharmacists can offer clinical services, but low utilization (24%) highlights implementation barriers. Addressing resource limits and workflow integration is key to expanding pharmacy-based health care access.
Area of Science:
- Health Services Research
- Implementation Science
- Pharmacy Practice
Background:
- 2020 Virginia legislation allows pharmacists to provide clinical services via statewide protocols.
- Low utilization (24%) necessitates understanding implementation challenges.
- Expanding health care access through pharmacy services is a public health priority.
Purpose of the Study:
- Identify contextual factors influencing the implementation of statewide protocols for pharmacist-provided clinical services.
- Examine barriers and facilitators in Virginia community-based pharmacies.
- Inform strategies to increase the adoption of pharmacy clinical services.
Main Methods:
- Conducted semistructured interviews with 16 community-based pharmacists (November 2024 - May 2025).
- Utilized the Consolidated Framework for Implementation Research (CFIR) 2.0 for interview guide development and analysis.
- Employed inductive coding and deductive mapping to CFIR constructs for data analysis.
Main Results:
- Facilitators included perceived patient access benefits and alignment with professional roles.
- Barriers involved resource limitations, protocol complexity, and structural issues (space, workflow).
- Independent pharmacists reported more autonomy; rural pharmacists showed innovation in addressing access gaps.
Conclusions:
- Statewide protocols offer potential for enhanced health care access but require interventions for resource constraints and workflow integration.
- Targeted support is crucial for successful implementation in community pharmacies.
- Tailored strategies are needed for independent and chain pharmacies to boost protocol adoption.
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