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Published on: February 19, 2021
Implementation of statewide protocols for community-based pharmacist services in Virginia: A qualitative study using
Background:
Despite the 2020 legislation authorizing Virginia pharmacists to provide clinical services under statewide protocols, utilization remains low at 24%. Understanding implementation barriers and facilitators is crucial for expanding health care access through pharmacy services.
Objective:
To identify contextual factors affecting the implementation of statewide protocols for pharmacist-provided clinical services in Virginia community-based pharmacies.
Methods:
Semistructured interviews were conducted with 16 community-based pharmacists between November 2024 and May 2025. The Consolidated Framework for Implementation Research (CFIR) 2.0 guided interview development and analysis. Interviews were transcribed verbatim and analyzed using inductive coding followed by deductive mapping to CFIR constructs.
Results:
Statewide protocol implementation was facilitated by clear relative advantage in improving patient access and strong alignment with pharmacists' professional mission. Key barriers included resource limitations, complexity, and structural characteristics namely physical space and workflow integration. Independent pharmacists reported greater implementation autonomy compared to chain pharmacists. Rural pharmacists faced unique challenges but emerged as innovators when protocols addressed critical health care access gaps.
Conclusions:
Statewide protocols show promise for expanding health care access but require targeted interventions addressing resource constraints, workflow integration, and implementation support. Tailored implementation strategies are needed for independent and chain community-based pharmacies to expand adoption.
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