Pharmacy role in the proMotion of continencE (PRIME): a co-production study to develop a pharmacy bladder and bowel...

Urinary and faecal incontinence affects millions. Community pharmacies provide local community healthcare highlighting opportunity for innovation in continence promotion. The Pharmacy Role In the proMotion of continencE (PRIME) study was conducted to investigate development of a Pharmacy Bladder and Bowel Service (PBBS) incorporating key stakeholder engagement.

A UK online survey, employing convenience sampling of community pharmacy staff identified current practice, and barriers and facilitators to PBBS development, between July and November 2022. These findings were incorporated into an evidence brief supported by findings from earlier PRIME sub-studies (systematic literature review and qualitative interviews). The evidence brief guided stakeholder participant workshop discussions using co-production methodology, during April and June 2023, to derive a protocolised service specification for the PBBS, detailing underpinning requirements and scope of service, as the final stage of this study.

Twenty-nine community pharmacy participants completed the survey reporting some provision of lifestyle advice in practice with clear scope for expansion. Subsequently, sixteen participants including Community Pharmacists, Bladder and Bowel Service staff, Service users and healthcare commissioners participated in two workshops. The PPBS service specification outlined three tiers of service provision: tier 1 - awareness raising, education and signposting; tier 2 - assessment and self-help advice; tier 3 - specialist input involving specific treatment strategies. Acknowledged limitations are the pressures and relatively novel nature of pharmacy research which presents challenge in promoting participation.

This is the first evidence-based PBBS service specification, developed to inform future practice. Key requirements include record sharing, advances in training, and reimbursement to enable the PBBS to be viable for community pharmacy provision. The PBBS provides potential for early identification, promotion of continence health, and self-help activation in community settings.