Implementation of cognitive pharmaceutical services in Danish community pharmacies - perceptions of strategists and practitioners

摘要

Objective:To understand how projects for the implementation of cognitive pharmaceutical services (CPS) are perceived as facilitators of change from the perspectives of practitioners and strategists. Setting Sixteen community pharmacies in Denmark and three organisations working on implementing CPS in pharmacy practice. Method Twenty semi-structured interviews were conducted with practitioners (pharmacy staff and owners) in 'professionally active' pharmacies, and eight interviews were conducted with 'professional strategists' in the field of pharmacy practice. Informants were asked about their goals for participation in and development of projects regarding implementation of CPS, and about change strategies used for implementation. An interview guide based on organisational theory was used, and an organisational theory framework formed the basis of the analysis. Key findings Eleven goals for the development of projects relating to CPS implementation from the strategist's perspective were identified. From the practitioners' perspective, nine goals for participation in such projects were identified. The two groups share four categories of goals regarding: competence development; implementation of CPS; marketing of the pharmacy; and improvement of patients' drug use and outcomes. Other goals from the two perspectives predominantly differ from each other. Two metaphors were developed as images of the two different ways of perceiving CPS projects. The strategists develop projects as 'standard menus', and the practitioners select projects in which to participate as if they were one of many dishes on a 'buffet'. Strategies for change were also identified. The humanistic change strategy predominated from both groups of informants' perspective. Conclusion While they "have some goals in common, there is a clear difference in the perspectives of strategists and practitioners in the development of and participation in CPS-related projects. The metaphors 'standard menu' and 'buffet' are two ways of understanding implementation. If these metaphors are accepted as a premise in the field of pharmacy practice, future work with implementation of CPS should take these differences into account.