Skip to main content
SpringerLink
Log in

Facilitators for practice change in Spanish community pharmacy

  • Research Article
  • Published:
Pharmacy World & Science Aims and scope Submit manuscript

Abstract

Objective To identify and prioritise facilitators for practice change in Spanish community pharmacy. Setting Spanish community pharmacies. Method Qualitative study. Thirty-three semi-structured interviews were conducted with community pharmacists (n = 15) and pharmacy strategists (n = 18), and the results were examined using the content analysis method. In addition, two nominal groups (seven community pharmacists and seven strategists) were formed to identify and prioritise facilitators. Results of both techniques were then triangulated. Main outcome measures Facilitators for practice change. Results Twelve facilitators were identified and grouped into four domains (D1: Pharmacist; D2: Pharmacy as an organisation; D3: Pharmaceutical profession; D4: Miscellaneous). Facilitators identified in D1 include: the need for more clinical education at both pre- and post-graduate levels; the need for clearer and unequivocal messages from professional leaders about the future of the professional practice; and the need for a change in pharmacists’ attitudes. Facilitators in D2 are: the need to change the reimbursement system to accommodate cognitive service delivery as well as dispensing; and the need to change the front office of pharmacies. Facilitators identified in D3 are: the need for the Spanish National Professional Association to take a leadership role in the implementation of cognitive services; the need to reduce administrative workload; and the need for universities to reduce the gap between education and research. Other facilitators identified in this study include: the need to increase patients’ demand for cognitive services at pharmacies; the need to improve pharmacist-physician relationships; the need for support from health care authorities; and the need for improved marketing of cognitive services and their benefits to society, including physicians and health care authorities. Conclusion Twelve facilitators were identified. Strategists considered clinical education and pharmacists’ attitude as the most important, and remuneration of little importance. Community pharmacists, in contrast, considered remuneration as the most important facilitator for practice change.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

Notes

  1. Spanish Pharmaceutical Care Forum participants: Health Care Ministry, National Professional Association (Consejo General de Colegios), Spanish Society of Community Pharmacy (SEFaC), Spanish Society of Hospital Pharmacy (SEFH), Spanish Society of Primary Care Pharmacists (SEFAP), Spanish Pharmaceutical Care Foundation, Pharmaceutical Care Research Group of the University of Granada (GIAF-UGR) and The Royal National Academy of Pharmacy.

References

  1. Cipolle RJ, Strand LM, Morley PC. Pharmaceutical care practice. New York: McGraw-Hill Companies; 1998. ISBN 0-07-012046-3.

  2. Martín Calero MJ, Machuca M, Murillo MD, Cansino J, Gastelurrutia MA, Faus MJ. Structural process and implementation programs of pharmaceutical care in different countries. Curr Pharm Des. 2004;10:3969–85. doi:10.2174/1381612043382549.

    Article  PubMed  Google Scholar 

  3. Rogers EM. Diffusion of innovations. 5th ed. New York: Free Press; 2003. ISBN 0-7432-2209-1.

  4. Odedina FT, Segal R, Hepler CD, Lipowski E, Kimberlin C. Changing pharmacists’ practice pattern: pharmacists’ implementation of pharmaceutical care factors. J Soc Adm Pharm. 1996;13:74–88.

    Google Scholar 

  5. Bell HM, McElnay JC, Hughes CM, Woods A. A qualitative investigation of the attitudes and opinions of community pharmacists to pharmaceutical care. J Soc Adm Pharm. 1998;15:284–95.

    Google Scholar 

  6. van Mil JWF, de Boer WO, Tromp ThFJ. European barriers to implementation of pharmaceutical care. Int J Pharm Practice. 2001;9:163–8.

    Google Scholar 

  7. Rossing C, Hansen EH, Krass I. Barriers and facilitators in pharmaceutical care: perceptions and experiences among Danish community pharmacies. J Soc Adm Pharm. 2001;19:55–64.

    Google Scholar 

  8. Plaza L, Herrera J. The new challenge of pharmaceutical care: the search of an agreement among professionals. Pharm Care Esp. 2003; 5:160–5.

    Google Scholar 

  9. Hidalgo J, Cámara D, Baena MI, Fajardo PC, Martínez-Martínez F. Barriers for implementing pharmacotherapy follow-up in community pharmacies from Granada (Spain). Seguimiento Farmacoterapeutico. 2005; 3(3):144–9.

    Google Scholar 

  10. Gastelurrutia MA, Fernandez-Llimos F, Benrimoj SI, Castrillon CC, Faus MJ. Barriers for the implementation of cognitive services in Spanish community pharmacies. Aten Primaria. 2007; 39(9):465–72.

    Google Scholar 

  11. Roberts AS, Hopp T, Sorensen EW, Benrimoj SI, Chen TF, Herborg H, et al. Understanding practice change in community pharmacy: a qualitative research instrument based on organisational theory. Pharm World Sci. 2003; 25(5):227–34. doi:10.1023/A:1025880012757.

    Google Scholar 

  12. Hopp T, Sørensen EW, Herborg H, Roberts AS. Implementation of cognitive pharmaceutical services in Danish community pharmacies—perceptions of strategists and practitioners. Int J Pharm Pract. 2006;14:37–49. doi:10.1211/ijpp.14.1.0006.

    Article  Google Scholar 

  13. Roberts AS, Benrimoj SIC, Chen TF, Williams KA, Hopp TR, Aslani P. Understanding practice change in community pharmacy: a qualitative study in Australia. Res Social Adm Pharm. 2005;1:546–564. doi:10.1016/j.sapharm.2005.09.003.

    PubMed  Google Scholar 

  14. Gastelurrutia MA, Fernández-Llimós F, García Delgado P, Gastelurrutia P, Faus MJ, Benrimoj SI. Barriers and facilitators to the dissemination and implementation of cognitive services in Spanish community pharmacies. Seguimiento Farmacoterapeutico. 2005;3(2):65–77.

    Google Scholar 

  15. Weber RP. Basic content analysis. 2nd ed. Newbury Park, CA: Sage; 1990. ISBN 0-8039-3863-2.

  16. Gastelurrutia MA, Faus MJ, Fernandez-Llimos F. Providing patient care in community pharmacies in Spain. Ann Pharmacother. 2005;39:2105–10. doi:10.1345/aph.1G121.

    Article  PubMed  Google Scholar 

  17. Pickard AS. Towards supporting scholarship in research by clinical pharmacy faculty. Pharm Pract. 2006;4(4):191–4.

    Google Scholar 

  18. Andrés Iglesias JC, Andrés Rodríguez NF, Fornos Pérez JA. Community pharmacy-based research in Spain (1995–2005): a bibliometric study. Pharm Pract. 2007;5(1):21–30.

    Google Scholar 

  19. Armour C, Brillant M, Krass I. Pharmacists’ views on involvement in pharmacy practice research: strategies for facilitating participation. Pharm Pract. 2007;5(2):59–66.

    Google Scholar 

  20. Baena MI, Faus MJ, Marín R, Zarzuelo A, Jiménez-Martín J, Martínez-Olmos J. Problemas de salud relacionados con los medicamentos en un servicio de urgencias hospitalario. Med Clin (Barc). 2005;124:250–5.

    Google Scholar 

  21. Ernst FR, Grizzle AJ. Drug-related morbidity and mortality: updating the cost-of-illness model. J Am Pharm Assoc. 2001;41:192–9.

    CAS  Google Scholar 

  22. Aguas Y, De Miguel E, Fernandez-Llimos F. Pharmacotherapy follow-up as an innovation in community pharmacies of Badajoz (Spain). Seguimiento Farmacoterapeutico. 2005;3:10–6.

    Google Scholar 

  23. Fernandez-Llimos F, Faus MJ. From “drug related problems” to “negative clinical outcomes”. Am J Health Syst Pharm. 2005;62:2348–50. doi:10.2146/ajhp050358.

    Article  PubMed  Google Scholar 

  24. Anonymous. Simpodader 07. Botika XXI. 2007; 10:1–20.

  25. Huyghebaert T, Farris KB, Volume CI. Barriers to pharmaceutical care. Perceptions of Alberta Community Pharmacists. Can Pharm J. 1999;132(2):36–42.

    Google Scholar 

  26. Cordina M, McElnay JC, Hugues CM. The importance that community pharmacists in Malta place on the introduction of pharmaceutical care. Pharm World Sci. 1999;21:69–73. doi:10.1023/A:1008658726755.

    Article  PubMed  CAS  Google Scholar 

  27. Dunlop JA, Shaw JP. Community pharmacists’ perspectives on pharmaceutical care implementation in New Zealand. Pharm World Sci. 2002;24:224–30. doi:10.1023/A:1021526425458.

    Article  PubMed  Google Scholar 

  28. Anonimous. [Spanish Medical Association rejects the role of Pharmaceutical Care in National Health Plan]. El Global. 2005; 28-Feb. to 6-Mar.

  29. Anonimous. [73% of physicians consider that Pharmacy should only be involve in dispensing activities]. El Global. 2004; 13-Dec to 19-Dec.

  30. Berringer R, Shibley MC, Cary CC, Pugh CB, Powers PA, Rafi JA. Outcomes of a community pharmacy-based diabetes monitoring program. J Am Pharm Assoc. 1999;39:791–7.

    CAS  Google Scholar 

  31. Isetts BJ, Brown LM, Schondelmeyer SW, Lenarz LA. Quality assessment of a collaborative approach for decreasing drug-related morbidity and achieving therapeutic goals. Arch Intern Med. 2003;163:1813–20. doi:10.1001/archinte.163.15.1813.

    Article  PubMed  Google Scholar 

  32. Castrillon CC, Gil de San Vicente O, Erauncetamurgil O, Gastelurrutia MA. Influence of facilitating activities taken by members of the staff of a community pharmacy to the implementation of the medication follow-up service. Pharm Pract. 2007;5(supl 1):25–41.

    Google Scholar 

Download references

Acknowledgement

We gratefully acknowledge the contributions of the participating pharmacists, both in the interviews and in nominal groups.

Funding

This study received no external funding.

Conflicts of Interest

None of the authors has a conflict of interest that could affect the study and its results.

Author information

Authors and Affiliations

  1. Community Pharmacist, Paseo de Larratxo, 98, 20017, San Sebastian, Spain

    Miguel A. Gastelurrutia & Carla C. Castrillon

  2. Pharmaceutical Care Research Group, University of Granada, Granada, Spain

    Miguel A. Gastelurrutia, María J. Casado de Amezua, Fernando Fernandez-Llimos & Maria J. Faus

  3. Department of Pharmacy Practice, University of Sydney, Sydney, Australia

    S. I. Charlie Benrimoj

  4. Department of Social Pharmacy, University of Lisbon, Lisbon, Portugal

    Fernando Fernandez-Llimos

Authors
  1. Miguel A. Gastelurrutia
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. S. I. Charlie Benrimoj
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Carla C. Castrillon
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. María J. Casado de Amezua
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Fernando Fernandez-Llimos
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Maria J. Faus
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Miguel A. Gastelurrutia.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Gastelurrutia, M.A., Benrimoj, S.I.C., Castrillon, C.C. et al. Facilitators for practice change in Spanish community pharmacy. Pharm World Sci 31, 32–39 (2009). https://doi.org/10.1007/s11096-008-9261-0

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11096-008-9261-0

Keywords

Search

Navigation