Implementing cognitive services in community pharmacy: a review of facilitators used in practice change

Objective To investigate facilitators of change in community pharmacy and their use in the implementation of cognitive pharmaceutical services (CPS). Method Relevant literature published in English was identified through searches of online databases (no date limits), texts, conference proceedings, and bibliographies of identified literature. Literature that involved a discussion of facilitators of community pharmacy practice change in relation to the implementation and/or delivery of CPS was selected for review. Some of the identified studies were conceptual in nature, and although they were selected in the same way as the empirical research papers, were not able to be critically reviewed in an equivalent manner. A narrative, rather than systematic review, was considered more appropriate. Key findings The identified facilitators exist at two levels: the individual (e.g. knowledge) and the organisation (e.g. pharmacy layout). Few studies identified or measured facilitators drawn from experience, with many based on the views of researchers or participants in the studies, in reaction to identified barriers to CPS implementation. Purposive sampling was common in the reviewed studies, limiting the generalisability of the findings. Conclusion Although a number of facilitators have been identified in the literature, it appears that little consideration has been given to how they can best be used in practice to accelerate CPS implementation. Identifying facilitators at both individual and organisational levels is important, and future research should focus not only on their identification in representative populations, but on how they should be incorporated into programmes for CPS delivery.