Designing a theory and evidence informed pharmacogenomic testing service in community pharmacy in England |
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| Affiliation: | 1. University of Bath, Claverton Down, Bath, BA2 7AY, United Kingdom;2. University of Leicester, University Rd, Leicester, LE1 7RH, United Kingdom;3. Day Lewis PLC, 2 Peterwood Way, Croydon CR0 4UQ, United Kingdom;1. Department of Infectious Disease, Medical College of Wisconsin and Milwaukee Veterans Affairs Medical Center, Milwaukee, WI, USA;2. Department of Research Health Specialist, Milwaukee Veterans Affairs Medical Center, Milwaukee, WI, USA;3. Department of Pharmacy, Milwaukee Veterans Affairs Medical Center, Milwaukee, WI, USA;1. Feinberg School of Medicine, Northwestern University, Chicago, IL, USA;2. Division of Gastroenterology and Hepatology - Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA;3. Institute for Public Health and Medicine - Center for Applied Health Research on Aging, Northwestern University, Chicago, IL, USA;1. Curtin Medical School, Faculty of Health Sciences, Curtin University, Kent Street, Bentley, Western Australia, 6102, Australia;2. North Metropolitan Health Service – Mental Health Pharmacy, Graylands Hospital, Brockway Road, Mount Claremont, Western Australia, 6010, Australia;3. Faculty of Medicine, Division of Pharmacy, University of Prishtina, Pristina, Republic of Kosovo;1. SA Pharmacy, SA Health, PO Box 287 Rundle Mall, Adelaide, SA, 5000, Australia;2. UniSA Clinical and Health Sciences, Level 6, HB Building, City West Campus, University of South Australia, Adelaide, SA, 5001, Australia;3. School of Medicine and Dentistry, 170 Kessels Road, Nathan Campus, Griffith University, Nathan, QLD, 4111, Australia |
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| Abstract: | IntroductionPharmacogenomics (PGx) uses DNA to predict an individual's response to a medicine. Internationally, the delivery of PGx is frequently via community pharmacies, who can take a saliva sample, send it off for analysis and contribute to the final clinical decision making. No similar service has been set up in England.AimTo identify the barriers, enablers and Behaviour Change Techniques (BCTs) to inform a service specification for delivery of a community pharmacy based PGx service in England.MethodThis qualitative co-design research study was designed in three stages using action-orientated theory-based frameworks and tools. The first stage mapped perceptions, barriers to, and enablers for, implementing a community pharmacy based PGx service, derived from a previous qualitative study onto the Theoretical Domains Framework (TDF). The second stage utilised the Theory and Techniques Tool (TTT) to link the identified TDF domain with corresponding BCTs. The final stage used a Delphi survey followed by a Nominal Group Technique session to facilitate community pharmacists selecting their preferred BCTs to include in a service specification.ResultsThe existing qualitative data were mapped onto six TDF domains: Knowledge, Skills, Social/professional role and identity, Optimism, Beliefs about Consequences, and Environmental context and resources. Forty-six BCTs were identified using the TTT and the consensus methods resulted in nine selected BCTs: Review outcome goal(s), Feedback on behaviour, Instruction on how to perform behaviour, Demonstration of the behaviour, Credible source and Adding objects to the environment.ConclusionUsing a range of action-orientated theoretical frameworks and tools, pragmatic BCTs have been identified as part of a co-design process, which can now be used as the basis to develop a service specification for the implementation of a PGx testing service in a community pharmacy setting in England. |
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| Keywords: | Theoretical domains framework Theory and techniques tool Behaviour change techniques Nominal group technique Delphi technique Pharmacogenomics Community pharmacy |
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