Utilization of an implementation framework to obtain provider perspectives of pharmacist-led clinical services

Pharmacist integration into health care teams has been shown to improve patients’ clinical outcomes and satisfaction with care. Medication therapy management (MTM) has been implemented in a variety of pharmacy practice settings. Pharmacist-provided medication reviews, a core element of MTM, have been shown to optimize therapeutic outcomes for patients and identify medication-related problems in a patient’s current regimen. Patients receiving care at Federally Qualified Health Centers (FQHCs) often face a number of challenges, such as multiple health conditions, transportation, and medication costs. Pharmacist-provided services can play an important role in providing patient-centered care in FQHCs. Seeking stakeholder input can be valuable to ensure services will benefit both patients and providers. The objective of this study was to obtain provider perspectives of psychological, socioeconomic, and practice-based factors to consider before implementing a pharmacist-led medication review services in a FQHC in north central Indiana. Five nurse practitioners employed by a FQHC in north central Indiana were interviewed. Thirty-four questions within 5 general domains were developed using the Consolidated Framework for Implementation Research. Responses were manually transcribed, coded by 3 reviewers, and then summarized using thematic analysis. Within the 5 interviews, a total of 97 codes were identified. The 251 mentions of the 97 codes were then thematically analyzed into 16 different themes. The 5 most referenced themes were feelings (n = 36), roles (n = 28), logistics (n = 26), benefits (n = 25), and communication (n = 21). Study participants noted that team roles, communication of information about the service, team/stakeholder concerns, and logistics should all be kept in mind when designing a new service. Semistructured interviews with providers at a FQHC in north central Indiana revealed multiple factors to consider before implementing a new pharmacist-led service in the clinic. Using a systematic approach to seek provider input can be beneficial in the design and implementation of pharmacist-led services.