A community pharmacy practice-based research network: A protocol for a realist evaluation.

BACKGROUND: Community pharmacists' active participation in research is essential to build a robust, translatable evidence base. Practice-based research networks (PBRNs) have been established to support collaborative research and knowledge translation in community pharmacies. However, PBRNs' effectiveness in supporting research engagement and knowledge translation remains unexplored. A new PBRN will be implemented in southeast Queensland, Australia. This realist evaluation seeks to explain whether, how, why, for whom, in what context and over what duration the PBRN supports community pharmacists to engage in research. OBJECTIVES: 1. to generate transferable knowledge about the different circumstances in which-and the mechanisms by which-a PBRN influences research engagement outcomes for different community pharmacists, in the form of a program theory. 2. To use the program theory to develop evidence-informed recommendations for use by PBRN stakeholders. METHODS: A realist evaluation will be conducted in four iterative phases: (1) theory development, (2) hypothesis generation, (3) observations, and (4) theory refinement. A two-year multi-method study will be conducted, including interviews with pharmacists, surveys, participatory and observational data collection. The evidence will be used to confirm, refute, and/or refine the program theory. The evaluation will adhere to the Realist And Meta-Narrative Evidence Synthesis (RAMESES) publication and quality standards. CONCLUSIONS: The evaluation will contribute to the body of knowledge by generating a realist program theory to explain how, why, for whom, in what contexts, to what extent, in what respects, and over what duration the PBRN supports community pharmacists to engage in research. The findings will support the broader implementation of PBRNs and future network activities.

Health needs assessment in a regional community pharmacy using the PRECEDE-PROCEED model.

BACKGROUND: Community pharmacies have capacity to provide a variety of professional pharmacy services. However, planning models are underutilised when guiding pharmacists in assessing local health and social needs for providing tailored services to meet community needs and priorities. OBJECTIVE: The objective of this was to utilize the PRECEDE-PROCEED model to perform a health needs assessment to identify health concerns in a regional Australian community for guiding professional pharmacy service development. METHODS: A health needs assessment using the PRECEDE-PROCEED model was conducted in November 2019 using a convergent mixed-methods design through: (1) convenience sampling of pharmacy customers with a survey, (2) purposive sampling of a sole community pharmacist with a semi-structured interview, and (3) collection of regional health and social data from online databases. RESULTS: The community survey response rate was 44.8%. Of 113 participants, the majority were female (71.7%) and town dwellers (89.4%), representing 6.4% of the town's population. Mental illness was cited by 35.3% of community survey participants to be impacting local health and wellbeing, with depression/anxiety the most prevalent self-reported condition (44.2%), predominantly affecting women (72%). The community pharmacist and regional secondary data provided additional support for the prioritization of mental illness. Depression/anxiety was associated with delays/avoidance of prescription medicine due to cost (p = .002), poor self-rated health (p = .012), worsening health over the past year (p < .001), seeking advice from a pharmacist about health or medicines (p = .03), and receipt of emergency care in the past year (p = .001). The lack of a local general practitioner, social isolation, and environmental issues also impacted health and wellbeing. CONCLUSIONS: The PRECEDE-PROCEED model identified mental health as the greatest health priority in the community, using multiple data sources and participatory methods. Using this model provides insight into the development of tailored community pharmacy interventions that address health priorities such as mental health needs in a community.

Utilisation of the PRECEDE-PROCEED model in community pharmacy for health needs assessment: A narrative review.

BACKGROUND: Health needs assessment tools such as the PRECEDE-PROCEED model (PPM) identify the key health concerns of communities, and may increase the capacity for community pharmacies to address these needs. OBJECTIVES: A narrative review was conducted to investigate to what extent the PPM has been used to guide pharmacy service development and evaluation. METHODS: A systematic search of six databases was conducted for peer-reviewed papers published from January 2000 to August 2019 that described the application of the PPM within the community pharmacy context. Search terms included variations of the following: 'pharmacists', 'precede proceed', 'pharmaceutical services', and 'community pharmacies'. Data extracted and analysed included study design, objectives, population, utilisation of the PPM, and outcomes. RESULTS: Fourteen eligible papers were identified, most of which were cohort or cross-sectional studies and utilised at least one element of the PPM to design or evaluate interventions that targeted either patient behaviours or pharmacist behaviours, or evaluated population health needs or programs. The range of behaviours assessed was limited to patient medication adherence, and billing behaviours, readiness for expanded scope of practice, and communication for pharmacists. None of the studies prioritised community health needs, actively engaged all relevant stakeholders, or utilised every element of the PPM. CONCLUSIONS: The PPM has been underutilised in community pharmacy research and represents an effective method for the assessment of health priorities for communities and the development and evaluation of health services targeted at addressing these priorities. Further research needs to demonstrate how key health needs assessment principles such as stakeholder engagement and a population-centred approach can influence effective health service delivery.