Introduction Pharmacogenomics (PGx) testing services have been delivered through community pharmacies across the globe, though not yet in the UK. This paper is reporting a focus group study, the first stage of a participatory co-design process to increase the chance of a successful implementation of a PGx service through community pharmacy in the UK. Aim To identify the barriers and enablers to implementing a community pharmacy based PGx service in the UK. Method Three focus groups were conducted with community pharmacists (n = 10), prescribers (n = 8) and patients (n = 8) in England. The focus groups were recorded, transcribed and thematically analysed using the Braun and Clarke six phase reflexive thematic analysis approach. Results The analysis identified five themes about PGx testing in community pharmacies: (1) In- principle receptiveness, (2) Appreciation of the benefits, (3) Lack of implementation resources (4) Ambiguity about implications for implementation and (5) Interprofessional relationship challenges. Conclusion The identified enablers for implementation of a PGx service were at a macro health system strategic level; the concerns were more at a granular operational procedural level. Overall receptiveness was noted by all three participant groups, and both prescriber and pharmacist groups appreciated the potential benefits for patients and the healthcare system. Prior to implementation in the UK, there is a need to disambiguate health professional’s concerns of the guidance, resources, and knowledge required to set up and deliver the service and to resolve patient concerns about the nature of genomics.
Background Pharmacogenomics is a novel arena of medicine that uses patients’ Deoxyribonucleic Acid to support pharmacists and prescribers selecting the most appropriate medicine for patients. Aim To review and validate a service specification for a pharmacogenomics testing service. Method Consensus methods (Delphi method and the Nominal Group Technique) were deployed. A consensus panel comprising of pharmacists, prescribers and patients was convened to participate in the co-design process. Panel members were first surveyed to obtain their views on Behaviour Change Techniques identified as necessary for the service in a previous study. Following this, a workshop was convened to discuss, agree and confirm details for the service specification and recommend strategies for operationalisation. Outputs from the workshop were used to inform a final version of the service specification. Results From the consensus panel (pharmacists (n = 6), general practitioners (n = 3) and patients (n = 3)), strategies for operationalisation of nine Behaviour Change Techniques were agreed as being required. In addition, several unique and innovative strategies for implementation of the community pharmacy service were identified and included in the service specification. Conclusion The research shows that to encourage community pharmacist engagement in providing a pharmacogenomic testing service and prescriber acceptance of recommendations for any changes to patients’ prescriptions, a multi-professional launch event is required. To agree communication strategies and professional boundaries, training in clinical decision making and patient support materials are required as is guidance on how to deliver the service in a standardised manner. Finally, healthcare professionals would be reassured by the provision of an expert help-line for any complex patients.
Introduction: Pharmacogenomics (PGx) testing services have been delivered through community pharmacies across the globe, though not yet in the UK. This paper is reporting a focus group study, the first stage of a participatory co-design process to increase the chance of a successful implementation of a PGx service through community pharmacy in the UK.Aim: To identify the barriers and enablers to implementing a community pharmacy based PGx service in the UK.Method: Three focus groups were conducted with community pharmacists (n= 10), prescribers (n= 8) and patients (n=8) in England. The focus groups were recorded, transcribed and thematically analysed using the Braun and Clarke six step reflexive thematic analysis approach.Results: The analysis identified five themes about PGx testing in community pharmacies: (1) In- principle receptiveness, (2) Appreciation of the benefits, (3) Lack of implementation resources (4) Ambiguity about implications for implementation and (5) Interprofessional relationship challenges.Conclusion: The identified enablers for implementation of a PGx service were at a macro health system strategic level; the concerns were more at a granular operational procedural level. Overall receptiveness was noted by all three participant groups, and both prescriber and pharmacist groups appreciated the potential benefits for patients and the healthcare system. Prior to implementation in the UK, there is a need to disambiguate health professional’s concerns of the guidance, resources, and knowledge required to set up and deliver the service and to resolve patient concerns about the nature of genomics.
Introduction: Pharmacogenomics is a novel arena of medicine that uses patients’ DNA to support pharmacists and prescribers selecting the most appropriate medicine for patients.Aim: To use an online consensus panel to review and validate a service specification for a PGx testing service in the English community pharmacy setting.Method: A consensus panel comprising of pharmacists, prescribers and patients was convened to participate in a co-design process of critical comment, reviewing the operationalisation of Behaviour Change Techniques identified in a previous study. Panel members completed a survey prior to attending a workshop to discuss, agree and confirm the content for a service specification. Following the workshop recommended strategies for operationalisation were extracted and informed a final version of the service specification.Results: From the consensus panel, strategies for operationalisation of the Behaviour Change Techniques were identified including a pre-launch engagement event, subject matter expert support for healthcare professionals, provision of supporting materials and training requirements for clinical decision making. These were all incorporated into the service specification as part of the co-design.Conclusion: Designing a community pharmacy led pharmacogenomic service using co-design methodology has resulted in critical feedback, ideas validation and operationalisation of behavioural science generated Behaviour Change Techniques to develop a pragmatic service specification. This is more likely to result in both pharmacist engagement to offer and deliver a community pharmacist led pharmacogenomic testing service and prescriber acceptance of recommendations for any changes to patients’ prescriptions.
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