A Rapid Realist Review of the Role of Community Pharmacy in the Public Health Response to COVID-19

Abstract

Introduction Community pharmacists and their teams have remained accessible to the public providing essential services despite immense pressures during the COVID-19 pandemic. They have successfully expanded the influenza vaccination programme and are now supporting the delivery of the COVID-19 vaccination roll-out. Aim This rapid realist review aims to understand how community pharmacy can most effectively deliver essential and advanced services, with a focus on vaccination, during the pandemic and in the future. Method An embryonic programme theory was generated using four diverse and complementary documents along with the expertise of the project team. Academic databases, preprint services and grey literature were searched and screened for documents meeting our inclusion criteria. The data was extracted from 103 documents to develop and refine a programme theory using a realist logic of analysis. Our analysis generated 13 context-mechanism-outcome configurations explaining when, why and how community pharmacy can support public health vaccination campaigns, maintain essential services during pandemics, and capitalise on opportunities for expanded, sustainable public health service roles. The views of stakeholders including pharmacy users, pharmacists, pharmacy teams and other healthcare professionals were sought throughout to refine the 13 explanatory configurations. Results The 13 context-mechanism-outcome configurations are organised according to decision makers, community pharmacy teams and community pharmacy users as key actors. Review findings include: supporting a clear role for community pharmacies in public health; clarifying pharmacists legal and professional liabilities; involving pharmacy teams in service specification design; providing suitable guidance, adequate compensation and resources; and leveraging accessible, convenient locations of community pharmacy. Discussion Community pharmacy has been able to offer key services during the pandemic. Decision makers must endorse, articulate and support a clear public health role for community pharmacy. We provide key recommendations for decision makers to optimise such a role during these unprecedented times and in the future.

REalist Synthesis Of non-pharmacologicaL interVEntions for antipsychotic-induced weight gain (RESOLVE) in people living with Severe Mental Illness (SMI)

“…This approach is based on that successfully used to understand medication management in older people on complex regimens (11) (12). Much work in this area is likely to be service evaluation type data or reports which may not be included in standard systematic reviews, but can be included in RESOLVE (13) (14). The interviews component of the study will generate qualitative data on the lived experience of weight gain and what works to help manage weight from a diverse group of service users and practitioners.…”

Pharmacy interventions on COVID-19 in Europe: Mapping current practices and a scoping review

“…Several pharmacy research papers at the onset of COVID-19 included scholarly commentaries, as expected in a pandemic, which offered an important reflection on additional new roles and challenges for pharmacy relevant in public health crisis including emergency supply of medications, increased demand/changes to repeat dispensing, extended prescribing roles, stock supply and management, dealing with shortages, home delivery of medications, drive-thru pharmacy services, managing minor ailments, managing chronic disease patients due to reduced primary care capacity, widespread use of technology for chronic disease patients, dealing with vulnerable patients including mental health, point-of-care antigen testing, antibody testing, COVID-19 vaccination, ensuring rapid access to approved antiviral treatment, and cross-country collaboration in guidance to assist pharmacists. 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 …”