Implementation of an interprofessional medication adherence program for HIV patients: description of the process using the framework for the implementation of services in pharmacy

Abstract

BackgroundThe community pharmacy center of the Department of Ambulatory Care and Community Medicine of the Policlinique Médicale Universitaire (PMU), Lausanne, Switzerland developed and implemented an interprofessional medication adherence program for chronic patients (IMAP). In 2014, a project was launched to implement the IMAP for HIV patients in a public non-academic hospital with the collaboration of community pharmacists in the Neuchâtel area (Switzerland). This article aims to describe the different implementation stages and strategies of the project.MethodsA posteriori description of the implementation process, including the conceptualization strategies and stages (exploration, preparation, operation, sustainability) using the Framework for the Implementation of Services in Pharmacy (FISpH).ResultsIn 2014, an attending infectious disease physician and a nurse at a public hospital (Neuchâtel, Switzerland) contacted the PMU to implement the IMAP in their setting in collaboration with community pharmacies. Five volunteer community pharmacies in Neuchâtel were trained to deliver the program. Three factors were found to be essential to the successful launch and progress of the implementation project: the experience of the community pharmacy center of the PMU with the IMAP, the involvement of the PMU research team, and collaboration with an external start up (SISPha) to train and support pharmacists. During the operation stage, the most important strategy developed was that of regular meetings between all stakeholders. These allowed healthcare professionals to discuss the implementation progress, to address each stakeholder’s expectations, and to exchange experiences to facilitate interprofessional collaboration and program delivery. Structural changes allowed the formalization of the activities at the hospital and in a community pharmacy. This formalization was identified as the transition step between the operation and the sustainability stages.ConclusionsThe transfer of the IMAP for HIV patients to a non-academic setting and its implementation are feasible. However, implementation of a new model of pharmacy service such as IMAP implies a deep change in practice. A transitional external support and the allocation of sufficient resources to carry out the IMAP are essential for its long-term sustainability.

Implementation and Effectiveness of an Interprofessional Support Program for Patients with Type 2 Diabetes in Swiss Primary Care: A Study Protocol

“…Implementation science shows that for behavioral change, strategies are required across multiple stages and levels [ 56 , 57 , 58 , 59 ]. In this research project, implementation strategies proposed were developed based on evidence from previous research projects [ 32 , 36 , 39 ]. Needs, barriers, and facilitators for implementation are evaluated continuously.…”

“…As such, the FISpH incorporates and tailors the aforementioned frameworks and models to community pharmacy. Thus, as the project deals with community pharmacies, the FISpH provides a solid base to be used as guidance in this hybrid study and another study used this framework in a similar context [ 32 ].…”

“…The implementation strategies available vary across the implementation stages. They are based on previous experiences that have highlighted the facilitators and barriers for transferring this type of chronic patient support programs into the daily practice of Swiss pharmacies [ 32 , 36 , 37 , 38 , 39 ]. The strategies were developed by the research team and discussed with Sispha.…”

“…Recognition of the project [36] by the FOPH and by other key pharmacy and health insurance stakeholders (Swiss association of pharmacists, santésuisse, curafutura) Establishment of an interprofessional steering committee [32,36] Information to health care professional associations (Swiss pharmacy Journal, Cantonal associations of pharmacists, mfe Swiss Association of Family Medicine, FMH Swiss Medical Association, Swiss association of diabetes, Cantonal associations of diabetes, Promotion of Integrated Patient Care Networks (PRISM), local media) [36] Information to Sispha's pharmacies and recruitment of pharmacies [32,36]…”

Role of Pharmacists in the Interprofessional Care Team for Patients with Chronic Diseases

“…29 In a public hospital in Neuchâtel, Switzerland, an infectious disease doctor and a nurse implemented interprofessional treatment adherence for patients with chronic diseases and collaborated with community pharmacies. 30 Healthcare teams with primary care prescribers (physicians, nursing practitioners, and physician assistants) and pharmacists working together at the clinical level and at the professional development level have made major strides in reducing the prescribing of potentially inappropriate drugs, thereby increasing patient safety. 17 Collaboration in establishing communication between multidisciplinary team members is essential to maintaining the quality of drug use among patients in geriatric medicine wards.…”