A qualitative case study exploring the implementation of pharmacist care planning services in community pharmacies

Abstract Objectives To describe the comprehensive annual care planning (CACP) process and to conceptualize how remunerated CACP services were implemented by community pharmacists. Design A comparative, multiple-case study approach with data consisting of document review, observation, and semi-structured interviews. Setting and Participants: Pharmacists, pharmacy technicians and staff, and pharmacy students from 4 different community pharmacy sites in Alberta, Canada, including independent, franchise, and corporate chain pharmacies. Patients and other health care providers were also included in the interviews. Outcome measures Constructivist grounded theory was used to understand how care planning services were implemented within the real-world context of community pharmacies as well as how pharmacists provided CACPs within their practice. Results Between May 2016 and January 2018, a total of 77 interviews and 94 hours of observation were completed at the 4 pharmacy sites, and 61 documents were collected. The CACP service required adaptation of workflow at each of the sites. However pharmacists and other pharmacy staff recognized benefits of the service with respect to pharmacist's role expansion. The overarching grounded theory concept was changing the status quo. Four themes emerged representing how the service was implemented: engaging patients, professional development and learning from experience, creating a supportive environment, and building community connections. Conclusion This study found that practice change, or changing the status quo, was needed in order to implement remunerated care planning services in community pharmacies. The results of this study may be of interest to community pharmacists, pharmacy managers, and policy makers implementing remunerated care planning services in other jurisdictions.