A holistic and integrated approach to implementing cognitive pharmaceutical services
Keywords:
Implementation, Cognitive pharmaceutical services, Community pharmacy, Change managementAbstract
Community pharmacy is part of the health care system which is currently under economic pressureand facing changes in demands from consumers and government. In response, the pharmacy profession is becoming more patient orientated and implementing cognitive pharmaceutical services(CPS). CPS in various countries has similar objectives with different emphasis, definitions, labels andusing different tools. However, they can be classified using a broad hierarchical model based onclinical decision making and the extent of change required (Box 1). The challenges faced by theprofession are related the development of a new patient orientated model of pharmacy which affectshealth care policy, education and research, the evolution of the market, the individual andorganisational approaches to change and the implementation of CPS. These issues and previousresearch conducted in pharmacy practice have been synthesised to provide a platform for change thatcan guide a holistic and integrated approach to CPS implementation. Implementation can beconceptually framed in six levels: clinical, service provision, community pharmacy, professionalorganisation, government and stakeholder (Figure 1). Past experience with service implementation hasseen the application of programs that include one or two of these levels in practice rather than aholistic approach. A concentric model was developed to illustrate the implementation of CPS and theholistic and integrated approach required to support change. A program (conSIGUE) being conductedin Spain has attempted to integrate all six levels to support the implementation and evaluation of amedication management service (Seguimiento Farmacoterapéutico)Downloads
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