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P04 Clinical pharmacists’ perceptions of the barriers and facilitators to the implementation of paediatric clinical pharmacy services in Hong Kong
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  1. Conor Sin,
  2. Chi Huynh,
  3. Ian Maidment
  1. Aston University

Abstract

Aim To identify barriers and facilitators that influenced the implementation of paediatric clinical pharmacy service (CPS) in Hong Kong’s public hospitals from clinical pharmacists’ perspective.

Methods A qualitative study based on semi-structured interviews (SSIs) of clinical pharmacists who practiced in paediatrics in four public hospitals situated in east and central Kowloon of Hong Kong. The questions in the interview schedules were based on previously determined themes identified in paediatric CPSs and were developed through consultations with all researchers.1 2 4 Pilot testing was performed with three study participants to confirm the coverage and relevance. Participants were given the choice to select either telephone or video conferencing for their SSIs. The interviews were conducted by the principal investigator (PI) in spoken Cantonese. The transcripts were translated into English by the PI, and a sample of the translated transcripts was subsequently checked by the research team for accuracy and to minimise transcriptional error. The transcripts were entered in QSR NVivo v.12 to support data analysis. Two researchers were responsible for the coding process. The resulting topics were organised by thematic analysis. Consensus was reached amongst the researchers for the identification of themes that emerged during the interviews. The Consolidated Criteria for Reporting Qualitative Research (COREQ) guidelines were used.3 Ethical approval for this study was obtained from the research ethics committees of the relevant institutions.

Results Of the 32 clinical pharmacists from across the study sites, 12 were interviewed by telephone that allowed for theoretical data saturation to be reached. Five barriers and three facilitators were identified as main themes. The barriers that were identified which hindered service implementation include the service penetration into the healthcare system, practice environment constraints, lack of affirmation from the administrative stakeholders, governance of the profession, and partnership with universities. The facilitators that were identified which enabled service implementation include other healthcare professionals’ trust and confidence in the service, the support from the pharmacy management team, and clinical pharmacists’ self-efficacy.

Conclusion The clinical pharmacists interviewed in this study reported that the successful implementation of paediatric CPS in public hospitals in Hong Kong is an area of continued development with several key barriers. The major implementation barriers identified include the availability and coverage of clinical pharmacists for service provision. Nevertheless, clinical pharmacists and healthcare professionals were found to have not only positive attitudes towards CPS but also support from clinical and pharmacy management teams. An enhanced internal and external governance infrastructure within the pharmacy profession would allow for the standardisation of practice and training, which would ultimately help drive the implementation of CPS forward as a whole.

References

  1. Brazinha I, Fernandex-Llimos F. Barriers to the implementation of advanced clinical pharmacy services at Portuguese hospitals. International Journal of Clinical Pharmacy 2014;36:1031–1038.

  2. Damschroder LJ, Aron DC, Keith RE, et al. Fostering implementation of health services research findings into practice: a consolidated framework for advancing implementation science. Implementation Science 2009;4:50 https://doi.org/10.1186/1748-5908-4-50

  3. Tong A, Sainsbuty P, Craig J. Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups. International Journal for Quality in Health Care 2007;9:349–57.

  4. Onatade R, Appiah S, Stephens M, et al. Evidence for the outcomes and impact of clinical pharmacy: context of UK hospital pharmacy practice. European Journal of Hospital Pharmacy 2018;25:e21–28.

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