An exploration of Scottish community pharmacists' adoption of innovative services and products relating to minor ailment management.
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This research utilised mixed methodology to gain insight into community pharmacists’ adoption of medicines and services related to two key innovative policy interventions aimed at enhanced minor ailment management; namely the ongoing legal status reclassification of medicines; and the introduction of the Scottish Minor Ailment Service. Prompted by the lack of qualitative and large scale quantitative evaluation from the pharmacists’ perspective, the aim was to investigate pharmacists’ adoption of these innovations. Data were generated to evaluate the process related aspects of innovation adoption from community pharmacists’ perspectives; and to identify and quantify key factors associated with the adoption of these innovations, thereby considering the wider relevance to new community pharmacy services. A range of methods was used including: formal systematic review of peer reviewed published literature on factors associated with innovation adoption following methods recommended by the Centre for Reviews and Dissemination at the University of York; extensive review of policy documents of all the devolved UK Governments; qualitative focus groups and interviews with 20 community pharmacists from four Scottish Health Boards; and lastly a cross sectional survey of the pharmacists responsible for nonprescription medicines from all Scottish community pharmacies (N=1138). The theoretical framework of diffusion of innovations was adopted to design the quantitative research instrument and interpret the data. Rigour was enhanced by consideration of aspects of validity and reliability at all stages. The highest standards of research governance and ethics were applied throughout the study. Qualitative interviews provided insight into the process related aspects of innovation adoption. Where current changes were embraced reluctantly by many who deemed the pace as fast and furious, others were keen to contribute to developments taking place within pharmacy and were eager to play a more proactive role in leading and introducing change to the public. Regardless of practice setting and ownership model, the merits of each innovation appeared to be considered at the individual practitioner level. Hence an organisational level decision to implement an innovation did not necessarily translate to adoption at the individual practitioner level. Using descriptive, bivariate and multivariate quantitative models informed by the results of the qualitative interviews and systematic review of the literature, the quantitative study showed pharmacists’ perceived attributes of innovations (such as benefits to their professional role development and patients); and patient demand and use of services had the highest association with whether or how far innovations were adopted. Issues such as differences in availability of resources were less able to explain differing level of innovation adoption by the pharmacist respondents. These findings suggest that as innovations around minor ailment management have not yet required reorientation of existing services, the issue of how pharmacists’ perceive the characteristics of the innovations such as: potential for financial benefits to pharmacy, professional role development and patients; is key to predicting whether future innovations of a similar nature will be successfully adopted by pharmacists.