Rapid realist review of the role of community pharmacy in the public health response to COVID-19

doi:10.1136/bmjopen-2021-050043

Review

. 2021 Jun 16;11(6):e050043.

doi: 10.1136/bmjopen-2021-050043.

Rapid realist review of the role of community pharmacy in the public health response to COVID-19

Ian Maidment¹, Emma Young², Maura MacPhee³, Andrew Booth⁴, Hadar Zaman⁵, Juanita Breen⁶, Andrea Hilton⁷, Tony Kelly⁸, Geoff Wong⁹

Affiliations

¹ College of Health and Life Sciences, Aston University, Birmingham, UK i.maidment@aston.ac.uk.
² The University of Sheffield, Sheffield, UK.
³ The University of British Columbia, Vancouver, British Columbia, Canada.
⁴ School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK.
⁵ University of Bradford, Bradford, UK.
⁶ College of Health and Medicine, University of Tasmania, Hobart, Tasmania, Australia.
⁷ Faculty of Health Sciences, University of Hull, Hull, UK.
⁸ NHS Birmingham and Solihull Clinical Commissioning Group, Birmingham, UK.
⁹ Primary Care Health Sciences, University of Oxford, Oxford, UK.

PMID: 34135054
PMCID: PMC8210681
DOI: 10.1136/bmjopen-2021-050043

Review

Rapid realist review of the role of community pharmacy in the public health response to COVID-19

Ian Maidment et al. BMJ Open. 2021.

. 2021 Jun 16;11(6):e050043.

doi: 10.1136/bmjopen-2021-050043.

Authors

Ian Maidment¹, Emma Young², Maura MacPhee³, Andrew Booth⁴, Hadar Zaman⁵, Juanita Breen⁶, Andrea Hilton⁷, Tony Kelly⁸, Geoff Wong⁹

Affiliations

¹ College of Health and Life Sciences, Aston University, Birmingham, UK i.maidment@aston.ac.uk.
² The University of Sheffield, Sheffield, UK.
³ The University of British Columbia, Vancouver, British Columbia, Canada.
⁴ School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK.
⁵ University of Bradford, Bradford, UK.
⁶ College of Health and Medicine, University of Tasmania, Hobart, Tasmania, Australia.
⁷ Faculty of Health Sciences, University of Hull, Hull, UK.
⁸ NHS Birmingham and Solihull Clinical Commissioning Group, Birmingham, UK.
⁹ Primary Care Health Sciences, University of Oxford, Oxford, UK.

PMID: 34135054
PMCID: PMC8210681
DOI: 10.1136/bmjopen-2021-050043

Abstract

Introduction: Community pharmacists and their teams have remained accessible to the public providing essential services despite immense pressures during the COVID-19 pandemic. They have successfully expanded the influenza vaccination programme and are now supporting the delivery of the COVID-19 vaccination roll-out.

Aim: This rapid realist review aims to understand how community pharmacy can most effectively deliver essential and advanced services, with a focus on vaccination, during the pandemic and in the future.

Method: An embryonic programme theory was generated using four diverse and complementary documents along with the expertise of the project team. Academic databases, preprint services and grey literature were searched and screened for documents meeting our inclusion criteria. The data were extracted from 103 documents to develop and refine a programme theory using a realist logic of analysis. Our analysis generated 13 context-mechanism-outcome configurations explaining when, why and how community pharmacy can support public health vaccination campaigns, maintain essential services during pandemics and capitalise on opportunities for expanded, sustainable public health service roles. The views of stakeholders including pharmacy users, pharmacists, pharmacy teams and other healthcare professionals were sought throughout to refine the 13 explanatory configurations.

Results: The 13 context-mechanism-outcome configurations are organised according to decision makers, community pharmacy teams and community pharmacy users as key actors. Review findings include: supporting a clear role for community pharmacies in public health; clarifying pharmacists' legal and professional liabilities; involving pharmacy teams in service specification design; providing suitable guidance, adequate compensation and resources; and leveraging accessible, convenient locations of community pharmacy.

Discussion: Community pharmacy has been able to offer key services during the pandemic. Decision makers must endorse, articulate and support a clear public health role for community pharmacy. We provide key recommendations for decision makers to optimise such a role during these unprecedented times and in the future.

Keywords: COVID-19; organisation of health services; qualitative research.

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Conflict of interest statement

Competing interests: GW is Deputy Chair of the NIHR HTA Prioritisation Committee: Integrated Community Health and Social Care (A) and Member of the NIHR HTA Prioritisation Committee: Integrated Community Health and Social Care (A) Methods Group. AB is a member of the National Institute for Health Research Health Services and Delivery Research Funding Board, the National Institute for Health Research Evidence Synthesis Programme Advisory Group and the National Institute for Health Research School for Social Care Research Commissioning Panel.

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Cross-sectional questionnaire study of the experiences of community pharmacists in Northern Ireland during the early phases of the COVID-19 pandemic: preparation, experience and response.
Patterson SM, Cadogan C, Barry HE, Bennett KE, Hughes C. Patterson SM, et al. BMJ Open. 2022 Sep 22;12(9):e064545. doi: 10.1136/bmjopen-2022-064545. BMJ Open. 2022. PMID: 36137621 Free PMC article.
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Abdelfatah OA, Hilton A, Schafheutle E, Wong G, Holden K, Scott L, Roberts N, Haddington N, Kelly T, Hibberd V, Sturrock A, Maidment I. Abdelfatah OA, et al. NIHR Open Res. 2024 Nov 18;4:72. doi: 10.3310/nihropenres.13766.1. eCollection 2024. NIHR Open Res. 2024. PMID: 39931701 Free PMC article.

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References

1. Parkhurst C, Singh Purewal G, Donyai P. And COVID-19—The unsung heroes on our high streets. Journal of Patient Experience 2020;7:282–4. - PMC - PubMed
1. Maidment I, Lawson S, Wong G, et al. Towards an understanding of the burdens of medication management affecting older people: the memorable realist synthesis. BMC Geriatr 2020;20:183. 10.1186/s12877-020-01568-x - DOI - PMC - PubMed
1. Barry HE, Hughes CM. Managing medicines in the time of COVID-19: implications for community-dwelling people with dementia. Int J Clin Pharm 2021;43:275–9. 10.1007/s11096-020-01116-y - DOI - PMC - PubMed
1. Wickware C. Pharmacies’ dispensing increases by up to a third as a result of COVID-19, survey finds. Pharm J 2020. 10.1211/PJ.2020.20207917 - DOI
1. Pharmaceutical Services Negotiating Committee . Flu vaccination service, 2020. Available: https://psnc.org.uk/services-commissioning/advanced-services/flu-vaccina...

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[1] Parkhurst C, Singh Purewal G, Donyai P. And COVID-19—The unsung heroes on our high streets. Journal of Patient Experience 2020;7:282–4. - PMC - PubMed

[2] Parkhurst C, Singh Purewal G, Donyai P. And COVID-19—The unsung heroes on our high streets. Journal of Patient Experience 2020;7:282–4. - PMC - PubMed

[3] Maidment I, Lawson S, Wong G, et al. Towards an understanding of the burdens of medication management affecting older people: the memorable realist synthesis. BMC Geriatr 2020;20:183. 10.1186/s12877-020-01568-x - DOI - PMC - PubMed

[4] Maidment I, Lawson S, Wong G, et al. Towards an understanding of the burdens of medication management affecting older people: the memorable realist synthesis. BMC Geriatr 2020;20:183. 10.1186/s12877-020-01568-x - DOI - PMC - PubMed

[5] Barry HE, Hughes CM. Managing medicines in the time of COVID-19: implications for community-dwelling people with dementia. Int J Clin Pharm 2021;43:275–9. 10.1007/s11096-020-01116-y - DOI - PMC - PubMed

[6] Barry HE, Hughes CM. Managing medicines in the time of COVID-19: implications for community-dwelling people with dementia. Int J Clin Pharm 2021;43:275–9. 10.1007/s11096-020-01116-y - DOI - PMC - PubMed

[7] Wickware C. Pharmacies’ dispensing increases by up to a third as a result of COVID-19, survey finds. Pharm J 2020. 10.1211/PJ.2020.20207917 - DOI

[8] Wickware C. Pharmacies’ dispensing increases by up to a third as a result of COVID-19, survey finds. Pharm J 2020. 10.1211/PJ.2020.20207917 - DOI

[9] Pharmaceutical Services Negotiating Committee . Flu vaccination service, 2020. Available: https://psnc.org.uk/services-commissioning/advanced-services/flu-vaccina...

[10] Pharmaceutical Services Negotiating Committee . Flu vaccination service, 2020. Available: https://psnc.org.uk/services-commissioning/advanced-services/flu-vaccina...

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Rapid realist review of the role of community pharmacy in the public health response to COVID-19

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Rapid realist review of the role of community pharmacy in the public health response to COVID-19

Authors

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Abstract

Conflict of interest statement

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