Background Effective transfer of interventions to improve patient initiation adherence to new long-term medications requires careful consideration of the implementation context. For example, global applications of the UK’s New Medicines Service (NMS) faced implementation barriers when implemented internationally including poor patient uptake, underdeveloped pharmacist and physician relationships and pharmacists’ time constraints.
Purpose The myCare Start implementation science project (myCare Start-I) is part of a national effort to implement the NMS in Switzerland under the name myCare Start. In parallel to a current feasibility pilot being led by the Swiss Pharmacists Association pharmaSuisse, the myCare Start-I project aims to optimise the myCare Start service for use in Switzerland using a context informed approach.
Method Guided by the Basel Approach for coNtextual ANAlysis (BANANA) and the Context and Implementation of Complex Interventions (CICI) framework, a contextual analysis was conducted in 11 Swiss pharmacies and neighbouring medical practices. A convergent mixed-methods approach was used and included individual interviews with patients, pharmacists, pharmacy technicians and physicians. Additionally, online surveys were administered to pharmacists and pharmacy technicians. Data will be analysed to construct an enhanced understanding of the Swiss context including the current patient journey upon commencement of a new medication, pharmacist and physician practice patterns and the multi-level factors influencing medication adherence and health service implementation.
Findings Between September 2023 and February 2024, individual interviews were conducted with 16 patients, 11 pharmacists, 11 pharmacy technicians and 22 physicians from both the French and German speaking regions of Switzerland. In addition, on average, 89% of pharmacists and pharmacy technicians employed at these pharmacies completed the online survey. Analysis is ongoing and complete results will be available at the conference. Preliminary findings, indicate that health service delivery is believed to be the shared responsibility of both pharmacists and physicians. Effective collaboration and understanding of each other’s roles will facilitate patient uptake of the service, improve continuity of care and the successful implementation and impact of health services such as myCare Start. It is essential that the intervention is adapted, and implementation strategies are selected to facilitate such organisational change.
Conclusion Findings will inform the development of a contextual modified myCare Start service, allow for the selection of context specific implementation strategies and offer a framework for optimising pharmacy services for any given context.
