Table of content

Table of content

I. Chapter I - Introduction ... 1

1.1 The evolution of the pharmacist’s role ... 2

1.1.1 The isotretinoin pregnancy prevention programme (PPP) ... 3

1.1.2 The medication adherence service ... 4

1.1.3 The medication review service ... 6

1.2 Implemented and reimbursed medication review and adherence support services across the world ... 7

1.2.1 The evolution of pharmaceutical services in Belgium ... 9

1.2.2 The evolution of pharmaceutical services in Switzerland ... 12

1.3 Implementation science - From theory to practice ... 15

1.3.1 Definition of implementation science ... 15

1.3.2 Two theories frequently used in community pharmacy implementation research .. 16

1.3.3 The framework for the Implementation of Services in Pharmacy (FISpH) ... 17

1.4 Implementation of the isotretinoin PPP ... 22

1.5 Implementation of medication review and adherence support services in community pharmacies ... 23

1.5.1 The gap between theory and practice ... 23

1.5.2 Facilitators and barriers encountered by community pharmacists ... 24

1.5.3 Implementation strategies used to implement medication review and adherence support services in community pharmacies - review ... 28

II. Chapter II - Objectives of the thesis ... 40

III. Chapter III - Materials and method ... 42

3.1 First project – Implementation of the isotretinoin pregnancy prevention programme in practice ... 43

3.2 Second and third projects – Implementation studies of adherence support and medication review services in community pharmacies ... 44

3.2.1 Implementation evaluation – RE-AIM model ... 44

IV. Chapter IV – Results ... 47

4.1 Implementation of the isotretinoin pregnancy prevention program in practice ... 48

4.1.1 Evaluation of compliance with isotretinoin PPP recommendations and exploration of reasons for non-compliance: Survey among French-speaking health care professionals and patients in Belgium ... 48

4.1.2 Assessment of medication adherence and responsible use of isotretinoin and contraception through Belgian community pharmacies by using pharmacy refill data ... 60

4.2 Implementation studies of new pharmaceutical services in community pharmacies ... 73

4.2.1 Implementation study of an interprofessional medication adherence program for HIV patients in Swiss community pharmacies – Description of the process ... 73

4.2.2 Implementation study of an interprofessional medication adherence program for HIV patients in Switzerland – Quantitative and qualitative implementation results ... 84

4.2.3 Implementation study of the medication review in Belgian community pharmacies – the SIMENON study ... 103

V. Chapter V – General discussion ... 126

5.1 The isotretinoin PPP ... 127

5.1.1 Summary of major results ... 127

5.1.2 Proposed implementation strategies ... 127

5.1.3 Reflection about the methodology ... 128

5.2 New medication review and adherence support services in community pharmacies .... 130

5.2.1 Summary of major results ... 130

5.2.2 Proposed implementation strategies ... 132

5.2.3 Reflection about the methodology ... 136

VI. Chapter VI - Conclusion and perspectives ... 138

References ... 141

Appendix ... 156

Appendix 1 – Published article about the interprofessional medication adherence program (IMAP) ... 156

Appendix 2 – Semi-structured interview guides related to the implementation of the medication adherence program in Switzerland [French] ... 170

Appendix 3 – Themes developed during the qualitative analyses and associated sentences .... 180

Appendix 4 – Flow diagram of the activity at the hospital and into community pharmacies ... 192

Appendix 5 - Semi-structured interview guides related to the implementation of the medication review in Belgium [French and Dutch] ... 194

Appendix 6 – “Patient responsiveness” questionnaire related to the implementation of the medication review in Belgium [French and Dutch] ... 197