Capacity, motivation, and opportunity model-derived taxonomy of pharmacist-led interventions applicable to people self-managing cancer medication

Introduction With health systems facing increasing challenges, it is important to define new care models that may release some of the burden on the workforce, whilst maintaining quality and improving patient convenience. The objective of this study was to create a taxonomy of pharmacist-led interventions aimed at supporting improved health outcomes of people self-managing cancer medication. Methods The list was developed following a literature search conducted in Cochrane Library and MEDLINE (PubMed) databases. The Capacity, Motivation and Opportunity (CMO) model developed for people living with HIV was used as theoretical framework to organise the pharmacist-led interventions emerging from literature. A panel of experts (hospital pharmacists with experience in oncology) selected through national hospital pharmacy societies was invited to participate in a consensusseeking Delphi survey, focusing on the most important and feasible interventions. Results A total of 28 experts answered and rated 39 interventions. Whilst 35 of the proposed pharmacist-led interventions were considered important (median score above 8, on a scale of 1 to 9, without disagreement among experts), only eight were considered feasible for implementation in practice. The most frequently mentioned reasons for others not to be feasible were understaffing and excessive workload. Nevertheless, there were interventions considered vital for patients’ care and hence kept in the final taxonomy. Discussion Future hospital-based studies should incorporate this taxonomy based on the CMO model to measure pharmacists’ interventions in real clinical practice.