Implementation of cognitive pharmaceutical services (CPS) in professionally active pharmacies

Objective To investigate the implementation process of cognitive pharmaceutical services (CPS) in ‘professionally active’ pharmacies in Denmark; to describe the factors that influence the implementation process in the context of organisational theory. Method Twenty semi-structured interviews were conducted with pharmacy staff and owners in ‘professionally active’ pharmacies from 16 community pharmacies in Denmark. Key findings Fifty-one factors that influence the implementation process were identified. Based on their content and relationships, the factors were categorised into nine ‘common sense’ dimensions: network and relations with the environment; the environment's expectations and pressure for change; barriers to implementation of CPS; competence in relation to CPS; organising the pharmacy for provision of CPS; culture of the pharmacy; resources within the pharmacy; management within the pharmacy; the role of the pharmacy. Subsequently the 51 factors were categorised and described in relation to Leavitt's model of an organisation. Conclusion Implementation of CPS in the pharmacy is a very complex process, which is unique to the individual pharmacy. The model formed a relevant basis for describing the factors, and the theoretical analysis showed a complex interdependence of the factors identified in the study. Many interdependent factors influence the process and this has to be taken into account in designing future models for implementation of CPS. Such models should support comprehensive and flexible strategies that can be adapted to the dynamics of the individual organisation.