Primary care provider perspectives on the role of community pharmacy in colorectal cancer screening: a qualitative study

BMC Health Services Research

Research

Daniel S. Reuland¹  Alison T. Brenner²  Rachel M. Ceballos³  Annika Ittes⁴  Dana L. Atkins⁴  Parth D. Shah⁴  Rachel B. Issaka⁵  Sara Correa⁶  Austin R. Waters⁷  Olufeyisayo O. Odebunmi⁷  Renée M. Ferrari⁸  Stephanie B. Wheeler⁹  Mary Wangen^1,10  Catherine L. Rohweder^1,10 

[1] Division of General Medicine and Clinical Epidemiology, Department of Medicine, University of North Carolina School of Medicine, Chapel Hill, NC, US;Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, 27599, Chapel Hill, NC, USA;Division of General Medicine and Clinical Epidemiology, Department of Medicine, University of North Carolina School of Medicine, Chapel Hill, NC, US;Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, 27599, Chapel Hill, NC, USA;UNC Center for Health Promotion and Disease Prevention, University of North Carolina at Chapel Hill, 27599, Chapel Hill, NC, USA;Division of Public Health Sciences, Fred Hutchinson Cancer Center, 98109, Seattle, WA, USA;Hutchinson Institute for Cancer Outcomes Research, Fred Hutchinson Cancer Center, 98109, Seattle, WA, USA;Hutchinson Institute for Cancer Outcomes Research, Fred Hutchinson Cancer Center, 98109, Seattle, WA, USA;Division of Gastroenterology, School of Medicine, University of Washington, 98104, 98109, Seattle, WA, USA;Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, 27599, Chapel Hill, NC, USA;Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, 27599, Chapel Hill, NC, USA;Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 27599, Chapel Hill, NC, USA;Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, 27599, Chapel Hill, NC, USA;Department of Maternal and Child Health, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 27599, Chapel Hill, NC, USA;Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, 27599, Chapel Hill, NC, USA;UNC Center for Health Promotion and Disease Prevention, University of North Carolina at Chapel Hill, 27599, Chapel Hill, NC, USA;Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 27599, Chapel Hill, NC, USA;UNC Center for Health Promotion and Disease Prevention, University of North Carolina at Chapel Hill, 27599, Chapel Hill, NC, USA;

关键词: Colorectal Cancer screening;    Pharmacy;    Fecal immunochemical test;    Pharmacist;   

DOI  :  10.1186/s12913-023-09828-3

 received in 2023-04-20, accepted in 2023-07-17,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundThe United States Preventive Services Task Force (USPSTF) lists 32 grade A or B recommended preventive services for non-pregnant United States (US) adults, including colorectal cancer screening (CRC). Little guidance is given on how to implement these services with consistency and fidelity in primary care. Given limited patient visit time and competing demands, primary care providers (PCPs) tend to prioritize a small subset of these recommendations. Completion rates of some of these services, including CRC screening, are suboptimal. Expanding delivery of preventive services to other healthcare providers, where possible, can improve access and uptake, particularly in medically underserved areas or populations. Fecal immunochemical testing (FIT) (at-home, stool-based testing) for CRC screening can be distributed and resulted without PCP involvement. Pharmacists have long delivered preventive services (e.g., influenza vaccination) and may be a good option for expanding CRC screening delivery using FIT, but it is not clear how PCPs would perceive this expansion.MethodsWe used semi-structured interviews with PCPs in North Carolina and Washington state to assess perceptions and recommendations for a potential pharmacy-based FIT distribution program (PharmFIT™). Transcripts were coded and analyzed using a hybrid inductive-deductive content analysis guided by the Consolidated Framework for Implementation Research (CFIR) to elucidate potential multi-level facilitators of and barriers to implementation of PharmFIT™.ResultsWe completed 30 interviews with PCPs in North Carolina (N = 12) and Washington state (N = 18). PCPs in both states were largely accepting of PharmFIT™, with several important considerations. First, PCPs felt that pharmacists should receive appropriate training for identifying patients eligible and due for FIT screening. Second, a clear understanding of responsibility for tracking tests, communication, and, particularly, follow-up of positive test results should be established and followed. Finally, clear electronic workflows should be established for relay of test result information between the pharmacy and the primary care clinic.ConclusionIf the conditions are met regarding pharmacist training, follow-up for positive FITs, and transfer of documentation, PCPs are likely to support PharmFIT™ as a way for their patients to obtain and complete CRC screening using FIT.

【 授权许可】

CC BY   
© BioMed Central Ltd., part of Springer Nature 2023

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