Characteristics for successful implementation of professional services in Australian community pharmacies

Abstract

Community pharmacy in Australia has expanded beyond dispensing to include patient‑centred and public health services. Despite strong evidence of effectiveness, these services are often inconsistently implemented and not sustained once external support ends. Existing research has focused on service models or strategies in controlled settings, offering limited insight into everyday practice. This thesis investigates how pharmacists implement and sustain services in real-world settings, focusing on their role as implementation leads and identifying pharmacist implementer archetypes.

A multi method approach informed by implementation science and psychology was used. Four studies were conducted: (1) a systematic review of implementation strategies and effectiveness; (2) a national survey of service delivery and implementation practices; (3) qualitative interviews exploring factors supporting successful implementation; and (4) Q methodology to identify archetypal roles and practices.

Limited comparative evidence was identified via systematic review, although higher intensity training was linked to better outcomes. Survey results showed pharmacists prioritised internal operational factors, with more experienced pharmacists placing less emphasis on external influences. Interviews highlighted key elements supporting sustained implementation. Q methodology identified four distinct pharmacist archetypes reflecting different approaches to successful service delivery.

Successful implementation depends not only on strategies but on how they are applied in practice. Experience, operational priorities, and adaptive behaviours shape long term success. The four archetypes show implementation is not one size fits all, highlighting the need to align strategies with those leading implementation, and informing future research, policy, and workforce development.