Capabilities, opportunities and motivations within Australian community pharmacy to deliver clinical standard-aligned care for knee osteoarthritis: A mixed-methods evaluation

Abstract

Objective: To evaluate the capabilities, opportunities, and motivations of community pharmacists and pharmacy assistants to deliver osteoarthritis (OA) care, aligned with the Australian Osteoarthritis of the Knee Clinical Care Standard. Method: Quantitative data from pharmacists and pharmacy assistants working in Australian community pharmacies were collected via e-surveys. Behaviour-change theory-informed items measured pharmacists’ capabilities, opportunities, and motivations to provide Standard-aligned care. Pharmacy assistants reflected on their perceived role in OA care through focus groups. Results: 407 pharmacists and 148 pharmacy assistants responded. Most pharmacists (>80%) reported high motivations to engage in OA care, with >80% agreeing that five of the seven quality statements were within their scope of practice. Across quality statements, median feasibility to deliver Standard-aligned care (measured on 9-point numeric rating scale; 1 = not at all feasible; 9 = highly feasible) ranged from 6–7 within knowledge, 5–7 within workload, 6–7 within workflow, 8 within pharmacy layout/infrastructure, and 1–5 in absence of additional remuneration. More time-consuming care (e.g., self-management support, patient review) was rated less feasible. Adjusted linear regression models identified that perceived workload and workflow feasibility increased when more pharmacists were on duty (R2: 0.02–0.11). Three themes (with sub-themes) emerged from pharmacy assistants’ qualitative data (n = 13): 1) professional activities related to OA care; 2) capabilities and scope of practice; and 3) managing workflow and alleviating workload pressures. Conclusion: While pharmacists self-reported high motivation and capabilities to deliver Standard-aligned OA care, implementation feasibility will likely depend on addressing workload, workflow, and, particularly, remuneration barriers. Role delineation and training for pharmacy assistants may support better OA care within community pharmacies.