Australian pharmacists' experiences and perspectives in implementing a chronic kidney disease screening service in community pharmacies: A qualitative study

Background: The emerging role of pharmacists in chronic kidney disease (CKD) care prompted the pharmacy-led screening and quality use of medicines in CKD trial (QUM-CKD), a pharmacy-led screening initiative to detect previously undiagnosed CKD and improve medication safety.Objective: To explore pharmacists' experiences and perspectives on the implementation of the QUM-CKD trial in Australian community pharmacies. Methods: A descriptive phenomenological qualitative approach was employed, involving in-depth, semi-structured telephone interviews with thirteen metropolitan and rural community pharmacists in the trial. Pharmacists were selected via purposive maximum variation sampling and were recruited mid-trial. Interviews were audio- recorded, transcribed verbatim, and thematically analysed using both deductive and inductive approaches in NVivo 14. Results: Most participating pharmacists reported having positive experiences with the trial's implementation. Facilitators of implementation included pharmacists' knowledge and beliefs, the availability of resources, support and training. The alignment with roles, values, and systems, along with perceived benefits of the service, the point-of-care testing service, a whole-team approach, and patient acceptance coupled with positive feedback, also facilitated implementation. Barriers included insufficient pharmacist staffing, time constraints, heavy workload, trial software and documentation issues, patients' lack of time, interest or unfavourable perceptions of the service, and interprofessional communication challenges between pharmacists and general practitioners (GPs). Pharmacists also suggested several potential improvements and expressed concerns about the sustainability of the service. Conclusions: Australian community pharmacists generally reported positive experiences in implementing the QUM-CKD trial. To ensure the service's success and sustainability, we recommend adequate pharmacy staffing, appropriate pharmacist remuneration, active stakeholder promotion and strong interprofessional collaboration. Pharmacists' suggestions for service improvement should also be considered.