Expanded practice in rural community pharmacy: a macro-, meso and micro-level perspective

Introduction: Expanding community pharmacists’ scope of practice, in rural and remote locations has the potential to improve access health care outcomes. Internationally, a lack support from other professionals (HPs) presented barrier uptake expanded pharmacy models. Rural allied workers, including pharmacists, however, already work across an extended using generalist specialist skills meet unique needs with limited infrastructure for support. Limited data on practice Australia prompted this study explore Australian doctor, nurse perspectives services non-metropolitan settings. Methods: An ethnographic lens culture was applied descriptive qualitative study. Semi-structured, in-depth interviews were conducted HPs working Australia. Inductive deductive thematic analysis guided by multi-level macro- (policy level), meso- (HP level) micro- (consumer perspectives. The World Health Organization (WHO) framework integrated people-centred provided strategies align theoretical analysis. Results: Twenty-three (doctors (8), nurses (4), (11)) participated. Key themes identified included supportive government funding provisions (macro); collaboration providers (meso); ensuring pharmacists have required knowledge, skills, quality assurance safety measures place capacity, time space opportunity empower engage consumers through pharmacies (micro). Conclusion: As internationally continue develop their these results provide first evidence consider when planning developing Recognition challenges motivators are highlighted. Engagement both is seen as crucial models evolve deliver improved outcomes communities.