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CFIR Framework in Pharmacy and Health Services Research

Sarah J. Shoemaker-Hunt, Ellen Childs, and Holly Swan, Abt Associates; and Geoffrey Curran, University of Arkansas for Medical Sciences


June 23, 2022

How can researchers better answer existing and emerging questions about the implementation of pharmacy or health services already in practice? Abt implementation scientists provide new insights in chapter five of Contemporary Research Methods in Pharmacy and Health Services, which offers practical methods that may be used in the training of future pharmacy and health services researchers.

In the chapter, the authors explain how researchers can use the Consolidated Framework for Implementation Research (CFIR), a determinant framework which identifies factors that influence outcomes. The CFIR specifically aims to help researchers to identify what works where and why across multiple contexts, thus providing a more comprehensive accounting of factors that have been identified in other research. As a determinant framework, CFIR offers an overarching typology from which pharmacy researchers can select constructs that are best suited to evaluate implementation progress, explain findings, or assess implementation context.

Because pharmacies have unique contextual features that may impact implementation (e.g., retail environment, incentive structures) and potentially unique staffing-related barriers compared to other health care professionals, the authors conducted a critical review of 45 articles on professional services to provide a framework for implementation research for community pharmacy based on the CFIR. They applied the framework to professional services including medication therapy management (MTM), immunizations, and rapid HIV testing.

While most of the included studies did not use the CFIR or any implementation framework, the authors mapped study findings to CFIR constructs. Along with key findings, the chapter explains CFIR’s utility and application to a professional service like MTM and immunizations  and not just to a discrete intervention. More specifically, the authors determined “[t]he CFIR—as an implementation science framework—has a demonstrated utility in continuing to advance and understand the effective implementation of pharmacy and health services.”