Usability evaluation of standard operating procedures for extended community pharmacy services

Abstract

Objective: To develop standard operating procedures (SOPs) for extended community pharmacy services and assess the practicality and outcomes of implementation. Methods: Phase I: Development of SOPs and checklists for extended services. Phase II: Assessment of face and content validity through expert panel review. Phase III: Usability testing over 300 hours in a community pharmacy in Malta, targeting up to 10 patients per service. The outcomes measured included time to provide service, clinical interventions, and implementation challenges. Key findings: SOPs and checklists were developed for 12 extended services, classified into medicine use review (MUR), patient review (blood pressure measurement, weight management, urinalysis), and advice/treatment services (eye, ear, skin conditions, sore throat, urinary tract infection, smoking cessation, routine immunization, and international travel health). Expert validation showed high ratings for relevance, clarity, and presentation. During usability testing, 88 patients were recruited. The number of patients and mean time for service provision were as follows: MUR (𝘯 = 10, 14 minutes), patient review (𝘯 = 22, 21 minutes), and advice/treatment services (𝘯 = 56, 17 minutes). The clinical interventions included non-pharmacological advice (𝘯 = 88), referral to physician (𝘯 = 44), and dispensing non-prescription medicines (𝘯 = 42). Referrals were commonly due to side effects, drug interactions, abnormal urinalysis results, and uncontrolled blood pressure. The key challenges identified were limited access to electronic health records, time constraints, and lack of pharmacist prescribing authority. Conclusions: The SOPs outline key components of best practice for delivering extended services in community pharmacy. Usability testing demonstrated that implementation of the SOPs and checklists was practical and led to valuable clinical interventions. The study proposes a transferable model for extended community pharmacy services within collaborative healthcare systems.