[Translated article] Qualitative study on the adoption and enhancement of the capacity-motivation-opportunity model for pharmaceutical care in outpatient pharmacy consultations in Spain.

Objective: To analyse and address the barriers that Pharmacy Services encounter when adopting the capacity-motivation-opportunity (CMO) pharmaceutical care model in outpatient consultations, identifying the relevant actors in the ecosystem, as well as the motivations. Finally, to make a first approach to solutions that will help us to select those that could be developed through future initiatives.

Method: A structured methodology was developed in several phases. Two teams were formed: the "Core Team," consisting of hospital pharmacists with experience in pharmaceutical care and patient-centered care, and the "Guiding Team," made up of professionals from various disciplines. The first phase included an online prospecting workshop to explore the phases of model adoption. Subsequently, semi-structured interviews were conducted with key actors, such as physicians, managers, and patient associations, to identify needs and barriers. Finally, a face-to-face workshop was organized to facilitate the ideation and validation of solutions.

Results: Three categories of actors in the CMO model ecosystem were identified: interested agents (beneficiaries), interesting agents (influencers), and executive agents (implementers). Significant barriers were found, including variability in infrastructure, lack of commitment from managers, and the workload of pharmacists. However, there was also growing motivation among professionals and organizations to adopt the model. During the ideation workshop, ten initiatives were prioritized, including the use of digital technologies and ongoing training programs.

Conclusions: The study highlights the high potential of the CMO model to improve pharmaceutical care in outpatient settings in Spain, despite the identified barriers. The proposed strategies, focused on digitalization and multidisciplinary collaboration, are essential for effective implementation. Future research is suggested to evaluate the long-term impact of these initiatives and to strengthen the involvement of patient associations and other actors in the adoption process.