OBJECTIVES: Pharma-sponsored patient support programmes aim to improve patient outcomes. These are often complex interventions, with multiple interacting components and stakeholders, which must be operationalised in the context of many practical local constraints. There is an industry wide recognition that Implementation Science (IS) methodologies can bring a scientific lens to enhance the execution of PSPs. Our objective was to evaluate implementation barriers with explicit consideration of IS to guide recommendations for PSP enhancement.

METHODS: An inductive and deductive qualitative approach was used to explore perceptions of internal stakeholders experienced in the running of European PSPs. Seven 1:1 semi-structured interviews and 1 focus group were conducted. A topic guide informed by the Theoretical Domains Framework was used to explore different components of implementation. Behavioural and implementation frameworks informed the translation of insights into actionable enhancement strategies.

RESULTS: There was consensus that proactive understanding of the barriers to service delivery is critical, with a more formal approach perceived as beneficial to optimisation. Key themes included: Detailed consideration of the local context early in the design process; identification and inclusion of local stakeholders early in design; provision of guidance to support flexibility and adaptations, whilst maintaining fidelity; importance of collecting operational data and experiences of service delivery staff to inform programme evolution. Key enhancement strategies included formal use of IS frameworks to aid characterisation of barriers and implementation planning, proactive knowledge sharing and training, with opportunities to foster collaboration between internal stakeholders.

CONCLUSIONS: PSP Implementation can encounter many practical and motivational barriers. Systematic application of IS methods early in design, in line with complex intervention best practice, enables identification of key facilitators of effective implementation, that can ensure pragmatic, flexible and efficient operationalisation of PSPs.