A Critical Evaluation of Contextual Factors Affecting the Implementation of Pharmacist-Led Colorectal Cancer Screening - Systematic Review

Sep 22, 2026

Colorectal cancer remains a highly lethal but largely preventable disease, and screening disparities persist—especially in rural communities and groups with limited access to care. Community pharmacies offer a trusted, accessible venue to expand screening, yet pharmacy implementation depends on diverse real-world contextual conditions. This scoping narrative hybrid review synthesizes evidence on barriers and facilitators for pharmacist-led CRC screening, then links actionable strategies to an implementation logic model. Findings emphasize reimbursement, training, workflow integration, care coordination, and supportive policy reform to sustain equitable uptake.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages10

Reading Time25 min

AccessFree to download

Summary

What is known about this topic?

What is added by this report?

What are the implications for public health practice?

Abstract

Introduction

Methods

Results

Conclusion

PREVENTING CHRONIC DISEASE P U B L I C H E A L T H R E S E A R C H , P R A C T I C E , A N D P O L I C Y Volume 23, E05 MARCH 2026 SYSTEMATIC REVIEW A Critical Evaluation of Contextual Factors Affecting the Implementation of PharmacistLed Colorectal Cancer Screening: AScoping Narrative Hybrid Review Arinze Nkemdirim Okere, PharmD, MS, MBA, BCPS, BCCP1; Md. Mohaimenul Islam, PhD1 [Accessible Version: www.cdc.gov/pcd/issues/2026/25_0380.htm](Accessible Version: www.cdc.gov/pcd/issues/2026/25_0380.htm) [Suggested citation for this article:](Suggested citation for this article: Nkemdirim Okere A)[ Nkemdirim Okere A](Suggested citation for this article: Nkemdirim Okere A) , Islam MDM . A Critical Evaluation of Contextual Factors Affecting the Implementation of Pharmacist-Led Colorectal Cancer Screening: A Scoping Narrative Hybrid Review. Prev Chronic Dis 2026;23:250380. DOI: [https://doi.org/10.5888/](https://doi.org/10.5888/)[ ](https://doi.org/10.5888/)[pcd23.250380.](pcd23.250380.) PEER REVIEWED Summary What is known about this topic? Colorectal cancer (CRC) is among the most frequently diagnosed cancers in the US, and screening disparities persist in rural populationsand in populations with inadequate access to care. Community pharmacies represent a promising setting to expand CRC screening. What is added by this report? We conducted a literature review to examine the barriers to and facilitators of pharmacy-based CRC screening. Key barriers included lack of reimbursement, workflow constraints, pharmacist knowledge gaps, and limited care coordination. Facilitators included high patient willingness, trust in pharmacies, compatibility with existing workflows, and professional support from pharmacists and providers. What are the implications for public health practice? Community pharmacies are well positioned to expand CRC screening access to reduce disparities and improve population health. Abstract Introduction Colorectal cancer (CRC) is among the most preventable cancersand causes more than 50,000 deaths annually in the US. Screening disparities persist in rural versus urban populations and in populations with inadequate access to care. Community pharmacies, given their accessibility and trusted role in preventive care, represent a promising setting to expand CRC screening. Methods This scoping narrative hybrid review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) guidelines and the Arksey and O’Malley framework, along with other refinements. Literature searches were conducted in PubMed, Embase (via Elsevier), ProQuest, Medline (via OVID), and ClinicalTrials.gov by using broad key words related to CRC screening and pharmacy. Eligible studies included US-based studies describing pharmacist involvement in community pharmacy CRC screening. Data were synthesized by using the Consolidated Framework for Implementation Research, with strategies mapped to the Implementation Research Logic Model. Results Ten US studies met inclusion criteria: 1 randomized community–pharmacy intervention trial, 1 pilot implementation study, 3 stakeholder qualitative studies, and 5 national or statewide surveys. Key barriers included lack of reimbursement, workflow constraints, pharmacist knowledge gaps, and limited care coordination. Facilitators included high patient willingness, trust in pharmacies, compatibility with existing workflows, and professional support from pharmacists and providers. Evidence-based strategies included targeted pharmacist training, workflow reminders, formal referral agreements with primary care, and patient engagement initiatives. Policy reforms to establish reimbursement and strengthen information exchange were identified as essential for sustainability. Conclusion Community pharmacies are well positioned to expand CRC screening access. Addressing reimbursement, training, workflow, and coordination

FAQs

What motivated this review on pharmacist-led colorectal cancer screening?

Screening disparities persist, particularly for rural populations and those with inadequate access to care. Community pharmacies are a promising setting, but uptake depends on contextual factors affecting implementation.

Which barriers did the review identify as most important?

Key barriers included lack of reimbursement, workflow constraints, pharmacist knowledge gaps, and limited care coordination.

What strategies and policy actions are recommended to improve implementation?

Evidence-based strategies include targeted pharmacist training, workflow reminders, formal referral agreements with primary care, and patient engagement initiatives. Policy reforms to establish reimbursement and strengthen information exchange were identified as essential for sustainability.

Sep 22, 2026

Uploaded by Nguyễn Văn Học