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Background: Since the early 90s, patient navigation programs were introduced in the United States to address inequitable access to cancer care. Programs have since expanded internationally and in scope. The goals of patient navigation programs are to: a) link patients and families to primary care services, specialist care, and community-based health and social services (CBHSS); b) provide more holistic patient-centred care; and, c) identify and resolve patient barriers to care. This paper fills a gap in knowledge to reveal what is known about motivators and factors influencing implementation and maintenance of patient navigation programs in primary care that link patients to CBHSS. It also reports on outcomes from these studies to help identify gaps in research that can inform future studies.Methods: This scoping literature review involved: i) electronic database searches; ii) a web site search; iii) a search of reference lists from literature reviews; and, iv) author follow up. It included papers from Canada, the United States, the United Kingdom, Australia, New Zealand, and/or Western Europe published between January 1990 and June 2013 if they discussed navigators or navigation programs in primary care settings that linked patients to CBHSS.Results: Of 34 papers, most originated in the United States (n = 29) while the remainder were from the United Kingdom, Canada and Australia. Motivators for initiating navigation programs were to: a) improve delivery of health and social care services; b) support and manage specific health needs or specific population needs, and; c) improve quality of life and wellbeing of patients. Eleven factors were found to influence implementation and maintenance of these patient navigation programs. These factors closely aligned with the Diffusion of Innovation in Service Organizations model, thus providing a theoretical foundation to support them. Various positive outcomes were reported for patients, providers and navigators, as well as the health and social care system, although they need to be considered with caution since the majority of studies were descriptive.Conclusions: This study contributes new knowledge that can inform the initiation and maintenance of primary care patient navigation programs that link patients with CBHSS. It also provides directions for future research. [ABSTRACT FROM AUTHOR]

Community pharmacists are potentially in a strong position to contribute to improved patient care by providing medicines management services. Several major trials of community pharmacy medicines management (CPMM) have been conducted in Europe, North America, and Australia. Their findings show that some, but not all, of the potential of CPMM is being met, and thus far, evidence of benefit from CPMM is equivocal. There is a need to review the appropriateness of some of the primary outcome measures used in research to date. Key factors in pharmacy practice that impede CPMM include insufficient integration of community pharmacy input into patient pathways through treatment, poorly developed relationships between pharmacists and primary care physicians, lack of access to patient information, inadequate methods for targetting services to patients with identified medication-related problems, and community pharmacists’ willingness (or lack thereof) to provide the service. Recommendations as to how to improve CPMM services so that they deliver their full potential include integrating work practices with medical colleagues, targeting of patients, providing pharmacist access to patientsʼ medical records, and improving communication with patients. [ABSTRACT FROM AUTHOR]