Transforming organisational change in polypharmacy management within healthcare in Oman: planning for the development and implementation of a strategic framework.

This doctoral research was conducted in two stages using a mixed-methods approach. The first stage involved a scoping review, while the second one consisted of two data collection phases. The first utilised a semi-structured qualitative interview approach, while the second phase employed an online Delphi approach. The doctoral research is presented in six chapters that are outlined below: Chapter one: The chapter is an introduction to the thesis, providing a comprehensive overview of polypharmacy management at the patient level as well as the organisational level, with the presentation of organisational change models. It also provides a brief overview regarding global initiatives that address polypharmacy management, such as the World Health Organization's Third Global Patient Safety Challenge "Medication Without Harm", Oman's healthcare system and outlines the overall aim and objectives of this doctoral research. Chapter two: This chapter focuses on research paradigms, research philosophies, methodologies and methods. The chapter explains the rationality of selecting particular methodologies for the doctoral research and provides information and background regarding various types of reviews and the use of theoretical frameworks specifically the use in this research. The chapter also provides information on reflexivity, rigour and robustness of research. Chapter three: The chapter provides a comprehensive review of polypharmacy management implementation frameworks at organisational level. The findings of the review revealed a lack of research evidence on the implementation framework for organisational level change in polypharmacy management, with identification of barriers and facilitators for implementation of the framework and strategies. Chapter four: This chapter demonstrates the findings of the semi-structured qualitative interviews with key stakeholders in the Ministry of Health Oman using the Consolidated Framework of Implementation Research (CFIR) as a theoretical framework. The main aim was the identification of the factors that affect the implementation of a polypharmacy management framework, including barriers and facilitators at the organisational level. The findings indicate the availability of more facilitators that enable implementation over barriers that may hinder implementation. Chapter five: The chapter illustrates the results of an online Delphi study with stakeholders in the ministry with an objective of determining the structure and content of an implementation framework for managing polypharmacy for Ministry of Health Oman. The Delphi results also highlighted the challenges that must be addressed prior to the implementation of the framework. Chapter six: This chapter concludes the thesis of this doctoral research and presents a comprehensive summary of the findings, strengths, and limitations. The chapter also discusses the originality and impact of the research. This chapter outlines various possibilities for future research as a continuation of this doctoral study. It is anticipated that this doctoral research will make a valuable contribution to the establishment of an evidence-based implementation framework for polypharmacy management in Oman. Upon completing this work, the doctoral student plans to seek additional work and establish a collaboration with the World Health Organization (WHO) Regional Office for the Eastern Mediterranean (EMRO) in partnership with Robert Gordon University.

Grantor dc:publisher.institution

Robert Gordon University

Year dc:date.issued

2025

Author dc:creator

• Al Bulushi, Sara

Advisor dc:contributor.advisor

• S. Cunningham, T. McIntosh, A. Grant, H. Talkhan, M. Fahmi, and D. Stewart

• Polypharmacy management
• Implementation frameworks
• Organisational change
• Healthcare
• Stakeholder perspectives
• Mixed-methods research
• Delphi studies

Language dc:language

en

Identifier

oai:rgu-repository.worktribe.com:3217647
https://doi.org/10.48526/rgu-wt-3217647

OAI identifier oai:identifier

oai:rgu-repository.worktribe.com:3217647