opportunities and challenges in social pharmacy and pharmacy practice research

Download Opportunities and challenges in social pharmacy and pharmacy practice research

Post on 30-Dec-2016

212 views

Category:

Documents

0 download

Embed Size (px)

TRANSCRIPT

  • men

    geac.Drauthern

    Univ

    l Sci

    to reect on the current state of research in framework than ever before.

    * Corresponding author. Tel.: 45 65503089.E-mail address: abalmars@health.sdu.dk (A.B. Almarsdottir).

    Research in Social and

    Administrative Pharmacy 10 (2014) 252255Introduction

    Pharmacy practice and social pharmacy aretwo important contemporary research areaswithin the eld of pharmaceutical sciences. As is

    the case with other pharmaceutical sciences, theyhave increasingly become multidisciplinary, com-bining natural sciences with social and humanistic

    research to study the role of medicines, patients,and pharmacists within the health care sector andsociety at large.13 As the disciplines have under-

    gone and are still undergoing changes, it is useful

    these elds as the basis for discussing furtherdevelopment.

    This paper in particular addresses how bothdisciplines are currently lacking consensus anda common understanding of what constitutes their

    research areas.4 Further, how they have beencharged with aiming too often on evaluating nar-rowly focused pharmacy services.5 With the added

    challenge of diminished research funding and thepressure to publish results,6 this paper also willdiscuss how the disciplines have to accommodate

    outside pressures within a much broader researchKeywords: Pharmacy practice; Social pharmacy; Research; ParadigmsSummary

    Pharmacy practice and social pharmacy are two important research areas within pharmaceutical and

    health sciences. As the disciplines have undergone and are still undergoing changes, it is useful to reect onthe current state of their research as the basis for discussing further development. The two areas arecurrently beset by a lack of consensus and charged all too often with evaluating narrowly focused

    pharmacy services. With the added challenge of diminished funding for research and the pressures topublish results, these elds have to accommodate a much broader research framework than ever before. Inthis article, the challenges and opportunities in current research are reviewed, and suggestions provided onhow to further research in these areas. A systematic content analysis is important to benchmark trends in

    the types of studies conducted, and to map the collaboration and funding within these areas. 2014 Elsevier Inc. All rights reserved.Com

    Opportunities and challenpharmacy pr

    Anna Birna Almarsdottir, PhJanine M. T

    aResearch Unit of Clinical Pharmacology, University of SoubFaculty of Pharmaceutical Sciences,

    cDepartment of Pharmacy, Faculty of Health and Medica1551-7411/$ - see front matter 2014 Elsevier Inc. All rightshttp://dx.doi.org/10.1016/j.sapharm.2013.04.002tary

    s in social pharmacy andtice research.a,b,*, Susanne Kaae, Ph.D.c,lsen, Ph.D.c

    Denmark, J.B. Winslwsvej 19, 5000 Odense C, Denmark

    ersity of Iceland, Reykjavk, Iceland

    ences, University of Copenhagen, Copenhagen, Denmarkreserved.

  • research to social pharmacy research, a well-developed academic discipline in the Nordic coun-

    How can we understand this narrow research

    253Almarsdottir et al. / Research in Social and Administrative Pharmacy 10 (2014) 252255tries. It is evident when viewing homepages of

    various schools of pharmacy in dierent countriesthat dierent terms are used to describe whatresearchers in the Nordic countries call social

    pharmacy compared to the rest of Europe andNorth America. Departments or divisions withinpharmacy schools often have been identied as

    social/administrative pharmacy, but the termpharmacoepidemiology also has appeared inrecent years. In Great Britain, however, depart-ments with a similar focus are often called

    pharmacy practice. In North America, pharmacypractice is also known as a research discipline,primarily carried out by clinical and/or hospital

    pharmacists. Also in North America, the termpharmacy administration was previously used forsocial and administrative aspects of pharmacy, but

    in the past two decades this label often refers topharmaceutical outcomes and/or policy analysis.

    Besides the lack of consensus in terminology,

    the subdisciplines are characterized by a disagree-ment about what they should do and how.Pharmacy practice and pharmacy administrationhave been observed in a US-based study as having

    softer or less focused research agendas thanother pharmaceutical subdisciplines such as me-dicinal chemistry, pharmacology, and pharmaceu-

    tics.4,7 The concept of hard/soft dimension inscholarly work relates to the work of Biglan8 asone of the three dimensions that he found to be

    highly predictive in determining the degreescholars were socially connected to others, theircommitment to research, and scholarly productiv-ity. This nding correlated to the hard-soft dimen-

    sion in Kuhns9 1970s work on paradigmaticdevelopment or the degree of consensus or shar-ing of beliefs within a scientic eld about theory,

    methodology, techniques and problems. Thus,the higher the degree of consensus, the harderthe eld of inquiry is viewed.

    Actors and power relations

    In addition to the weakness observed regarding

    lack of consensus, the opinion has been voicedthat pharmacy practice and social pharmacyLack of consensus in social pharmacy andpharmacy practice research

    From the authors viewpoint, it is paramountto relate the academic eld of pharmacy practiceresearch has all too often aimed at evaluatingfocus in the pharmacy professions search fora new role in healthcare? Researchers in Canada

    and Australia have suggested that despite in-creased eorts and important policy initia-tives,15,16 the majority of pharmacists still prefer

    status quo with dispensing as their main profes-sional activity.5,17 The low preparedness of phar-macists indicates that research on pharmacists

    and how the world views them is not the mostpromising way forward. This may seem contraryto the role that critics say much nursing research

    has had in carving out a niche for the professionas a patient centered counterpart to the objective(hard) science approach of medicine.10

    A recent editorial by van Mil and Fernandez-

    Llimos18 highlights this dilemma of a commonunderstanding within the elds of pharmacy prac-tice and social pharmacy. The fact is that the cen-

    tral concept of pharmaceutical care has neverbeen considered for inclusion in the main biomedi-cal thesaurus, the MeSH database, with other

    health care terminologies such as nursing careand dental care.

    Funding within a multi-disciplinary research

    framework

    The question of who funds pharmacy practiceand social pharmacy research is crucial to howsocial pharmacy and pharmacy practice research

    is viewed. Researchers in these two disciplineslikewise face pressure to secure extramural fund-ing, whether from the state, private non-prot

    foundations, or industry. Pharmacy owners asso-ciations have been prominent funders in countriesas far apart geographically as Denmark and

    Australia.16,19

    In countries such as the US, Australia, andnarrowly focused pharmacy services; i.e., howinterventions are viewed by pharmacists them-selves, patients, and other healthcare profes-sionals.5 These claims are in line with what has

    been written in recent years about the eld ofnursing research.10 Contrary to pharmacys questto resist losing ground,11,12 the nursing profes-

    sion was attempting to develop into a scienticdiscipline.13 Some nursing research has been criti-cized for relying on and reproducing an unexam-

    ined professional ideology and support toa professionalizing project,13,14 which should bea warning to pharmacy practice and social phar-

    macy researchers.Norway healthcare payers are increasingly

  • for this research, such as reducing inappropriate

    gen, Faculty of Pharmaceutical Sciences. Available

    from: http://www.farma.ku.dk/index.php/Social-

    2011;7:415420.

    254 Almarsdottir et al. / Research in Social and Administrative Pharmacy 10 (2014) 252255prescribing and enhancing adherence to medi-cines. One prominent example is the Australian

    National Medicines Policy that has engenderedtenders for research calling for the consultationand engagement of all key stakeholders in the

    rational use of medicines.22

    To secure funding in an increasingly competi-tive environment, the trend has been toward

    more interdisciplinary collaboration, be it inter-professional or across dierent scientic sub-disciplines. Academics have pointed out a tendencytoward authorship proliferation due to pressures to

    obtain funding. Dotson et al,6 evaluated changes inauthorship patterns in pharmacy journals andfound similar to what is observed in the medical lit-

    erature23; that the number of authors per articlehas risen dramatically within past decades.

    A study by Figg et al24 supported the hypoth-

    esis that the degree of collaboration is increasingover time and that clinical researchers are morelikely to collaborate than basic science re-

    searchers. Their study of six leading scienticjournals in the eld of pharmaceutical sciencesshowed that investigators who are more collabo-rative produce a superior product that results in

    a higher impact of their publications.Researchers can no longer expect to secure

    funding for projects solely focused on pharmacy

    practice, whether concerning interventions ormore descriptive work. The practice of otherprofessions than pharmacy needs to be included,

    primarily that of physicians and nurses. Moreover,pharmacy practice/social pharmacy research teamshaveaccording to the focus of each studytoinvolve scientists with dierent backgrounds such

    as sociology

Recommended

View more >