Opportunities and challenges in social pharmacy and pharmacy practice research

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<ul><li><p>men</p><p>geac.Drauthern</p><p>Univ</p><p>l Sci</p><p>to reect on the current state of research in framework than ever before.</p><p>* Corresponding author. Tel.: 45 65503089.E-mail address: abalmars@health.sdu.dk (A.B. Almarsdottir).</p><p>Research in Social and</p><p>Administrative Pharmacy 10 (2014) 252255Introduction</p><p>Pharmacy practice and social pharmacy aretwo important contemporary research areaswithin the eld of pharmaceutical sciences. As is</p><p>the case with other pharmaceutical sciences, theyhave increasingly become multidisciplinary, com-bining natural sciences with social and humanistic</p><p>research to study the role of medicines, patients,and pharmacists within the health care sector andsociety at large.13 As the disciplines have under-</p><p>gone and are still undergoing changes, it is useful</p><p>these elds as the basis for discussing furtherdevelopment.</p><p>This paper in particular addresses how bothdisciplines are currently lacking consensus anda common understanding of what constitutes their</p><p>research areas.4 Further, how they have beencharged with aiming too often on evaluating nar-rowly focused pharmacy services.5 With the added</p><p>challenge of diminished research funding and thepressure to publish results,6 this paper also willdiscuss how the disciplines have to accommodate</p><p>outside pressures within a much broader researchKeywords: Pharmacy practice; Social pharmacy; Research; ParadigmsSummary</p><p>Pharmacy practice and social pharmacy are two important research areas within pharmaceutical and</p><p>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</p><p>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</p><p>the types of studies conducted, and to map the collaboration and funding within these areas. 2014 Elsevier Inc. All rights reserved.Com</p><p>Opportunities and challenpharmacy pr</p><p>Anna Birna Almarsdottir, PhJanine M. T</p><p>aResearch Unit of Clinical Pharmacology, University of SoubFaculty of Pharmaceutical Sciences,</p><p>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</p><p>s in social pharmacy andtice research.a,b,*, Susanne Kaae, Ph.D.c,lsen, Ph.D.c</p><p>Denmark, J.B. Winslwsvej 19, 5000 Odense C, Denmark</p><p>ersity of Iceland, Reykjavk, Iceland</p><p>ences, University of Copenhagen, Copenhagen, Denmarkreserved.</p></li><li><p>research to social pharmacy research, a well-developed academic discipline in the Nordic coun-</p><p>How can we understand this narrow research</p><p>253Almarsdottir et al. / Research in Social and Administrative Pharmacy 10 (2014) 252255tries. It is evident when viewing homepages of</p><p>various schools of pharmacy in dierent countriesthat dierent terms are used to describe whatresearchers in the Nordic countries call social</p><p>pharmacy compared to the rest of Europe andNorth America. Departments or divisions withinpharmacy schools often have been identied as</p><p>social/administrative pharmacy, but the termpharmacoepidemiology also has appeared inrecent years. In Great Britain, however, depart-ments with a similar focus are often called</p><p>pharmacy practice. In North America, pharmacypractice is also known as a research discipline,primarily carried out by clinical and/or hospital</p><p>pharmacists. Also in North America, the termpharmacy administration was previously used forsocial and administrative aspects of pharmacy, but</p><p>in the past two decades this label often refers topharmaceutical outcomes and/or policy analysis.</p><p>Besides the lack of consensus in terminology,</p><p>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</p><p>softer or less focused research agendas thanother pharmaceutical subdisciplines such as me-dicinal chemistry, pharmacology, and pharmaceu-</p><p>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</p><p>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-</p><p>sion in Kuhns9 1970s work on paradigmaticdevelopment or the degree of consensus or shar-ing of beliefs within a scientic eld about theory,</p><p>methodology, techniques and problems. Thus,the higher the degree of consensus, the harderthe eld of inquiry is viewed.</p><p>Actors and power relations</p><p>In addition to the weakness observed regarding</p><p>lack of consensus, the opinion has been voicedthat pharmacy practice and social pharmacyLack of consensus in social pharmacy andpharmacy practice research</p><p>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</p><p>and Australia have suggested that despite in-creased eorts and important policy initia-tives,15,16 the majority of pharmacists still prefer</p><p>status quo with dispensing as their main profes-sional activity.5,17 The low preparedness of phar-macists indicates that research on pharmacists</p><p>and how the world views them is not the mostpromising way forward. This may seem contraryto the role that critics say much nursing research</p><p>has had in carving out a niche for the professionas a patient centered counterpart to the objective(hard) science approach of medicine.10</p><p>A recent editorial by van Mil and Fernandez-</p><p>Llimos18 highlights this dilemma of a commonunderstanding within the elds of pharmacy prac-tice and social pharmacy. The fact is that the cen-</p><p>tral concept of pharmaceutical care has neverbeen considered for inclusion in the main biomedi-cal thesaurus, the MeSH database, with other</p><p>health care terminologies such as nursing careand dental care.</p><p>Funding within a multi-disciplinary research</p><p>framework</p><p>The question of who funds pharmacy practiceand social pharmacy research is crucial to howsocial pharmacy and pharmacy practice research</p><p>is viewed. Researchers in these two disciplineslikewise face pressure to secure extramural fund-ing, whether from the state, private non-prot</p><p>foundations, or industry. Pharmacy owners asso-ciations have been prominent funders in countriesas far apart geographically as Denmark and</p><p>Australia.16,19</p><p>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</p><p>been written in recent years about the eld ofnursing research.10 Contrary to pharmacys questto resist losing ground,11,12 the nursing profes-</p><p>sion was attempting to develop into a scienticdiscipline.13 Some nursing research has been criti-cized for relying on and reproducing an unexam-</p><p>ined professional ideology and support toa professionalizing project,13,14 which should bea warning to pharmacy practice and social phar-</p><p>macy researchers.Norway healthcare payers are increasingly</p></li><li><p>for this research, such as reducing inappropriate</p><p>gen, Faculty of Pharmaceutical Sciences. Available</p><p>from: http://www.farma.ku.dk/index.php/Social-</p><p>2011;7:415420.</p><p>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</p><p>National Medicines Policy that has engenderedtenders for research calling for the consultationand engagement of all key stakeholders in the</p><p>rational use of medicines.22</p><p>To secure funding in an increasingly competi-tive environment, the trend has been toward</p><p>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</p><p>obtain funding. Dotson et al,6 evaluated changes inauthorship patterns in pharmacy journals andfound similar to what is observed in the medical lit-</p><p>erature23; that the number of authors per articlehas risen dramatically within past decades.</p><p>A study by Figg et al24 supported the hypoth-</p><p>esis that the degree of collaboration is increasingover time and that clinical researchers are morelikely to collaborate than basic science re-</p><p>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</p><p>a higher impact of their publications.Researchers can no longer expect to secure</p><p>funding for projects solely focused on pharmacy</p><p>practice, whether concerning interventions ormore descriptive work. The practice of otherprofessions than pharmacy needs to be included,</p><p>primarily that of physicians and nurses. Moreover,pharmacy practice/social pharmacy research teamshaveaccording to the focus of each studytoinvolve scientists with dierent backgrounds such</p><p>as sociology, economics, and epidemiology to gettheir research widely recognized and accepted asscience. Pharmacists also can through such multi-</p><p>disciplinary research educate policymakers andother health professions about the width andbreadth of the contribution of the profession to</p><p>society in general and public health in particularand thereby better secure research funding.13,25</p><p>Conclusion</p><p>Within the context of pharmaceutical sciencesthe terms social pharmacy and pharmacy practicecontributing to large pharmacy practice projectswithin a larger framework of healthcare re-forms.16,20,21 These funding bodies can be said</p><p>to have very specic practical and economic goalsoften have referred to similar types of studies.4. Desselle SP, Collins CC, Harrold MW, Kalis MM,</p><p>Quattrocchi EJ. Consensus within ve academic sub-</p><p>disciplines of pharmacy: progress toward establish-</p><p>ing their scientic paradigms. J Pharm Teach 2002;</p><p>9(2):2746.</p><p>5. Rosenthal M, Austin Z, Tsuyuki RT. Are pharma-</p><p>cists the ultimate barrier to pharmacy practice</p><p>change? CPJ 2010;143(1):3742.</p><p>6. Dotson B, McManus KP, Zhao JJ, Whittaker P. Au-</p><p>thorship and characteristics of articles in pharmacy</p><p>journals: changes over a 20-year interval. Ann Phar-</p><p>macother 2011;45:357363.</p><p>7. Holmes ER,Desselle SP. The use of speech disuency</p><p>as an indicant of paradigm development in phar-</p><p>macys academic subdisciplines. Res Soc Adm Pharm</p><p>2012;8:443454.</p><p>8. Biglan A. Relationships between subject matter char-</p><p>acteristics and the structure and output of universityPharmacy/2760/0/. [cited 20.04.11].</p><p>2. Harding G, Taylor KMB. Dening social pharmacy.</p><p>Int J Pharm Pract 1993;2:6263.</p><p>3. Hassali MA, Shae AA, Al-HaddadMS, et al. Social</p><p>pharmacy as a eld of study: the needs and challenges</p><p>in global pharmacy education.Res Soc Admin PharmLack of consensus and a narrow focus on thepharmacy profession have been identied aschallenges. As such, it is very important to follow</p><p>temporal trends in the types of studies conducted,and to map the collaboration and cross-disciplinary research focus. Studies of the stateof the art and development in pharmacy practice</p><p>and social pharmacy research should focus on thedomains under study; the level and type ofcollaboration; and the funding and interest groups</p><p>involved. Systematic content analyses of pub-lished outputs of pharmacy practice and socialpharmacy research need to answer the question</p><p>whether the research agenda is getting morefocused and productive, relative to other pharma-ceutical sciences as well as other sciences.</p><p>Acknowledgments</p><p>The authors wish to thank Dr. Vivienne Mak</p><p>and Dr. Jenni Ilomaki at the University of SouthAustralia for their valuable comments on anearlier draft of this manuscript.</p><p>References</p><p>1. University of Copenhagen [Homepage on the Inter-</p><p>net]. Copenhagen,Denmark:University of Copenha-departments. J Appl Psychol 1973;57:204213.</p></li><li><p>9. Kuhn TS. The Structure of Scientific Revolutions.</p><p>Chicago, IL: University of Chicago Press; 1970.</p><p>10. Traynor M. Humanism and its critiques in nursing</p><p>research literature. J AdvNurs 2009;65(7):15601567.</p><p>11. Anderson L. Casus Belli (Events Provoking War).</p><p>Remington Honor Medal Lecture. Washington, DC:</p><p>American Pharmacists Assocation; 2004.</p><p>12. Almarsdottir AB, Traulsen JM. Multimethod re-</p><p>search into policy changes in the pharmacy sector</p><p>theNordic case.Res Soc AdmPharm 2009;5(1):8290.</p><p>13. Traynor M. Bibliometrics as politics: the case of</p><p>emerging disciplines. Int Nurs Rev 2011;58:2627.</p><p>14. JohnsonM. Observations on positivism and pseudo-</p><p>science in qualitative nursing research. J Adv Nurs</p><p>1999;30(1):6773.</p><p>15. Canadian Pharmacists Association. Blueprint for</p><p>Pharmacy: Designing the Future Together. Ottawa,</p><p>Ontario: Canadian Pharmacists Association, 2008.</p><p>Available: http://blueprintforpharmacy.ca/docs/pdfs/</p><p>2011/05/11/BlueprintVision.pdf [cited 17.03.12].</p><p>16. The fifth Community Pharmacy Agreement Between</p><p>the Commonwealth of Australia and the Pharmacy</p><p>Guild of Australia. 2010. Available from: http://</p><p>www.guild.org.au/iwov-resources/documents/The_</p><p>Guild/PDFs/Other/Fifth%20Community%20Phar</p><p>macy%20Agreement.pdf [cited 17.03.12].</p><p>17. Mak VSL, Clark A, Poulsen JH, et al. Pharmacists</p><p>awareness of Australias health care reforms and</p><p>18. van Mil JW, Fernando-Llimos F. What is pharma-</p><p>ceutical care in 2013? Int J Clin Pharm 2013;35:12.</p><p>19. Herborg H, Srensen EW, Frkjr. Pharmaceutical</p><p>care in community pharmacies: practice and research</p><p>in Denmark. Ann Pharmacother 2007;41:681689.</p><p>20. Kaiser Permanente. Pharmacoepidemiology. [Home-</p><p>page on the Internet] Oakland, California: Kaiser</p><p>Permanente Department of Research. Available</p><p>from: http://www.dor.kaiser.org/external/research/</p><p>topics/Pharmacoepidemiology/. [cited 17.03.12].</p><p>21. Helse- og Omsorgsdepartementet. Rett Kurs Mot</p><p>Riktigere Legemiddelbruk. Stortingsmelding nr. 18</p><p>(2004-2005). 2005. Available from: http://www.reg</p><p>jeringen.no/nb/dep/hod/dok/regpubl/stmeld/20042005/</p><p>Stmeld-nr-18-2004-2005-.html?id406517 [cited 24.04.11]</p><p>22. Australian Pharmaceutical Advisory Council.Guiding</p><p>Principles to Achieve Continuity in Medication Man-</p><p>agement. Canberra: Commonwealth of Australia;</p><p>2005.</p><p>23. Levsky ME, Rosin A, Coon TP, Enslow WL,</p><p>Miller MA. A descriptive analysis of authorship</p><p>within medical journals 19952005. South Med J</p><p>2007;100(4):371375.</p><p>24. FiggWD,DunnL,LiewehrDJ, et al. Scientic collab-</p><p>oration results in higher citation rates of published ar-</p><p>ticles. Pharmacotherapy 2006;26:759767.</p><p>25. Traulsen JM, Almarsdottir AB. Pharmaceutical pol-</p><p>255Almarsdottir et al. / Research in Social and Administrative Pharmacy 10...</p></li></ul>

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