Research in Social and

Administrative Pharmacy 10 (2014) 252–255

Commentary

Opportunities and challenges in social pharmacy andpharmacy practice research

Anna Birna Almarsdottir, Ph.D.a,b,*, Susanne Kaae, Ph.D.c,Janine M. Traulsen, Ph.D.c

aResearch Unit of Clinical Pharmacology, University of Southern Denmark, J.B. Winsløwsvej 19, 5000 Odense C, DenmarkbFaculty of Pharmaceutical Sciences, University of Iceland, Reykjavık, Iceland

cDepartment of Pharmacy, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark

Summary

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 reflect 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 fields 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.

Keywords: Pharmacy practice; Social pharmacy; Research; Paradigms

Introduction

Pharmacy practice and social pharmacy aretwo important contemporary research areaswithin the field 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.1–3 As the disciplines have under-

gone and are still undergoing changes, it is usefulto reflect on the current state of research in

* Corresponding author. Tel.: þ45 65503089.

E-mail address: abalmars@health.sdu.dk (A.B. Almarsdott

1551-7411/$ - see front matter � 2014 Elsevier Inc. All rights

http://dx.doi.org/10.1016/j.sapharm.2013.04.002

these fields 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 researchframework than ever before.

ir).

reserved.

253Almarsdottir et al. / Research in Social and Administrative Pharmacy 10 (2014) 252–255

Lack of consensus in social pharmacy andpharmacy practice research

From the authors’ viewpoint, it is paramountto relate the academic field of pharmacy practice

research to social pharmacy research, a well-developed academic discipline in the Nordic coun-tries. It is evident when viewing homepages of

various schools of pharmacy in different countriesthat different 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 identified 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 finding correlated to the hard-soft dimen-

sion in Kuhn’s9 1970s work on paradigmaticdevelopment or “the degree of consensus or shar-ing of beliefs within a scientific field about theory,

methodology, techniques and problems.” Thus,the higher the degree of consensus, the “harder”the field 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 pharmacyresearch has all too often aimed at evaluating

narrowly 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 field ofnursing research.10 Contrary to pharmacy’s questto resist “losing ground,”11,12 the nursing profes-

sion was attempting to develop into a scientificdiscipline.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.How can we understand this narrow research

focus in the pharmacy profession’s search fora new role in healthcare? Researchers in Canada

and Australia have suggested that despite in-creased efforts 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 fields 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-profit

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, andNorway healthcare payers are increasingly

254 Almarsdottir et al. / Research in Social and Administrative Pharmacy 10 (2014) 252–255

contributing to large pharmacy practice projectswithin a larger framework of healthcare re-forms.16,20,21 These funding bodies can be said

to have very specific practical and economic goalsfor this research, such as reducing inappropriateprescribing 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 different scientific 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 scientificjournals in the field 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 teamshave–according to the focus of each study–toinvolve scientists with different backgrounds such

as sociology, economics, and epidemiology to gettheir research widely recognized and accepted asscience. Pharmacists also can through such multi-

disciplinary research educate policymakers andother health professions about the width andbreadth of the contribution of the profession to

society in general and public health in particularand thereby better secure research funding.13,25

Conclusion

Within the context of pharmaceutical sciencesthe terms social pharmacy and pharmacy practiceoften have referred to similar types of studies.

Lack of consensus and a narrow focus on thepharmacy profession have been identified aschallenges. As such, it is very important to follow

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

and social pharmacy research should focus on thedomains under study; the level and type ofcollaboration; and the funding and interest groups

involved. Systematic content analyses of pub-lished outputs of pharmacy practice and socialpharmacy research need to answer the question

whether the research agenda is getting morefocused and productive, relative to other pharma-ceutical sciences as well as other sciences.

Acknowledgments

The authors wish to thank Dr. Vivienne Mak

and Dr. Jenni Ilomaki at the University of SouthAustralia for their valuable comments on anearlier draft of this manuscript.

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