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563 KiB

Open AccessArticle

Understanding Users in the ‘Field’ of Medications

by Peri J. Ballantyne

Pharmacy 2016, 4(2), 19; https://doi.org/10.3390/pharmacy4020019 - 6 May 2016

Cited by 3 | Viewed by 6287

Abstract

The numbers of medicinal drugs available for human consumption have increased rapidly in the past several decades, and physician prescribing practices reflect the growing reliance on medicines in health care. However, the nature of medicines-as-technology makes problematic taken-for-granted relationships among actors involved in [...] Read more.

The numbers of medicinal drugs available for human consumption have increased rapidly in the past several decades, and physician prescribing practices reflect the growing reliance on medicines in health care. However, the nature of medicines-as-technology makes problematic taken-for-granted relationships among actors involved in the delivery, or who are the recipients of medicines-reliant health care. In this article, I situate the medicine user in the ‘field’ of medications—where interests, actions and outcomes are continually negotiated among and between the various players—physicians, pharmacists, government regulatory bodies, the pharmaceutical industry and users of medicines. The objective of the paper is to illuminate the complex context in which the medicine-user—the target of the pharmacy profession’s service to the public—accesses and uses medicines. Full article

(This article belongs to the Special Issue Social Pharmacy)

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619 KiB

Open AccessArticle

Restrictions to Pharmacy Ownership and Vertical Integration in Estonia—Perception of Different Stakeholders

by Marit Gross and Daisy Volmer

Pharmacy 2016, 4(2), 18; https://doi.org/10.3390/pharmacy4020018 - 19 Apr 2016

Cited by 4 | Viewed by 7270

Abstract

Objectives: From 2020, the ownership of community pharmacies in Estonia will be limited to the pharmacy profession, and the vertical integration of wholesale companies and community pharmacies will not be allowed. The aim of this study was to evaluate the perception of different [...] Read more.

Objectives: From 2020, the ownership of community pharmacies in Estonia will be limited to the pharmacy profession, and the vertical integration of wholesale companies and community pharmacies will not be allowed. The aim of this study was to evaluate the perception of different stakeholders in primary healthcare toward the new regulations of the community pharmacy sector in Estonia. Methods: A qualitative electronic survey was distributed to the main stakeholders in primary healthcare and higher education institutions providing pharmacy education (n = 40) in May 2015. For data analysis, the systematic text condensation method was used. Results: The study participants described two opposing positions regarding the development of community pharmacies in the future. Reform supporters emphasized increased professional independence and more healthcare-oriented operation of community pharmacies. Reform opponents argued against these ideas as community pharmacists do not have sufficient practical experience and finances to ensure sustainable development of the community pharmacy sector in Estonia. Conclusion: Based on the current perception of all respondents, the future operation of the community pharmacy sector in Estonia is unclear and there is urgent need for implementation criteria for the new regulations. Full article

(This article belongs to the Special Issue Social Pharmacy)

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192 KiB

Open AccessArticle

Falsified Medicines—Bridging the Gap between Business and Public Health

by Rasmus Borup and Janine Traulsen

Pharmacy 2016, 4(2), 16; https://doi.org/10.3390/pharmacy4020016 - 28 Mar 2016

Cited by 6 | Viewed by 5924

Abstract

The pharmaceutical industry is one of the most regulated industries in the world. While legislation is necessary to protect patients, too much legislation is said to hamper innovation and increase medicine prices. Using qualitative methods such as interviews and document analysis, we investigated [...] Read more.

The pharmaceutical industry is one of the most regulated industries in the world. While legislation is necessary to protect patients, too much legislation is said to hamper innovation and increase medicine prices. Using qualitative methods such as interviews and document analysis, we investigated the role of private stakeholders in the EU policymakers’ decision to initiate legislation to combat falsified medicines in 2008. Our results show that the pharmaceutical industry, brand owners in particular, were strong proponents of legislation to combat falsified medicines. Their support was not fueled by fear that falsified medicines would harm patients or their own business, but rather because legislative action in this area would advance policies that benefit their businesses objectives. The brand owners framed the issue to policymakers as best to support their business objectives. In general, supply chain actors lobbied for stricter requirements in order to challenge competitors. In the end, the Falsified Medicines Directive may have suffered from company influence not by addressing the primary problem of falsified medicines, but rather by creating additional legislation that benefits the supply chain actors. Full article

(This article belongs to the Special Issue Social Pharmacy)

215 KiB

Open AccessArticle

General Practitioners and Chronic Non-Malignant Pain Management in Older Patients: A Qualitative Study

by Mary-Claire Kennedy, Martin C. Henman and Gráinne Cousins

Pharmacy 2016, 4(1), 15; https://doi.org/10.3390/pharmacy4010015 - 10 Mar 2016

Cited by 5 | Viewed by 7424

Abstract

Chronic non-malignant pain (CNMP) is commonly managed by General Practitioners (GPs) in primary care. Analgesics are the mainstay of CNMP management in this setting. Selection of medications by GPs may be influenced by micro factors which are relevant to the practice setting, meso [...] Read more.

Chronic non-malignant pain (CNMP) is commonly managed by General Practitioners (GPs) in primary care. Analgesics are the mainstay of CNMP management in this setting. Selection of medications by GPs may be influenced by micro factors which are relevant to the practice setting, meso factors which relate to the local or regional environment or macro factors such as those arising from national or international influences. The aim of this study is to explore influences on GP practises in relation to pain management for older adults with CNMP. Semi-structured interviews were conducted with 12 GPs. Transcripts were organised using the Framework Method of Data Management while an applied thematic analysis was used to identify the themes emerging from the data. Clinical considerations such as the efficacy of analgesics, adverse effects and co-morbidities strongly influence prescribing decisions. The GPs interviewed identified the lack of guidance on this subject in Ireland and described the impact of organisational and structural barriers of the Irish healthcare system on the management of CNMP. Changes in practice behaviours coupled with health system reforms are required to improve the quality and consistency of pharmacotherapeutic management of CNMP in primary care. Full article

(This article belongs to the Special Issue Social Pharmacy)

179 KiB

Open AccessArticle

The Raison D’être for the Community Pharmacy and the Community Pharmacist in Sweden: A Qualitative Interview Study

by Kristin Wisell and Sofia Kälvemark Sporrong

Pharmacy 2016, 4(1), 3; https://doi.org/10.3390/pharmacy4010003 - 25 Dec 2015

Cited by 3 | Viewed by 5510

Abstract

Community pharmacies are balancing between business (selling medicines and other products) and healthcare (using the pharmacists’ knowledge in order to improve drug utilization). This balance could be affected by regulations decided upon by politicians, but also influenced by others. The aim of this [...] Read more.

Community pharmacies are balancing between business (selling medicines and other products) and healthcare (using the pharmacists’ knowledge in order to improve drug utilization). This balance could be affected by regulations decided upon by politicians, but also influenced by others. The aim of this study was to explore important stakeholders’ views on community pharmacy and community pharmacists in Sweden. The method used was that of semi-structured qualitative interviews. Political, professional, and patient organization representatives were interviewed. The results show that informants who are pharmacists or representatives of a professional pharmacist organization generally have a healthcare-centered view on community pharmacy/pharmacists. However, different views on how this orientation should be performed were revealed, ranging from being specialists to dealing with uncomplicated tasks. Political organization representatives generally had a more business-oriented view, where competition in the market was believed to be the main driving force for development. A third dimension in which competition was not stressed also emerged; that community pharmacies should primarily distribute medicines. This dimension was most prevalent among the political and patient organization representatives. One conclusion to be drawn is that no stakeholder seemed to have a clear vision or was willing to take the lead for the development of the community pharmacy sector. Full article

(This article belongs to the Special Issue Social Pharmacy)

520 KiB

Open AccessArticle

Education Intervention on Chronotherapy for Final-Year Pharmacy Students

by Gagandeep Kaur, Maya Saba, Craig L. Phillips, Keith Wong and Bandana Saini

Pharmacy 2015, 3(4), 269-283; https://doi.org/10.3390/pharmacy3040269 - 4 Nov 2015

Cited by 5 | Viewed by 5531

Abstract

Chronotherapy involves altering the timing of medication administration in coordination with the body’s circadian rhythms to improve the overall control of disease and to minimise treatment side effects. Training on chronotherapy requires students to map different topics learnt in earlier years of their [...] Read more.

Chronotherapy involves altering the timing of medication administration in coordination with the body’s circadian rhythms to improve the overall control of disease and to minimise treatment side effects. Training on chronotherapy requires students to map different topics learnt in earlier years of their professional degree and apply these concepts clinically. This requires strategic educational design. Therefore, the aim of the study was to develop, implement and evaluate an educational intervention focusing on the application of chronotherapy for final-year undergraduate pharmacy students. An educational intervention utilizing multiple learning strategies for enhancing chronotherapy related awareness was designed and implemented in the final year undergraduate pharmacy cohort at the University of Sydney Australia (2013). A custom-designed questionnaire measuring awareness about (13 items scored 0 or 1), and attitudes (12 items scored on a Likert scale of 1–5) towards chronotherapy was administered pre and post intervention to evaluate its impact. The pre-intervention mean total awareness and attitude scores were 6.5 ± 2.0 (score range 0–13) and 47.4 ± 6.9 (score range 12–60) respectively. The mean total post-intervention scores were significantly higher for total awareness (10.1 ± 1.9) and attitude (54.0 ± 6.0). Carefully designed educational interventions utilising pedagogic principles for pharmacy students can improve awareness of and enhance positive attitudes toward pharmacists’ roles in optimizing drug therapy using chronotherapy. Full article

(This article belongs to the Special Issue Social Pharmacy)

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654 KiB

Open AccessCommentary

Social Pharmacy Research in Copenhagen—Maintaining a Broad Approach

by Sofia Kälvemark Sporrong, Lotte Stig Nørgaard, Helle Wallach-Kildemoes, Lourdes Cantarero-Arévalo and Susanne Kaae

Pharmacy 2016, 4(1), 11; https://doi.org/10.3390/pharmacy4010011 - 2 Feb 2016

Cited by 1 | Viewed by 7072

Abstract

Social Pharmacy (SP) is a multidisciplinary field to promote the adequate use of medicine. The field of SP is increasingly important due to a numbers of new trends all posing challenges to society. The SP group at the University of Copenhagen has for [...] Read more.

Social Pharmacy (SP) is a multidisciplinary field to promote the adequate use of medicine. The field of SP is increasingly important due to a numbers of new trends all posing challenges to society. The SP group at the University of Copenhagen has for several years used a broad approach to SP teaching and research, often illustrated by the four levels: individual, group, organizational, and societal. In this paper the relevance of maintaining a broad approach to SP research is argued for and examples of the importance of such type of research is presented. Full article

(This article belongs to the Special Issue Social Pharmacy)

192 KiB

Open AccessCommentary

Social Pharmacy and Clinical Pharmacy—Joining Forces

by Anna Birna Almarsdottir and Anne Gerd Granas

Pharmacy 2016, 4(1), 1; https://doi.org/10.3390/pharmacy4010001 - 22 Dec 2015

Cited by 17 | Viewed by 9757

Abstract

This commentary seeks to define the areas of social pharmacy and clinical pharmacy to uncover what they have in common and what still sets them apart. Common threats and challenges of the two areas are reviewed in order to understand the forces in [...] Read more.

This commentary seeks to define the areas of social pharmacy and clinical pharmacy to uncover what they have in common and what still sets them apart. Common threats and challenges of the two areas are reviewed in order to understand the forces in play. Forces that still keep clinical and social pharmacy apart are university structures, research traditions, and the management of pharmacy services. There are key (but shrinking) differences between clinical and social pharmacy which entail the levels of study within pharmaceutical sciences, the location in which the research is carried out, the choice of research designs and methods, and the theoretical foundations. Common strengths and opportunities are important to know in order to join forces. Finding common ground can be developed in two areas: participating together in multi-disciplinary research, and uniting in a dialogue with internal and external key players in putting forth what is needed for the profession of pharmacy. At the end the question is posed, “What’s in a name?” and we argue that it is important to emphasize what unifies the families of clinical pharmacy and social pharmacy for the benefit of both fields, pharmacy in general, and society at large. Full article

(This article belongs to the Special Issue Social Pharmacy)

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