Research in Social and Administrative Pharmacy RSS feed: Current Issue. Research in Social and Administrative Pharmacy (RSAP) is a quarterly publication featuring original scientific reports and comprehensive review articles in the social and administrative pharmaceutical sciences. Topics of interest include outcomes evaluation of products, programs, or services; pharmacoepidemiology; medication adherence; direct-to-consumer advertising of prescription medications; disease state management; health systems reform; drug marketing; medication distribution systems such as e-prescribing; web-based pharmaceutical/medical services; drug commerce and re-importation; and health professions workforce issues. RSAP strives to become a widely recognized venue for publishing articles that proffer new models to guide existing research, make methodological arguments, or otherwise describe the results of rigorous theory-building research. Papers that translate the results of such research into information useful for practitioners are also welcome. RSAP encourages submission of manuscripts from multi-disciplinary collaborators on projects whose goal is to address medication use policy. RSAP also publishes special thematic issues that will be of interest and benefit to its readers and to the community at large. http://www.rsap.org/?rss=yesElsevier Inc.en © 2009 Elsevier Inc. All rights reserved. Research in Social and Administrative Pharmacy1551-741154December 2009 © 2009 Elsevier Inc. All rights reserved. healthpermissions@elsevier.comhttp://www.rsap.org/article/PIIS1551741109000692/abstract?rss=yesThe work of Bush et al in this issue of Research in Social & Administrative Pharmacy extends our understanding of a conflict faced on a daily basis by employee pharmacists in corporate community pharmacies in the United Kingdom, United States, and elsewhere—professional duties to patients and organizational requirements of employment are often misaligned. This worthy addition to the literature examining professional aspirations and impediments to achieving them resonates with findings in earlier research on pharmacy work in the United States. It was observed that employee pharmacists in management roles were more likely to see their employing corporation, not the profession, as their major referent. Further study revealed a positive relationship between participation in decisions affecting conditions of work and employee pharmacists' organizational commitment. Barriers to the extension of professional roles encountered by corporately employed community pharmacists in the United Kingdom cited by Bush are consistent with the low pharmacy service orientation ratings reported for corporate community pharmacies in the United States; lower than for any other type of pharmacy.Corporate control and professional prerogative: An unresolved tension for pharmacistsBartholomew E. Clark10.1016/j.sapharm.2009.05.003Research in Social and Administrative Pharmacy 5, 4 (2009)2009-12-01Research in Social and Administrative Pharmacy2009-12-0154S1551-7411(09)X0005-7Editorials299301http://www.rsap.org/article/PIIS1551741109000771/abstract?rss=yesOver the past decade, the provision of patient-centered care has taken on new emphasis based on the reports from the Institute of Medicine and the Health Council of Canada. Pharmacy leaders have been advocating for more than 30 years for practice to move to a more patient-centered approach of care delivery. Research on the changing role of pharmacists has focused on 2 general areas: (1) the economic, humanistic, and clinical outcomes that pharmacists can influence and (2) the reasons for success or failure of service program implementation, including pharmacists' and practice environment characteristics.Health care at a crossroad: What will the pharmacists' role be?Mary K. Gurney10.1016/j.sapharm.2009.07.002Research in Social and Administrative Pharmacy 5, 4 (2009)2009-12-01Research in Social and Administrative Pharmacy2009-12-0154S1551-7411(09)X0005-7Editorials302304http://www.rsap.org/article/PIIS1551741109000291/abstract?rss=yesAbstract: Background: Pharmacy has experienced both incomplete professionalization and deprofessionalization. Since the late 1970s, a concerted attempt has been made to re-professionalize pharmacy in the United Kingdom (UK) through role extension—a key feature of which has been a drive for greater pharmacy involvement in public health. However, the continual corporatization of the UK community pharmacy sector may reduce the professional autonomy of pharmacists and may threaten to constrain attempts at reprofessionalization.Objectives: The objectives of the research: to examine the public health activities of community pharmacists in the UK; to explore the attitudes of community pharmacists toward recent relevant UK policy and barriers to the development of their public health function; and, to investigate associations between activity, attitudes, and the type of community pharmacy worked in (eg, supermarket, chain, independent).Methods: A self-completion postal questionnaire was sent to a random sample of practicing community pharmacists, stratified for country and sex, within Great Britain (n=1998), with a follow-up to nonresponders 4 weeks later. Data were analyzed using SPSS (SPSS Inc., Chicago, IL, USA) (v12.0). A final response rate of 51% (n=1023/1998) was achieved.Results: The level of provision of emergency hormonal contraception on a patient group direction, supervised administration of medicines, and needle-exchange schemes was lower in supermarket pharmacies than in the other types of pharmacy. Respondents believed that supermarkets and the major multiple pharmacy chains held an advantageous position in terms of attracting financing for service development despite suggesting that the premises of such pharmacies may not be the most suitable for the provision of such services.Conclusions: A mixed market in community pharmacy may be required to maintain a comprehensive range of pharmacy-based public health services and provide maximum benefit to all patients. Longitudinal monitoring is recommended to ensure that service provision is adequate across the pharmacy network.The corporatization of community pharmacy: Implications for service provision, the public health function, and pharmacy's claims to professional status in the United KingdomJoseph Bush, Christopher A. Langley, Keith A. Wilson10.1016/j.sapharm.2009.01.003Research in Social and Administrative Pharmacy 5, 4 (2009)2009-04-27Research in Social and Administrative Pharmacy2009-04-2754S1551-7411(09)X0005-7Original Research305318http://www.rsap.org/article/PIIS1551741109000023/abstract?rss=yesAbstract: Background: Multidisciplinary team development generates changes in roles, responsibilities, and identities of individual health care providers. The Integrating Family Medicine and Pharmacy to Advance Primary Care Therapeutics (IMPACT) project introduced pharmacists into family practice teams across Ontario, Canada, to provide medication assessments, drug information, and academic detailing and to develop office system enhancements to improve drug therapy.Objective: To analyze pharmacists' narrative accounts during early integration to study identity development within emerging team-based care.Method: Qualitative design using 63 pharmacist narrative reports of pharmacists' experiences over a 9-month integration period. Four independent researchers with varied professional backgrounds used immersion and crystallization to identify codes and iterative grounded theory to determine and debate process and content themes relevant to identity development.Results: The pharmacists' narratives spoke of the daily experiences of integrating into a family practice setting: feeling valued and contributing concretely to patient care; feeling underutilized; feeling like a nuisance, or feeling as though working too slowly. Pharmacist mentors helped deal with uncertainty and complexity of care. Pharmacists perceived that complementary clinical contributions enhanced their status with physicians and motivated pharmacists to take on new responsibilities. Changes in perspective, clinic-relevant skill development, and a new sense of professionalism signaled an emerging pharmacist family practice identity.Conclusion: Pharmacists found that the integration into team-based primary health care provided both challenges and fresh opportunities. Pharmacists' professional identities evolved in relation to valued role models, emerging practice-level opportunities, and their patient-related contributions.Pharmacist's identity development within multidisciplinary primary health care teams in Ontario; qualitative results from the IMPACT (†) projectKevin Pottie, Susan Haydt, Barbara Farrell, Natalie Kennie, Connie Sellors, Carmel Martin, Lisa Dolovich10.1016/j.sapharm.2008.12.002Research in Social and Administrative Pharmacy 5, 4 (2009)2009-04-27Research in Social and Administrative Pharmacy2009-04-2754S1551-7411(09)X0005-7Original Research319326http://www.rsap.org/article/PIIS1551741108001137/abstract?rss=yesAbstract: Background: Patient-focused care provided by an interprofessional team has long been presented as the preferred method of primary care delivery. Community pharmacists should and can provide leadership for many clinical and managerial activities within the primary care team.Objective: To determine the extent to which community pharmacists are prepared to be members of the health care team, and to assess their support for general expansion of clinical responsibilities.Methods: A mail questionnaire (in either English or French) was sent to 1500 community pharmacists between February and April 2004. Respondents were asked to indicate the necessity of pharmacy leadership for a range of clinical and managerial services associated with a primary care team. Respondents were also asked to indicate the extent to which they should be more involved in drug therapy selection and monitoring, as well as assuming greater responsibility for treating both minor and chronic illnesses.Results: The response rate was 35.2% (470/1337) with the highest response rate in the Prairie provinces (40.6%) and the lowest in Quebec (24.4%). Most pharmacists in the study did not advocate a strong leadership role for non-discipline-specific clinical and managerial activities. Most of them indicated that community pharmacists should be more involved in selecting (69.9%) and monitoring (81.0%) drug therapy, and be more responsible for treating minor illnesses (72.0%). Support for more responsibility declined to 50% for chronic illnesses.Conclusions: The findings of the study suggest substantial variability among pharmacists in their perception of the need for pharmacy leadership across 16 clinical and managerial activities.Taking the lead: Community pharmacists' perception of their role potential within the primary care teamRoy T. Dobson, Jeff G. Taylor, Carol J. Henry, Jean Lachaine, Gordon A. Zello, David L. Keegan, Dorothy A. Forbes10.1016/j.sapharm.2008.11.002Research in Social and Administrative Pharmacy 5, 4 (2009)2009-04-27Research in Social and Administrative Pharmacy2009-04-2754S1551-7411(09)X0005-7Original Research327336http://www.rsap.org/article/PIIS1551741108001149/abstract?rss=yesAbstract: Background: The health care systems of Estonia and other Baltic States underwent major reforms between restoration of independence from the USSR and admittance to the European Union. These reforms included changes to the regulations regarding the ownership, location, and number of community pharmacies.Objectives: The objective of this study was to analyze changes in access to, image of, and satisfaction with community pharmacy services in Tartu, Estonia, between 1993 and 2005.Methods: A survey instrument was mailed to a stratified random sample of 713 Estonians aged 20-69 years living in Tartu in 1993 and again to 1000 Estonians aged 20-69 years living in Tartu in 2005. Completed survey instruments were returned by 448 (63%) respondents in 1993 and 386 (39%) respondents in 2005.Results: Respondents in 2005 reported more frequent visits to pharmacies than respondents in 1993 (P=.012) and were more likely to indicate that pharmacies have more appropriate locations and opening hours (P<.001). In 2005, 71% of respondents reported always visiting the same pharmacy compared to 35% in 1993. The perceived trustworthiness of pharmacists remained constant. Respondents believed that the role of the pharmacist as a provider of drug information should be expanded; however, demand for extended community pharmacy services was low.Conclusion: Postindependence reforms to health care and pharmacy systems in Estonia have coincided with greater utilization of community pharmacy services. Higher rates of utilization and continued good standing within the community suggest that pharmacies are potentially well placed to make additional contributions to the evolving primary health care system in Estonia.Change in public satisfaction with community pharmacy services in Tartu, Estonia, between 1993 and 2005Daisy Volmer, J. Simon Bell, Riina Janno, Ain Raal, David D. Hamilton, Marja S. Airaksinen10.1016/j.sapharm.2008.12.001Research in Social and Administrative Pharmacy 5, 4 (2009)2009-04-27Research in Social and Administrative Pharmacy2009-04-2754S1551-7411(09)X0005-7Original Research337346http://www.rsap.org/article/PIIS1551741109000242/abstract?rss=yesAbstract: Background: Because community pharmacists are encouraged to provide clinical services, there is a need to determine the role perceptions of both community pharmacists and general practitioners (primary care physicians). Differing role perceptions are likely to result in barriers to pharmacists expanding their roles in health care.Objectives: The purpose of this study was to investigate whether community pharmacists' and general practitioner's perceptions of the role of community pharmacists may be a barrier to pharmacists increasing their role in medication management. Other potential barriers were also explored that could provide a framework for future research.Methods: A postal survey to 900 and 1000 randomly selected community pharmacists and general practitioners, respectively, elicited the perceptions of these groups toward the role of community pharmacists. Likert scales were used to quantify the results.Results: The results revealed a gap in perceptions regarding the role of the community pharmacist, with general acceptance of the technical roles but less acceptance of clinical roles by general practitioners. Barriers to increased involvement of community pharmacists in clinical services included a perceived lack of mandate, legitimacy, adequacy, and effectiveness by both groups. Also observed was a lack of readiness to change by community pharmacists.Conclusions: This study suggests that there are significant barriers to community pharmacists increasing clinical services, both from the community pharmacists themselves and from the general practitioners. Attention to change management in a complex environment will be necessary if community pharmacists are to change their role toward more clinical services.General practitioners' and pharmacists' perceptions of the role of community pharmacists in delivering clinical servicesLinda J.M. Bryant, Gregor Coster, Greg D. Gamble, Ross N. McCormick10.1016/j.sapharm.2009.01.002Research in Social and Administrative Pharmacy 5, 4 (2009)2009-04-27Research in Social and Administrative Pharmacy2009-04-2754S1551-7411(09)X0005-7Original Research347362http://www.rsap.org/article/PIIS1551741109000308/abstract?rss=yesAbstract: Background: The burden of chronic noncommunicable diseases continues to rise in South Africa, leading to high rates of morbidity and mortality. The control of hypertension is far from optimal because of factors such as inadequate patient understanding of the condition and its therapy, as well as poor adherence to prescribed regimens.Objective: This study investigated the effect of an educational intervention on selected hypertensive participants' levels of knowledge about hypertension, their beliefs about medicines, and adherence to antihypertensive therapy.Method: Participants took part in an educational intervention that provided them with information about hypertension and its therapy through presentations, monthly meetings, and a summary information leaflet. The participants' levels of knowledge about hypertension and its therapy as well as their beliefs about medicines were measured using interviews and/or self-administered questionnaires. Levels of adherence were assessed using pill counts, self-reports, and punctuality in collecting medication refills. Paired t tests for dependent samples were performed to compare the participants' levels of knowledge about hypertension and its therapy, beliefs about medicines, and levels of adherence to antihypertensive therapy before and after the educational intervention.Results: There were significant increases in the participants' levels of knowledge about hypertension and its therapy (P<.0001). Most of the parameters used to indicate beliefs about medicines were significantly modified in a positive manner (P<.01 for concerns about medicines, P<.01 for beliefs about the harmful nature of medicines, and P<.01 for the necessity-concerns differential).Conclusion: Results of this study show that the educational intervention led to an increase in the participants' levels of knowledge about hypertension and a positive influence on their beliefs about medicines. Despite these positive changes, adequate time is required before anticipated behavioral changes, such as increased adherence, can be observed.The effect of an educational intervention on patients' knowledge about hypertension, beliefs about medicines, and adherenceC. Magadza, S.E. Radloff, S.C. Srinivas10.1016/j.sapharm.2009.01.004Research in Social and Administrative Pharmacy 5, 4 (2009)2009-12-01Research in Social and Administrative Pharmacy2009-12-0154S1551-7411(09)X0005-7Original Research363375http://www.rsap.org/article/PIIS1551741109000035/abstract?rss=yesAbstract: Background: Changes in US Medicare legislation could benefit pharmacy's attempt to make medication therapy management (MTM) practice more commonplace; however, little is known about pharmacists' capabilities and preferences to do so.Objectives: The purpose of this study was to explore US pharmacists' perceived preparedness, willingness, and challenges toward providing MTM services.Methods: A brief purpose of the survey and its website link were included in the electronic weekly newsletter of the National Community Pharmacists Association (NCPA) in January 2007. The web-based survey consisted of 8 demographic questions, 8 questions examining preparedness and willingness of the respondents regarding MTM, 2 questions regarding reimbursement to pharmacists, and 2 checklists for challenges in establishing MTM services.Results: Most of the 143 respondents indicated that they were aware of MTM, and 92 (65%) reported that they were currently practicing MTM. A majority of the sample agreed that pharmacists should provide MTM and have the ability to do so. Major challenges reported by the sample include the different specification of MTM by each health plan, time, staffing, and reimbursement issues. Respondents selected valid measures of program effectiveness but revealed that they needed help with documentation and billing. Expected reimbursement range was $1-10/minute.Conclusion: Community independent pharmacists reported being ready, willing, and able to provide MTM services, but need assistance in the process, that is, standardized MTM protocols, documentation and billing.Ready, willing, and able to provide MTM services?: A survey of community pharmacists in the USAAnandi V. Law, Mark P. Okamoto, Kelly Brock10.1016/j.sapharm.2009.01.001Research in Social and Administrative Pharmacy 5, 4 (2009)2009-04-29Research in Social and Administrative Pharmacy2009-04-2954S1551-7411(09)X0005-7Research Brief376381http://www.rsap.org/article/PIIS1551741108001125/abstract?rss=yesThe national shortage of pharmacists in the United States encompasses almost all pharmacy practice areas. In a report to Congress by the Department of Health & Human Services in 2000, the shortage of pharmacists is a result of an unprecedented demand for pharmacists despite an overall increase in the supply of pharmacists. The Bureau of Labor Statistics estimates 196,700 pharmacists were employed in 2001 and the projected need will be 417,000 by 2020. The total pool of available candidates for these positions is 260,000, leaving a shortage of 157,000 pharmacists. In a review of pharmacist availability from September 1999 through September 2003, the Aggregate Demand Index found the need for pharmacists' continues to outpace the supply. The increased demand for pharmacists is the result of a variety of factors including increasing prescription volume, expanding retail pharmacies and institutional facilities, and the expanding professional roles of the pharmacist in health care. The severity of the shortage varies with the position and geographic location. Rural settings experience the greatest need in attracting, recruiting, and retaining qualified individuals. It has predicted that the need for pharmacist services will continue for at least some years to come.Collaboration: What can health-care organizations learn about pharmacist retention from Magnet status hospitals?Nancy Brahm, Merry Kelly-Rehm, Kevin C. Farmer10.1016/j.sapharm.2008.11.001Research in Social and Administrative Pharmacy 5, 4 (2009)2009-04-29Research in Social and Administrative Pharmacy2009-04-2954S1551-7411(09)X0005-7Commentary382389http://www.rsap.org/article/PIIS1551741109001120/abstract?rss=yesTable of Contents10.1016/S1551-7411(09)00112-0Research in Social and Administrative Pharmacy 5, 4 (2009)2009-12-01Research in Social and Administrative Pharmacy2009-12-0154S1551-7411(09)X0005-7FrontmatterA3A4