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 Published by Elsevier Inc. Research in Social and Administrative Pharmacy1551-741181January 2012 Published by Elsevier Inc. healthpermissions@elsevier.comhttp://www.rsap.org/article/PIIS1551741111000404/abstract?rss=yesWhite et al provide an important contribution to the literature with their study featured in the current issue of Research in Social and Administrative Pharmacy. Their findings focus greater attention to consumers’ beliefs, which impact the utilization of valuable services. They examined patients’ perceived benefits and barriers of a Home Medicine Review (HMR) service in Australia among those who used the service and those, who were eligible, who had never used it. The research has the inherent limitations of a semistructured focus group design, as noted by the research team; however, this process brings richness and depth about the use of such a service that are often unattainable in quantitative surveys.Lessons learned from the Australian Home Medicine Review programNicole Brandt, Nicole Hahn10.1016/j.sapharm.2011.02.002Research in Social and Administrative Pharmacy 8, 1 (2012)2012-01-01Research in Social and Administrative Pharmacy2012-01-0181S1551-7411(11)X0006-2Editorial13http://www.rsap.org/article/PIIS155174111000166X/abstract?rss=yesAbstract: Background: The Australian Home Medicines Review (HMR) is a free consumer service to assist individuals living at home to maximize the benefits of their medicine regimen and prevent medication-related problems. It consists of a pharmacist reviewing a person’s medicines and collaborating with the general practitioner to optimize the individual’s medicine management. The uptake of this service has remained below the projected use, although the program has shown to successfully identify medication-related problems and improve drug knowledge and adherence of the patient.Objectives: This study investigates the perceived benefits and barriers of the patients regarding the HMR service who have used the service and who are eligible for it but have never used it.Methods: Consumer perceptions were drawn from 14 semistructured focus groups, with patients and carers belonging to the general HMR target population and consumer segments that have been postulated to be underrepresented with regard to this service.Results: The major benefits reported were acquisition of medicine information, reassurance, feeling valued and cared for, and willingness to advocate medication changes to the general practitioner. Perceived barriers were concerns regarding upsetting the general practitioner, pride and independence, confidence issues with an unknown pharmacist, privacy and safety concerns regarding the home visit, and lack of information about the program. Participants agreed that the potential benefits of the service outweighed its potential barriers.Conclusions: It is expected that direct-to-consumer promotion of HMRs would increase the uptake of this valuable service. It would be necessary to ensure that the process and benefits of the service are communicated clearly and sensitively to eligible patients and their carers to obviate common consumer misconceptions and/or barriers regarding the HMR service. Furthermore, any direct-to-consumer promotion of the service must enable patient/carer self-identification of eligibility.Consumer perspectives of the Australian Home Medicines Review Program: Benefits and barriersLesley White, Christiane Klinner, Stephen Carter10.1016/j.sapharm.2010.11.003Research in Social and Administrative Pharmacy 8, 1 (2012)2011-04-14Research in Social and Administrative Pharmacy2011-04-1481S1551-7411(11)X0006-2Original Research416http://www.rsap.org/article/PIIS1551741110001683/abstract?rss=yesAbstract: Objective: To determine the alignment between New Zealand pharmacists’ views and the New Zealand Ten-Year Vision (TYV) document and explore factors associated with individuals’ alignment.Methods: A postal survey of 1892 practicing pharmacists was conducted. The questionnaire included 37 attitude statements informed by analysis of 6 focus groups in which pharmacists discussed 24 statements representing 12 main vision areas. Responses are reported by proportion. Bivariate analysis compared differences in demographic characteristics and alignment with vision statements between 3 professional subgroups: community, hospital, and pharmacists working in District Health Boards or Primary Health Organizations.Results: Nine hundred and eighty (54.6%) analyzable surveys were returned. Respondents broadly agreed with the 12 vision areas. There was a clear patient focus and strong support for extending roles to better serve patient care. Pharmacists believe that current practice and funding models need to change and want greater involvement in setting health policy. There are significant differences in agreement and level of agreement between professional subgroups. Notably, community pharmacists are more likely to put their relationship with the patient above that with the doctor, to believe that other professions would resist role extension, to support minor ailments schemes, and to indicate a shift in funding models was necessary to support innovative pharmacy practice. There are statistically significant and potentially important demographic differences between professional subgroups, including age, sex, formal postgraduate training, and experience working in health care in other countries. Further analysis is required to understand the interplay of these factors and how this may influence alignment with the TYV document.Conclusions: Pharmacists’ responses indicated a high level of alignment with vision outlined in the TYV. Pharmacists appear receptive to practice and funding changes in order to facilitate greater contribution to patient care. Respondents demonstrated a clear desire to be involved in setting medicines-related health policy and feel underrepresented at this level.New Zealand pharmacists’ alignment with their professional body’s vision for the futureJeff Harrison, Shane Scahill, Janie Sheridan10.1016/j.sapharm.2010.12.001Research in Social and Administrative Pharmacy 8, 1 (2012)2011-04-14Research in Social and Administrative Pharmacy2011-04-1481S1551-7411(11)X0006-2Original Research1735http://www.rsap.org/article/PIIS1551741110001725/abstract?rss=yesAbstract: Background: The drive for integrative systems and collaboration across organizations and professions involved in the provision of health and social care has led to the development of a number of scales and models that conceptualize collaborative behavior. Few models have captured the dynamics of the collaboration between community pharmacy and general medicine, 2 professional groups that are increasingly being encouraged to adopt more collaborative practices to improve patient care.Objectives: This article presents a new model of collaboration derived from interviews with general practitioners (GPs) and community pharmacists in England involved in service provision that required some form of collaboration.Methods: Qualitative interviews were conducted with purposive samples of 13 GPs and 18 community pharmacists involved in the provision of local pharmaceutical services pilots and 14 GPs and 13 community pharmacists involved in the provision of repeat dispensing.Results: The model highlights key components of collaboration, including the importance of trust, communication, professional respect, and “knowing” each other. It is argued here that previous models fail to recognize the asymmetry and differentiation between GPs and community pharmacists, including differences in perception toward and importance assigned to trust and communication. GPs were found to adopt demarcation strategies toward community pharmacies and pharmacists, with independent pharmacies being favored over multiple chains and regular pharmacists favored over locum/sessional pharmacists. This differentiation was repeatedly highlighted by GPs and found to affect their ability or willingness to collaborate.Conclusion: The model provides a foundation for the future development of strategy and research focused on the improvement or study of collaborative relationships between community pharmacy and general practice.Integration and differentiation: A conceptual model of general practitioner and community pharmacist collaborationFay Bradley, Darren M. Ashcroft, Peter R. Noyce10.1016/j.sapharm.2010.12.005Research in Social and Administrative Pharmacy 8, 1 (2012)2011-04-01Research in Social and Administrative Pharmacy2011-04-0181S1551-7411(11)X0006-2Original Research3646http://www.rsap.org/article/PIIS1551741110001701/abstract?rss=yesAbstract: Background: Meta-analyses of oral hypoglycemic agents (OHAs) revealed that rosiglitazone increased the risk of myocardial infarction (MI) and heart failure (HF) and that pioglitazone increased the risk of HF and decreased the risk of MI.Objective: To characterize the change in the pattern of use of OHAs immediately after the publication of these meta-analyses on May 21, 2007.Methods: Pharmacy and medical claims data for a managed care organization were analyzed for patients continuously enrolled from January 1, 2005, to November 30, 2007, with at least 1 pharmacy claim for OHA in the 13-month period between November 1, 2006, and November 30, 2007. A 5-month pre-publication period (November 1, 2006, through March 31, 2007) was compared with a 5-month post-publication period (July 1, 2007, through November 30, 2007) using a differences-in-differences multinomial logistic regression. This regression explored discontinuation; continuation with monotherapy or adding another drug; and switching to a drug different from the index monotherapy drug after adjusting for gender, age, type of insurance, past 1-year history of MI or HF, and risk factors for MI and HF in the past 1 year.Results: The relative rate of switching to nonindex drug in the postpublication relative to prepublication was 2.64 (P=.046) for monotherapy rosiglitazone users and 0.72 (P=.583) for monotherapy pioglitazone users. The differences-in-differences estimate of the rate of switching to nonindex drugs for monotherapy rosiglitazone users was 3.64 (P=.090) times higher relative to the estimate for monotherapy pioglitazone users.Conclusion: The pattern of use differed fundamentally between monotherapy rosiglitazone users and users of all other monotherapy OHAs in the postperiod. Not only were monotherapy rosiglitazone patients switching to non-rosiglitazone drugs at a higher rate, but the rate also was more than 3 times higher than similar switches among monotherapy pioglitazone users in the postperiod relative to the preperiod. This shows that the market response as observed by patient/prescriber decisions to the adverse news was interpreted narrowly to monotherapy rosiglitazone, and there is little or no spillover to the other drugs. Therefore, this study found that there was a differential effect of meta-analyses on the use of the 2 drugs.Use of rosiglitazone and pioglitazone immediately after the cardiovascular risk warningsRahul Jain, C. Daniel Mullins, Helen Lee, Winston Wong10.1016/j.sapharm.2010.12.003Research in Social and Administrative Pharmacy 8, 1 (2012)2011-07-07Research in Social and Administrative Pharmacy2011-07-0781S1551-7411(11)X0006-2Original Research4759http://www.rsap.org/article/PIIS1551741110001695/abstract?rss=yesAbstract: Background: Medication reconciliation has been recognized as an important process in care transitions to prevent adverse health outcomes. Because older adults have multiple comorbid conditions and use multiple medications, they are more likely to experience complicated transitions between acute and long-term care settings. Hence, it is important to develop effective interventions to protect older adults at transition points of care.Objective: To systematically review the literature and evaluate studies performing medication reconciliation interventions in patients transferred to and from long-term care settings.Methods: The literature search focused on studies that evaluated an intervention involving medication reconciliation in patients transferred to and/or from long-term care settings, such as nursing homes, skilled nursing facilities, residential care facilities, assisted living facilities, homes for the aged, and hospice care. A search was conducted on Ovid MEDLINE (1950-August 2010), Ovid HealthSTAR (1966-August 2010), Cumulative Index to Nursing and Allied Health Literature (1982-August 2010), PubMed (1980-August 2010), The Cochrane Database of Systematic Reviews (2005-August 2010), the Agency for Healthcare Research and Quality website, and reference lists of relevant articles were hand-searched. Two reviewers screened the titles and abstracts for potentially relevant studies. Data abstraction from the included articles was performed independently by 4 reviewers.Results: Seven studies met the inclusion criteria. Four studies were performed in the United States, whereas 3 studies were performed in other countries. A clinical pharmacist proved to be useful in providing medication reconciliation interventions by adopting specialized responsibilities such as serving as a transition pharmacist coordinator or working through a call center. Although improvement in the outcome(s) examined was shown in all of the studies, there were study design flaws.Conclusion: There is a need for well-designed studies demonstrating the effectiveness of medication reconciliation interventions in long-term care settings. Future studies should focus on employing appropriate methods so that their interventions can be evaluated more effectively.Medication reconciliation during the transition to and from long-term care settings: A systematic reviewPankdeep T. Chhabra, Gail B. Rattinger, Sarah K. Dutcher, Melanie E. Hare, Kelly L. Parsons, Ilene H. Zuckerman10.1016/j.sapharm.2010.12.002Research in Social and Administrative Pharmacy 8, 1 (2012)2011-04-22Research in Social and Administrative Pharmacy2011-04-2281S1551-7411(11)X0006-2Review Article6075http://www.rsap.org/article/PIIS1551741110001671/abstract?rss=yesAbstract: Background: The lack of a single pharmacy regulator in Canada has led to a wide variety of processes for reporting and learning from medication errors and near misses, collectively known as quality-related events (QREs). These processes range from completely informal processes, through to primarily manual processes that rely on paper forms and incident reports stored in a binder, all the way to fully computerized processes such as anonymous online reporting to a national database.Objectives: The objective of the study was to develop and test a model of the influence of various QRE reporting process characteristics on levels of QRE reporting process support and QRE reporting in Canadian community pharmacies.Methods: A questionnaire was administered to 427 pharmacy managers, pharmacists, and technicians in Nova Scotia, Canada, in 2010, with 210 questionnaires returned. Partial least squares was performed on a subgroup of the data set (N=121) to test and refine the model. Content analysis of the open-ended data provided additional support for model variables.Results: The final model retained all proposed variables except for anonymous reporting. The model highlights that process ease and learning capability both greatly influence the overall support for the QRE process; with these 2 variables explaining 62% of the variance in QRE process support and QRE process support explaining 34% of the variance in overall levels of QRE reporting.Conclusions: The findings have implications for the creation and implementation of successful QRE reporting processes in community pharmacies. Implementing effective QRE reporting tools is paramount to ensuring that pharmacies report and learn from QREs. Dynamic QRE reporting tools that are modern, up to date, integrated into workflow, easy to use, and quick have been shown to be the most effective.Implications of process characteristics on quality-related event reporting in community pharmacyTodd A. Boyle, Andrea C. Scobie, Neil J. MacKinnon, Thomas Mahaffey10.1016/j.sapharm.2010.11.004Research in Social and Administrative Pharmacy 8, 1 (2012)2011-12-12Research in Social and Administrative Pharmacy2011-12-1281S1551-7411(11)X0006-2Proposed Model7686http://www.rsap.org/article/PIIS1551741111000817/abstract?rss=yesAbstract: Background: Self-medication is an important component of health care. To optimize pharmacists’ over-the-counter counseling, there are several guidelines and protocols used in practice. In a self-care environment, protocols should comprise items related to patients’ autonomy. The structure of self-medication protocols, among other elements, should present steps to facilitate patients’ participation.Objective: To analyze structural differences between existing community pharmacy minor ailment protocols, including those related to patient autonomy and empowerment in self-medication conditions.Methods: The study design followed a cross-sectional descriptive approach. Self-medication protocols were systematically collected from 3 different professional sources (Pharmaceutical Society [OF], National Pharmacies Association [ANF], and Grupo Holon [GH]). A structural-based analysis, by comparison with the general self-medication OF standard protocol, produced outcome measures such as frequencies of flowchart critical steps, active pharmaceutical substances, dosage forms, and posologies. Simple scores were computed to assess protocols’ structural quality, as well as differences between protocols, produced by each professional organization.Results: Forty-four protocols presented on average 8 counseling steps toward 10 different active substances, 7 dosages forms, and 14 posologic schemes. From a maximum of 30 critical items, 1 protocol scored 24, 7 scored 23, and 5 scored less than 15 items. Significant differences were found between protocols’ structural components from different sources, particularly between GHs’ protocols compared with those produced by OF and ANF.Conclusions: In general, all protocols matched the OF standard for ailment characterization but fell short on steps related to medicine information and selection. Steps for patient participation and agreement were absent, as was pharmacists’ expected role of outcomes monitoring. It might be appropriate to redesign self-medication protocols, preferably through a consensus process that includes not only professionals’ but also patients’ preferences, starting from the prevalent conditions in Portuguese pharmacy practice.Pharmacists’ counseling protocols for minor ailments: A structure-based analysisAfonso M. Cavaco, Pedro F. Pereira10.1016/j.sapharm.2011.07.004Research in Social and Administrative Pharmacy 8, 1 (2012)2012-01-01Research in Social and Administrative Pharmacy2012-01-0181S1551-7411(11)X0006-2Research Brief87100http://www.rsap.org/article/PIIS1551741111001410/abstract?rss=yesTable of Contents10.1016/S1551-7411(11)00141-0Research in Social and Administrative Pharmacy 8, 1 (2012)2012-01-01Research in Social and Administrative Pharmacy2012-01-0181S1551-7411(11)X0006-2FrontmatterA3A4