University of Copenhagen
Department of Pharmacy
Objectives The aim was to identify local organisational factors that affect sustained delivery of the first Danish publicly reimbursed cognitive service, the Inhaler Technique Assessment Service (ITAS). The ITAS is a 10-min interactive... more
Objectives The aim was to identify local organisational factors that affect sustained delivery of the first Danish publicly reimbursed cognitive service, the Inhaler Technique Assessment Service (ITAS). The ITAS is a 10-min interactive counselling session during which pharmacy staff assess the inhalation technique of individual asthma patients at the pharmacy counter, and correct any errors. Knowledge of how the organisation of a local pharmacy influences ITAS provision will be used to develop quality indicators as part of a targeted quality-assurance system to support the sustainability of the service in all Danish community pharmacies. Methods Qualitative methods included field observations, semi-structured interviews, group interviews and the collecting of documentary material. Data-source and method triangulation were applied. Seven pharmacies were included in the study. A cross-case analysis compared pharmacies with sustained and reduced numbers of services based on three selected themes: administration of the ITAS, leadership interventions and professional values of pharmacy owner and staff. Key findings Pharmacies with sustained delivery had introduced systematic evaluations of the local delivery of the ITAS and made ongoing efforts to improve staff competencies. They dealt with individual barriers such as lack of knowledge of rarely distributed inhalation devices and communication techniques. Pharmacy staff in general rarely assessed patients' clinical needs before offering the service and rarely provided follow-up. Thus, pharmacy staff failed to utilise the full clinical potential of the ITAS. Conclusions In order to achieve and support further ITAS sustainability, the knowledge, skills and professional values of pharmacy staff must be developed. Human resource leadership techniques would be useful in achieving this aim, as would focusing on the service by providing systematic evaluations.
Objective of the study The objective of the overall study was to create a foundation for improving the quality of counselling practice in pharmacies. The research question addressed in this sub-study was to describe drug-related problems... more
Objective of the study The objective of the overall study was to create a foundation for improving the quality of counselling practice in pharmacies. The research question addressed in this sub-study was to describe drug-related problems (DRPs) in terms of frequency as well as type in people with angina pectoris, type 2 diabetes and asthma, as the problems were identified through medication reviews and home interviews. Setting and method During their pharmacy internships, fourth-year pharmacy students collected data for the study in 1999, 2000 and 2001 by carrying out medication reviews, conducting home interviews and registering DRPs for 414 patients. Data were collected from the following patient groups in the years indicated: in 1999, 123 angina pectoris patients; in 2000, 192 type 2 diabetes patients, and in 2001, 99 asthma patients. The interviews dealt with the patient's drug-related experiences, knowledge, perceptions, problems and actions. The DRPs were registered according to the so-called PI-Doc system. Results A medication review was supplemented by qualitative interviews with the three patient groups, which revealed a relatively high number of DRPs compared to other studies. An average of 2.8 DRPs were identified per angina pectoris patient; 4.1 DRPs per type 2 diabetes patient and 4.0 DRPs per asthma patient. ''Inappropriate use of medicines by the patient'' and ''Other problems'' (such as limited knowledge of the illness, inappropriate lifestyle, fear of medication, lack of information, etc.) were the two most common DRP subcategories identified in all three patient groups. Conclusion The study provided a profile of a pharmacy-based population of 414 patients visiting the pharmacy, all of whom are at high risk of experiencing drug-related problems. Pharmacy staff needs to take this high rate of DRPs in people with angina pectoris, asthma and type 2 diabetes into account when dispensing medicines to and advising patients from the three groups, especially when explaining how to use medicines appropriately.
A participatory action research study design was developed and tested in 40 Danish internship pharmacies as part of a 3-year study supported by the Research Centre for Quality in Medicine Use. The aim of the study was to create a... more
A participatory action research study design was developed and tested in 40 Danish internship pharmacies as part of a 3-year study supported by the Research Centre for Quality in Medicine Use. The aim of the study was to create a foundation for improving the quality of counselling practice in pharmacies by comparing the pharmacy staff's views on, knowledge of and behaviour towards a specific patient group with the knowledge, perceptions and medication use of the same patients. Pharmacy students in their fourth year collected data for the study. In 1999, the students carried out 123 qualitative interviews with angina pectoris patients and collected 569 questionnaires from pharmacy staff in 40 internship pharmacies. The results indicate that discrepancies exist between the patients' and pharmacy staff's perspectives on important issues such as knowledge about medicines (patients)/provision of information about medicines (pharmacy staff), experienced side effects (patients)...
Objective To develop, apply and evaluate a new research method to establish relationships between structural and process elements of the provision of cognitive services. In-depth knowledge about how local organisational structural... more
Objective To develop, apply and evaluate a new research method to establish relationships between structural and process elements of the provision of cognitive services. In-depth knowledge about how local organisational structural elements of community pharmacies shape the implementation process of cognitive services is needed to develop targeted quality assurance systems to ensure that the services are continuously provided to the patients who need them. The first publicly reimbursed cognitive service in Denmark, the Inhaler Technique Assessment Service (ITAS) is used as the case. Setting The research method was developed at the Faculty of Pharmaceutical Sciences at the University of Copenhagen and later applied to seven community pharmacies geographically spread around Denmark. Methods A pilot study as well as a subsequent literature review was conducted to determine which structure-process elements to focus on in the research method as well as to select appropriate theories and methods. Results The developed research method was a qualitative exploratory multi-case study, that was based on method triangulation of field observations, semi-structured interviews, group interviews as well as collection of documentary material. The three main themes of the research method were: the administration of tasks, leadership style and professional values. We integrated the organisational theories of Mintzberg, Bolman and Deal as well as Sørensen to support and clarify the data collection process and analyses. A cross-case analysis and an exploratory contextual analysis relating the leadership style of the pharmacy owner to the ITAS provision were applied to the collected data. Conclusion The developed qualitative exploratory multi-case study research method was satisfactory with regard to achieving nuanced and in-depth results of some relationships between structural and process elements of provision of cognitive services. The research method can be considered an important supplement to the existing literature on the sustainability of cognitive services.
In a previous article in this series, we posed some questions about the visibility of gender and the relevance of feminism for pharmacy practice research.
Objective To develop, apply and evaluate a new research method to establish relationships between structural and process elements of the provision of cognitive services. In-depth knowledge about how local organisational structural... more
Objective To develop, apply and evaluate a new research method to establish relationships between structural and process elements of the provision of cognitive services. In-depth knowledge about how local organisational structural elements of community pharmacies shape the implementation process of cognitive services is needed to develop targeted quality assurance systems to ensure that the services are continuously provided to the patients who need them. The first publicly reimbursed cognitive service in Denmark, the Inhaler Technique Assessment Service (ITAS) is used as the case. Setting The research method was developed at the Faculty of Pharmaceutical Sciences at the University of Copenhagen and later applied to seven community pharmacies geographically spread around Denmark. Methods A pilot study as well as a subsequent literature review was conducted to determine which structure-process elements to focus on in the research method as well as to select appropriate theories and methods. Results The developed research method was a qualitative exploratory multi-case study, that was based on method triangulation of field observations, semi-structured interviews, group interviews as well as collection of documentary material. The three main themes of the research method were: the administration of tasks, leadership style and professional values. We integrated the organisational theories of Mintzberg, Bolman and Deal as well as Sørensen to support and clarify the data collection process and analyses. A cross-case analysis and an exploratory contextual analysis relating the leadership style of the pharmacy owner to the ITAS provision were applied to the collected data. Conclusion The developed qualitative exploratory multi-case study research method was satisfactory with regard to achieving nuanced and in-depth results of some relationships between structural and process elements of provision of cognitive services. The research method can be considered an important supplement to the existing literature on the sustainability of cognitive services.
Objectives: The purpose of this study was to conduct a health technology assessment (HTA) of automated dose dispensing in the Danish primary health care sector. The present article answers the sub question of how various groups of actors... more
Objectives: The purpose of this study was to conduct a health technology assessment (HTA) of automated dose dispensing in the Danish primary health care sector. The present article answers the sub question of how various groups of actors spoke about and understood the shaping of automated dose dispensing (positioning in discourses). Methods: The project utilized two methods: 11 qualitative research interviews with selected key actors and a net-based qualitative questionnaire of 97 selected practitioners. Results: Three main types of discourse were identified with respect to the development of automated dose dispensing, namely optimistic, sceptical and pragmatic. A wide diversity of opinion about automated dose dispensing was identified among the three discourses and their attendant scenarios. A number of factors are found in all three types of discourse, and are therefore considered to express common recommendations for decision makers and practitioners. These factors are described in the article. Conclusions: The article argues in favour of HTA, which to a great extent clarifies and initiates the perspectives of various groups of actors about the same technology. Our analyses show that conscious strategies must be employed to make the technology work successfully with the actors involved. The preferences, ideas and proposals for future actions and initiatives identified in the project could be the basis for defining future development strategies.
Objective To develop, apply and evaluate a new research method to establish relationships between structural and process elements of the provision of cognitive services. In-depth knowledge about how local organisational structural... more
Objective To develop, apply and evaluate a new research method to establish relationships between structural and process elements of the provision of cognitive services. In-depth knowledge about how local organisational structural elements of community pharmacies shape the implementation process of cognitive services is needed to develop targeted quality assurance systems to ensure that the services are continuously provided to the patients who need them. The first publicly reimbursed cognitive service in Denmark, the Inhaler Technique Assessment Service (ITAS) is used as the case. Setting The research method was developed at the Faculty of Pharmaceutical Sciences at the University of Copenhagen and later applied to seven community pharmacies geographically spread around Denmark. Methods A pilot study as well as a subsequent literature review was conducted to determine which structure-process elements to focus on in the research method as well as to select appropriate theories and methods. Results The developed research method was a qualitative exploratory multi-case study, that was based on method triangulation of field observations, semi-structured interviews, group interviews as well as collection of documentary material. The three main themes of the research method were: the administration of tasks, leadership style and professional values. We integrated the organisational theories of Mintzberg, Bolman and Deal as well as Sørensen to support and clarify the data collection process and analyses. A cross-case analysis and an exploratory contextual analysis relating the leadership style of the pharmacy owner to the ITAS provision were applied to the collected data. Conclusion The developed qualitative exploratory multi-case study research method was satisfactory with regard to achieving nuanced and in-depth results of some relationships between structural and process elements of provision of cognitive services. The research method can be considered an important supplement to the existing literature on the sustainability of cognitive services.
Objectives The aim was to identify local organisational factors that affect sustained delivery of the first Danish publicly reimbursed cognitive service, the Inhaler Technique Assessment Service (ITAS). The ITAS is a 10-min interactive... more
Objectives The aim was to identify local organisational factors that affect sustained delivery of the first Danish publicly reimbursed cognitive service, the Inhaler Technique Assessment Service (ITAS). The ITAS is a 10-min interactive counselling session during which pharmacy staff assess the inhalation technique of individual asthma patients at the pharmacy counter, and correct any errors. Knowledge of how the organisation of a local pharmacy influences ITAS provision will be used to develop quality indicators as part of a targeted quality-assurance system to support the sustainability of the service in all Danish community pharmacies. Methods Qualitative methods included field observations, semi-structured interviews, group interviews and the collecting of documentary material. Data-source and method triangulation were applied. Seven pharmacies were included in the study. A cross-case analysis compared pharmacies with sustained and reduced numbers of services based on three selected themes: administration of the ITAS, leadership interventions and professional values of pharmacy owner and staff. Key findings Pharmacies with sustained delivery had introduced systematic evaluations of the local delivery of the ITAS and made ongoing efforts to improve staff competencies. They dealt with individual barriers such as lack of knowledge of rarely distributed inhalation devices and communication techniques. Pharmacy staff in general rarely assessed patients' clinical needs before offering the service and rarely provided follow-up. Thus, pharmacy staff failed to utilise the full clinical potential of the ITAS. Conclusions In order to achieve and support further ITAS sustainability, the knowledge, skills and professional values of pharmacy staff must be developed. Human resource leadership techniques would be useful in achieving this aim, as would focusing on the service by providing systematic evaluations.
This study explores the lay view of pharmaceutical research and development-specifically pharmacogenomics. Forty-two persons participated in eight focus groups in Iceland. Participants were asked to comment on a future scenario consisting... more
This study explores the lay view of pharmaceutical research and development-specifically pharmacogenomics. Forty-two persons participated in eight focus groups in Iceland. Participants were asked to comment on a future scenario consisting of predictions made by researchers concerning the consequences of the Human Genome Project over the next 40 years, and asked to give advice to politicians and the pharmaceutical industry. A dominating theme in the focus groups was the expectation that drugs developed based on pharmacogenomics will be more expensive than conventional mass produced drugs and concerns were voiced that this new technology would lead to inequalities locally and globally.
Background Despite pharmacists' extensive knowledge in the optimization of patients' medical treatments, community pharmacies are still fighting to earn patients' trust with respect to medicinal counselling at the counter.
This study explores the lay view of pharmaceutical research and development-specifically pharmacogenomics. Forty-two persons participated in eight focus groups in Iceland. Participants were asked to comment on a future scenario consisting... more
This study explores the lay view of pharmaceutical research and development-specifically pharmacogenomics. Forty-two persons participated in eight focus groups in Iceland. Participants were asked to comment on a future scenario consisting of predictions made by researchers concerning the consequences of the Human Genome Project over the next 40 years, and asked to give advice to politicians and the pharmaceutical industry. A dominating theme in the focus groups was the expectation that drugs developed based on pharmacogenomics will be more expensive than conventional mass produced drugs and concerns were voiced that this new technology would lead to inequalities locally and globally.
- by Janine Traulsen and +1
- •
- Genetics, Pharmacogenomics, Focus Groups, Drug development
Objectives: To explore how ethnic minorities at risk of vitamin D deficiency are constructed in Danish policy documents (current as of April 2009), regarding vitamin D supplementation. Methods: Ten policy documents were analysed through... more
Objectives: To explore how ethnic minorities at risk of vitamin D deficiency are constructed in Danish policy documents (current as of April 2009), regarding vitamin D supplementation. Methods: Ten policy documents were analysed through content analysis, focusing on definitions and explanations of ethnic minorities being at risk of vitamin D deficiency. This formed the basis for an analysis of constructions of ethnic minorities at risk which was undertaken using the Social Construction of Technology (SCOT) theory as an organising framework. Results: The analysis showed a high degree of interpretative flexibility regarding how ethnic minorities are constructed as a risk group for vitamin D deficiency. The ten documents analysed revealed eight different constructions of the ethnic minorities groups at risk. A low degree of interpretative flexibility was found regarding the importance of skin colour and skin covering. Major disagreements were found regarding the importance attributed to the Islamic religion, other traditions, immigration, gender and age, and use of an evolutionary explanation for the increased risk. Conclusions: Ethnic minorities at risk of vitamin D deficiency are constructed very differently in Danish policies current as of April 2009. A more precise definition of ethnic minorities in policies and research may be helpful in seeking to identify which ethnic minorities are and are not at risk of vitamin D deficiency.
Objective To develop, apply and evaluate a new research method to establish relationships between structural and process elements of the provision of cognitive services. In-depth knowledge about how local organisational structural... more
Objective To develop, apply and evaluate a new research method to establish relationships between structural and process elements of the provision of cognitive services. In-depth knowledge about how local organisational structural elements of community pharmacies shape the implementation process of cognitive services is needed to develop targeted quality assurance systems to ensure that the services are continuously provided to the patients who need them. The first publicly reimbursed cognitive service in Denmark, the Inhaler Technique Assessment Service (ITAS) is used as the case. Setting The research method was developed at the Faculty of Pharmaceutical Sciences at the University of Copenhagen and later applied to seven community pharmacies geographically spread around Denmark. Methods A pilot study as well as a subsequent literature review was conducted to determine which structure-process elements to focus on in the research method as well as to select appropriate theories and methods. Results The developed research method was a qualitative exploratory multi-case study, that was based on method triangulation of field observations, semi-structured interviews, group interviews as well as collection of documentary material. The three main themes of the research method were: the administration of tasks, leadership style and professional values. We integrated the organisational theories of Mintzberg, Bolman and Deal as well as Sørensen to support and clarify the data collection process and analyses. A cross-case analysis and an exploratory contextual analysis relating the leadership style of the pharmacy owner to the ITAS provision were applied to the collected data. Conclusion The developed qualitative exploratory multi-case study research method was satisfactory with regard to achieving nuanced and in-depth results of some relationships between structural and process elements of provision of cognitive services. The research method can be considered an important supplement to the existing literature on the sustainability of cognitive services.
Background: This article presents the results of a study on quality of pharmacy services and perceived risk of pharmaceuticals. The results presented here are part of a multi-study evaluation of major changes in drug distribution in... more
Background: This article presents the results of a study on quality of pharmacy services and perceived risk of pharmaceuticals. The results presented here are part of a multi-study evaluation of major changes in drug distribution in Iceland. Objectives: This sub-study addressed the question: what is the lay user perspective on pharmaceuticals and pharmacy services, including their perception of risk? Methods:
- by Janine Traulsen and +1
- •
- Focus Groups, Health Policy, Iceland, Clinical Pharmacy
Pharmaceutical care is a widely accepted strategy in the world of pharmacy, as well as a topic of interest in pharmacy practice research. Most people in the field would agree that it is unfortunate that so little is known about... more
Pharmaceutical care is a widely accepted strategy in the world of pharmacy, as well as a topic of interest in pharmacy practice research. Most people in the field would agree that it is unfortunate that so little is known about pharmaceutical care outside the world of pharmacy. There is also wide agreement that the further development of pharmaceutical care requires that policymakers become aware of, accept and ultimately support it. Although attempts have been made, we have not yet managed to capture the attention and support of policymakers, including politicians. In this article we argue that the way to get the attention of policymakers/politicians is by changing the way we communicate with them, as a means of overcoming some of the barriers we normally meet when introducing pharmaceutical care. We suggest that one possible way of getting their attention and subsequent support is by gaining a better understanding of the way policymakers work in general and then adjusting our argumentation for pharmaceutical care to better fit into their rationality and work habits. In this article, we elaborate on this idea and discuss how proponents of pharmaceutical care can use 'health technology assessment' to argue their case.
In a previous article in this series, we posed some questions about the visibility of gender and the relevance of feminism for pharmacy practice research.