This document discusses the field of Social Pharmacy. It defines Social Pharmacy as using social scientific perspectives to study how social factors influence medicine use. Some key areas of research in Social Pharmacy include how social aspects of drugs like development, production, and policies influence their use, and how patients perceive and use medicines. The field draws on theories and methods from various social sciences and aims to better understand pharmacy practice from these perspectives.
This document discusses the field of Social Pharmacy. It defines Social Pharmacy as using social scientific perspectives to study how social factors influence medicine use. Some key areas of research in Social Pharmacy include how social aspects of drugs like development, production, and policies influence their use, and how patients perceive and use medicines. The field draws on theories and methods from various social sciences and aims to better understand pharmacy practice from these perspectives.
This document discusses the field of Social Pharmacy. It defines Social Pharmacy as using social scientific perspectives to study how social factors influence medicine use. Some key areas of research in Social Pharmacy include how social aspects of drugs like development, production, and policies influence their use, and how patients perceive and use medicines. The field draws on theories and methods from various social sciences and aims to better understand pharmacy practice from these perspectives.
This document discusses the field of Social Pharmacy. It defines Social Pharmacy as using social scientific perspectives to study how social factors influence medicine use. Some key areas of research in Social Pharmacy include how social aspects of drugs like development, production, and policies influence their use, and how patients perceive and use medicines. The field draws on theories and methods from various social sciences and aims to better understand pharmacy practice from these perspectives.
economics? • How is drug distribution carried out in countries that have different education and availability of pharmacists?
The Concept of • How do pharmacists perceive and act
upon their expanded roles in health care delivery? The other general area of research in
Social Pharmacy Social Pharmacy addresses user (or patient
or customer) perceptions and use of drugs/ medicines. Research questions in this area are as diverse as the patients and providers Sørensen EW* MSc(Pharm), Mount JK + PhD, RPh, Christensen ST** PhD(Pharm) involved in medication use activities, for example: * Associate professor, The Danish University of Pharmaceutical Sciences, • Why is the patient taking (or not Dept of Social Pharmacy, Copenhagen, Denmark taking) a medicine as it was prescribed? Email: ews@dfk.dk • What kind(s) of drug information has + Associate professor, University of Wisconsin, the best effect on patient understanding Dept of Social and Administrative Pharmacy, Madison, USA and when should it be provided? ** Assistant research professor, The Danish University of Pharmaceutical Sciences, • How can a pharmacist most effectively Dept of Social Pharmacy, Copenhagen, Denmark identify a patient’s drug-related problems/side effects? • How can new pharmaceutical services The 13th International Social Pharmacy Workshop will be held for the patient/customer be in Malta in July 2004. The Social Pharmacy Workshops are implemented in health care? international conferences for research in social and behavioural pharmacy. Meetings are held every second year Thus, Social Pharmacy can assist anyone who wants to use a scientific approach to and participation has grown steadily since the first Workshop describe, explain, understand, and/or was held in Helsinki, Finland, in 1980. Following the change practice. As such, it offers benefits successful 2002 conference in Sydney, Australia, the 2004 to researchers, policy-makers, and meeting in Malta will be the first one held in the pharmacists as well as other health care Mediterranean area! providers. The primary pursuit of Social Pharmacy research is to investigate questions and Introduction themes concerning pharmacy practice and But what is Social Pharmacy? In this sciences simply do not provide adequate medicine use. It is a hybrid field that uses article, we give a brief overview of this tools or perspectives. They need to be theories and methods from numerous field. We identify key questions addressed supplemented with knowledge from the humanistic and social scientific disciplines in Social Pharmacy research and introduce disciplines that deal with people and in order to explore all aspects of pharmacy its major theories, concepts, and research systems, i.e., the humanistic and social practice. Because of this interdisciplinary methods. Finally, we discuss the future of sciences. And this is where Social Pharmacy nature, it is necessary to be familiar with Social Pharmacy and how it relates to the comes into the picture. diverse disciplines and skilled in applying future of Pharmacy in general. Within Social Pharmacy, the drug/ their methods of inquiry. Social Pharmacy medicine sector is studied from the social regularly draws upon the disciplines of What is Social Pharmacy? scientific and humanistic perspectives. sociology, social psychology, psychology, Traditionally, chemistry, biochemistry, Topics relevant to Social Pharmacy consist political sciences, educational studies, physics and physiology form Pharmacy’s of all the social factors that influence communications, economics, history, and core knowledge base. Knowledge of medicine use, such as medicine- and health- anthropology. It leans more heavily on medications and their effects is the basis of related beliefs, attitudes, rules, psychology, social psychology, sociology, the pharmacists’ professional expertise. relationships, and processes. One general political science, and economics, especially Practising pharmacy, however, is carried out area of research focus addresses social as these relate to issues in public health among human beings, the persons referred aspects of drugs themselves including: drug and social politics. to as customers or patients or users. They, research and development, drug production, Figure I shows the hierarchy of natural in turn, are connected with one another in drug distribution, drug prescription, drug systems, the levels of organisation and the families, organizations and health systems information and drug control. Examples of disciplines in the pharmaceutical education. in countries and cultures around the world. questions within this area are: This is the waya that we at the Danish Thus, when trying to explain, understand or • How do laws influence development and University of Pharmaceutical Sciences change pharmacy practice, the natural approval of new drug products? explain the relationships between the
8 thechronic✱ill Issue 7 Summer 2003
different pharmaceutical relevant to Social Pharmacy disciplines. This also illustrates Figure I: Levels of Organisation and the research, a series of articles by how Clinical Pharmacy serves as Disciplines involved in Pharmaceutical Education Bissell, Traulsen, and Haugbølle13- a bridge that overlaps with and 15 is being published in the connects the natural sciences International Journal of Pharmacy and Social Pharmacy. Practice. Each article examines an Social Pharmacy has strong area of sociological theory and its connections to Pharmacy relation to pharmacy practice Practice. In virtually all cases, research. Approaches being booksb addressing subjects, examined include: functionalism, theories and methods of Social marxism, symbolic interactionism Pharmacy associate Social and ethno-methodology, Pharmacy with the term, feminism, post-modernism and activities, and/or field of post-structuralism, the work of Pharmacy Practise. This is Michel Foucault and the illustratedc by Wertheimer and developing sociology of the body. Smith,1 and Taylor and Harding.5 In fact, in some countries, Methods Social Pharmacy actually is In Social Pharmacy, as in the incorporated under the more social and humanistic sciences, general term “pharmacy there is no one single method of practice”. 4 research but several, because the types of question that need to be Research in Social Pharmacy 5. Improving quality of services and answered differ. Research is classified into Social Pharmacy/Pharmacy Practice quality assurance four types in relation to the core questions Research is linked to the broad field known 6. Evaluations of policy and practise they can answer, the typical design and as health services research. This linkage experiments and innovations research method(s) used, and the different emphasises that this is an applied field of 7. Interface between pharmaceutical and quality criteria for each type.16 This is shown research, concerned with both other health services in Table I. understanding and improving pharmacy 8. Payment and remuneration for services Research methodology in Social practice and medication use. Why is and pharmaceuticals Pharmacy/pharmacy practice is described in research of this type so important? Addressing all these topics obviously is by Taylor et al5 and Smith.17 Increasingly, we recognise that pharmacy a major challenge, one that leads Further information about research in practice must be evidence-based and must researchers into many different areas of Social Pharmacy, may be sought from the make use of best practices. Thus, it is investigation and application. How can following sources: important that pharmacy practices be such diverse studies be united with one evaluated and that findings of such research another? By using theories developed in International journals: be implemented. Much work is still needed the humanistic and social sciences to guide • Journal of Social and Administrative in this area. Reviews such as those by De Social Pharmacy investigations, we are able Pharmacy Young,6 Schumock7 and Singhal et al,8 to develop a more general understanding of • International Journal of Pharmacy conclude that pharmacist consultation and social factors that influence pharmacy Practice pharmacy-based interventions have positive practice and medicine use. effects. Applying the strict criteria used to As a relatively new discipline, though, Books about Social Pharmacy/Pharmacy conduct a systematic review, however, the theoretical bases of research in the area Beney, Bero and Bond 9 concluded that more Practice: of Social Pharmacy and Pharmacy Practice • Taylor K, Harding G (2001) Pharmacy rigorous research is needed to document the still are in the process development.11 The effects of pharmacist interventions. Thus, it Practice. London: Taylor and Francis. number and range of theories useful for is important that pharmacist practitioners research, however, are enormous and participate in collaborative Social Pharmacy varied. 12 In the Social Pharmacy research National or international conferences: research or undertake their own research community and at the Social Pharmacy • International Social Pharmacy Workshop and professional audits. Workshops, we recognize and try to improve • Pharmaceutical Care Network Europe upon this; theories are discussed, critiqued, (PCNE) What topics require investigation? and further integrated into current research. • European Society of Clinical pharmacy The Pharmacy Practice and Research Reflecting the wide array of theories (ESCP) Group 10 recommended eight themes and topics for pharmacy practice research: 1. Supply, distribution and availability of a) A similar model is described by Mount in Wertheimer and Smith (1989).1 services b) This section is based on the following sources: Lilja, 1988;2 Wertheimer and Smith, 1989;1 Harding, 2. Demand of services Nettleton and Taylor 1990;3 Harding, Nettleton and Taylor, 1994;4 Taylor and Harding 2001. 5 c) Language usage reflects social changes. For example, in their 1996 revised edition, Wertheimer and 3. Organisation and process of service Smith revised the title to Social and Behavioral Aspects of Pharmaceutical Care and Harding and delivery colleagues used the terms Sociology and Social Pharmacy in their earlier textbooks (Harding et al 4. Effectiveness and outcomes of services 1990; Harding et al 1994). 3,4
10 thechronic✱ill Issue 7 Summer 2003
• Health Services and Pharmacy Practice References Research conferences • FIP: The International Pharmaceutical 1. Wertheimer AI, Smith MC. Pharmacy Practice: 10. Mays N. Health Services Research in Federation Social and Behavioral Aspects. Philadelphia: Pharmacy: A Critical Personal Review. Williams and Wilkins; 1989. Manchester: University of Manchester, • American Pharmacists Association Pharmacy Practice Research Resource Centre 2. Lilja J. Theoretical Social Pharmacy: The Drug • American Society of Health-System Sector From a Social Science Perspective. 1994. Pharmacists Kuopio: University of Kuopio, Department for 11. Nørgaard LS, Morgall JM, Bissell P. Social Pharmacy; 1988. Arguments for theory-based pharmacy 3. Harding G, Nettleton S, Taylor K. Sociology for practice research. Int J Pharm Pract 2000:77- Conclusion: The Future Pharmacists: An Introduction. London: 81. Social Pharmacy has come to stay, and Macmillan; 1990. 12. Bissell P, Traulsen MJ, Haugbølle LS. (1) An there are reasons to believe that Social introduction to sociology - and what it can 4. Harding G, Nettleton S, Taylor K. Social Pharmacy will play an even more crucial role do for pharmacy practice research. Int J Pharmacy: Innovation and Development. in future pharmacy, i.e. drug engineering London: The Pharmaceutical Press; 1994. Pharm Pract 2001:9:289-95. based on gene technology and 5. Taylor K, Harding G. Pharmacy Practice. 13. Bissell P, Traulsen MJ, Haugbølle LS. (2) An nanotechnology and the increasing reliance London: Taylor and Francis; 2001. introduction to functionalist sociology: on drugs in dealing with human ailments Talcott Parsons’ concept of the “sick role”, 6. De Young M. Research on the effects of Int J Pharm Pract 2002:10:60-8. will pose and empower new challenges for pharmacist-patient communication in 14. Bissell P, Traulsen MJ, Haugbølle LS. (3) How pharmacists. The nature of modern and institutions and ambulatory care sites, 1969- 1994, American Journal of Health-System relevant is Marxist sociology for pharmacy future drugs calls for interdisciplinary Pharmacy 1996:53 (June 1):1277-91. practice research? Int J Pharm Pract approaches in both research and practice in 2002:10:127-40. order to fully understand the associated 7. Schumock GT, Butler MG, Meek PD, et al. Evidence of the economic benefit of clinical 15. Bissell P, Traulsen MJ, Haugbølle LS. (4) The complexity. In the future, health care contribution of interactionist sociology to pharmacy services: 1996-2000, systems will be stretched far as the Pharmacotherapy 2003:23(1):113-32. understand experience of health and illness. “invading nature” of future drugs will have Int J Pharm Pract 2002:10:213-24. 8. Singhal PK, Raisch DW, Gupchup GV. The substantial impact on pharmacists’ impact of pharmaceutical services in 16. Launsø L, Rieper O. Forskning om og med performance, health care policies and community and ambulatory care settings: mennesker. Nyt Nordisk Forlag Arnold Busck, 2000. expenditures, as well as on the individual Evidence and recommendations for future research, Annals of Pharmacotherapy 17. Smith FJ. Pharmacy practice research user whose life might be altered radically. 1999:33(Dec):1136-1355. methods. London: Pharmaceutical Press., Social Pharmacy is the interdisciplinary 9. Beney, J. Bero, LA. Bond, C. Expanding the 2002. discipline that enables the pharmacy roles of outpatient pharmacists. [Systematic profession to act, take part and take Review] Cochrane Effective Practice and responsibility in drug matters at a societal Organisation of Care Group Cochrane level. Being a discipline developing very Database of Systematic Reviews 2003:1. fast due to social demand, Social Pharmacy is likely to have a central position in the future curricula in Pharmacy Schools.
Table I: The Main Types of Research 14
Research Type Descriptive Explanatory Understanding Action-oriented Core Question How is X What X What is X? How do people distributed? causes Y? involved develop the action on basis What Y results of the knowledge from X? gained and communicated during the research process? Typical Design Survey Experimental Case study • Action research • Formative evaluation Dominating Method Quantitative Quantitative Quantitative Qualitative and quantitative
• Validity • Validity • Wholeness • Does learning occur? • Precision • Precision • Looking-glass • What direction does • Generalisation • Generalisation • Provocation change take? • Prediction • Enlargement • What does change of meaning mean?