Development of the specialist menopause pharmacist (SMP) role within a research framework
Objective: To determine the potential contribution of a new healthcare practice model, the specialist menopause pharmacist (SMP) role.
Method: Post pilot, the SMP’s remit was proposed as combining clinical practice (service delivery) and research studies, with emphasis on strengthening liaison between the secondary and primary care sectors. Action research, a qualitative research technique, was selected to document role development in the first year. Here the pharmacist- researcher’s focus was a local situation where the effects of a particular change, involving people who were part of the situation, were assessed. The change factor was the introduction of the pharmacist to the multi-disciplinary specialist team. The pharmacist-researcher did not attempt to hold anything constant but observed the changes occurring in a systematic manner. Analysis of on-going collaborative professional activity generated the hypothesis that the role was of use in enhancing patient care. Using triangulation and focusing on the descriptive phrase ‘of use’, it was then possible to study SMP implemented ‘actions’ that would be accepted as being ‘useful’ SMP functions. The aim was to test for reliability and obtain data with greater range and accuracy. The three studies undertaken included a controlled, questionnaire study asking for patients’ views on the pharmacist service, auditing health professionals usage of the pharmacist operated telephone help-line, and assessing the impact of structured on-site training on community pharmacists.
Main outcome measure: Overall impact and achievements over 3 years, against a background where the SMP role continued to develop during the study.
Results: Action research methodology engendered reflective practice, enabling the SMP to be both the service delivery provider (the intervention) and the researcher. This pharmacist practice model is accepted both by patients and health professional colleagues. The remit combines clinical practice with on-going research studies. In the UK setting, the SMP can undertake numerous liaison activities between secondary and primary care sectors to facilitate enhanced delivery of menopause patient care.
Conclusion: Using an action research approach, and combining qualitative and quantitative methods to complement data collection, it was possible to assess the specialist pharmacist role in depth.
KeywordsAction research Health care models Health care service Pharmaceutical care Primary care Research methods Secondary care Specialist pharmacist Triangulation United Kingdom
Unable to display preview. Download preview PDF.
- Ryan, M, Scott, DA, Reeves, C, Bate, A, Teijlingen, ER, Russell, EM, et al. 2001Eliciting public preferences for healthcare: a systematic review of techniques.Health Technol Assess (Southampton, UK)51186Google Scholar
- Davies, HT 1998Performance management using health outcomes: in search of instrumentality.J Eval Clin Prac435962Google Scholar
- Booth, A, Falzon, L 2001Evaluating information service innovations in the health service: ‘If I was planning on going there I wouldn’t start from here’.Health Inform J7139Google Scholar
- Cipolle, R, Strand, L, Morley, P 1998Pharmaceutical care practice.McGraw-Hill CompaniesNew YorkISBN 0-070-12046-3.Google Scholar
- Cipolle, R, Strand, L 1993Challenges for pharmaceutical care.Am J Hosp Pharm50161821Google Scholar
- Tanna, N 2002Progress made towards implementing pharmaceutical care.Pharm J26916669Google Scholar
- Hart, E, Bond, M 1995Action research for health and social care.Open University PressBuckingham, UKISBN 0-335-19262-9.Google Scholar
- Meyer, J 2000Qualitative research in health care.Using qualitative methods in health related action research. BMJ32017881Google Scholar
- Tanna, N, Pitkin, J 1997Monitoring patients on HRT within the primary care setting.J Br Men Soc31115Google Scholar
- Tanna, N, Pitkin, J, Anderson, C 1999The specialist pharmacist post to the menopause team at Northwick Park Hospital: impact on the primary health care team.Pharm Prac9706Google Scholar
- Lewin K (1946). Action research and minority problems. In Lewin G W, editor. Resolving social conflicts: Selected papers on group dynamics by Kurt Lewin (1948). Harpercollins College Div (January 2000). ISBN 0-060-33570-X. Google Scholar
- Smith, F 1999Health services research methods in pharmacy: triangulation.Int J Pharm Pract7608Google Scholar
- Pharmacy. The report of a committee of inquiry appointed by the Nuffield Foundation. London: Nuffield Foundation, 1986. Google Scholar
- The New NHS Modern and Dependable. Primary care groups: Delivering the agenda. UK Health Services Circular HSC 1998/228:LAC(98)32.Google Scholar
- Review of prescribing, supply & administration of medicines. Crown Report, London. March 1999.Google Scholar
- Horne, R, et al. 1995Impact of a hospital based programme of pharmaceutical care on elderly patients’ adherence (compliance) to medication following discharge into the community.Pharm J255(Suppl)R1Google Scholar
- Blenkinsopp, A, Clark, W, Purves, I, Fisher, M 1998Getting research into practice.Panton, RChapman, S eds. Medications Management.BMJ Books and Pharmaceutical PressLondon13353ISBN 0-7279-1274-7.Google Scholar
- Medicines, ethics and practice. The Royal Pharmaceutical Society of Great Britain, 2000.Google Scholar
- Nisbet, J 1980Education research: the state of the art.Dockrell, WBHamilton, D eds. Rethinking educational research.Hodder & StroughtonLondonISBN 0-340-20548-2.Google Scholar
- Webb, C 1989Action research: philosophy, method and personal experiences.1989. J Adv Nurs1440310Google Scholar
- Tanna, N, Protti, O, Pitkin, J, Anderson, C, Greene, R 1999Patient satisfaction with a specialist menopause pharmacist.Pharm J263R62Google Scholar
- Tanna, N, Pitkin, J, Anderson, C, Greene, R 1998Audit of a pharmacist led menopause telephone helpline for health professionals.Pharm J261R34Google Scholar
- Tanna, N, Pitkin, J, Anderson, C, Green, R 1999The impact of menopause training on community pharmacist HRT prescription interventions.Pharm J263R4Google Scholar
- Tanna, N, Pitkin, J, Anderson, C 2000Community pharmacists and menopause training: a qualitative study.Proceedings supplement. J Br Men Soc6 (Suppl.3)36Google Scholar
- Tanna, N, Pitkin, J, Anderson, C 1998Community pharmacists’ advice to hormone replacement therapy patients in Brent & Harrow.Pharm World Sci20No. 1AGoogle Scholar
- Gantley M, Harding G, Kumar S, Tissier J. Data analysis. An introduction to qualitative methods for health professionals. Royal College of General Practitioners 1999: 14. ISBN 0-850-84246-8.Google Scholar
- Pharmaceutical Care 1996 Award. A multidisciplinary approach for advice provision to the HRT patient. Pharm J 1997; 259: 18, 22.Google Scholar
- Tanna, N K, Pitkin, J, Jenkins, A, Irani, G, Guy, M 1999The Brent & Harrow Health Authority Menopause guidelines.Pharm J2621334Google Scholar
- The Sheffield Protocol for the management of the menopause and the prevention and treatment of osteoporosis. Lee SJ, editor, 6th revised edition, 2000. ISBN 0-9517596-5-5.Google Scholar
- Tanna N, Pitkin J, Filer M. A report on the design, piloting and initial achievements of a purpose built menopause database: MAUD. Vol. Proceedings of the 9th International Menopause Society World Congress, Japan, 1999: 357–363. Monduzzi Editore S p A. ISBN 88-323-1017-1.Google Scholar
- Hibbert, D 1994Evaluating qualitative research studies.Pharm Prac Res Resource Centre3214Google Scholar
- Kirk, J, Miller, ML 1986Reliability and validity in qualitative research.Sage PublicationsNewbury ParkISBN 0-8039-2470-4.Google Scholar
- Tanna N, Pitkin J, Frank A, Tellez M. Medication management clinics in the secondary care sector. http://bmj.com/cgi/ eletters/323/7325/1340 (15 January 2002).Google Scholar