Relationship between hospital pharmacists' job satisfaction and involvement in clinical activities

Job satisfaction among board-certified pharmacists in Virginia

BACKGROUND

Board certification has been associated with job satisfaction. Identifying factors influencing board-certified pharmacists' job satisfaction can assist employers in recruitment and retention.

OBJECTIVES

To identify factors associated with job satisfaction among board-certified pharmacists in Virginia.

METHODS

This cross-sectional study utilized data from the 2018 Virginia Pharmacy Workforce Survey and included pharmacists who held an active license in Virginia, were employed within the last year, and held any Board of Pharmacy Specialties certification. Descriptive statistics were used to summarize the data, and bivariate analyses compared job satisfaction across demographics and practice characteristics. Multivariable logistic regression identified factors associated with job satisfaction.

RESULTS

Of 15,424 licensed pharmacists, 13,962 completed the survey (90.5%), while 1,284 (9.2%) met the inclusion criteria. Respondents were primarily female (69.4%) with a mean (SD) of 10.5 (9.6) years of work experience. Pharmacists predominantly held one full-time position (81.5%), earned an annual income between $100,000-$149,999 (77.0%), and worked in inpatient health systems (43.9%). Most board-certified pharmacists (93.7%) reported being very/somewhat satisfied with their current job. Job satisfaction was associated with work setting, primary hours worked per week, and paid sick leave benefits in bivariate analyses. In the multivariable logistic regression model, pharmacists working 30-49 versus ≥50 h/wk in their primary job (aOR= 2.91, 95% CI 1.63, 5.20), earning ≥$150,000 versus $100,000-$149,999 (aOR=4.60, 95% CI 1.21, 17.46), and with paid sick leave benefits (aOR= 1.92, 95% CI 1.19, 3.10) were more likely to report higher job satisfaction. Additionally, working in academia (aOR= 5.36, 95% CI 1.45, 19.85), inpatient health system (aOR= 3.13, 95% CI 1.41, 6.94), and outpatient health system (aOR= 4.07, 95% CI 1.33, 12.51) were associated with job satisfaction.

CONCLUSION

Board-certified pharmacists in Virginia reported high job satisfaction. Primary hours worked per week, income, paid sick leave, and work setting were positively associated with job satisfaction.

Predictors of job satisfaction among pharmacists: A regional workforce survey

Background

Job satisfaction affects organizational outcomes including performance and retention. The pharmacy job satisfaction literature points to several predictors of job satisfaction, but educational debt and various work settings have not been previously examined.

Objectives

To identify predictors of Virginia pharmacists' job satisfaction.

Methods

This cross-sectional study used data from the 2018 Virginia Pharmacist Workforce Survey. Of 15,424 registered pharmacists, 13,962 (90.5%) completed the survey. Pharmacists who reported being employed and working in Virginia in the previous year (2017) were included in the analysis (n = 6042). Data were summarized using descriptive statistics. Multiple logistic regression identified predictors of job satisfaction.

Results

Respondents were primarily female (66.3%), Pharm.D. degree holders (65.5%), with a 14.8-year average work experience. Most pharmacists (86%) reported being very/somewhat satisfied with their job. Educational debt was not significantly associated with job satisfaction. Significant predictors of job satisfaction included: being female (aOR = 1.28, 95% CI 1.08, 1.52); working <30 (aOR = 1.80, 95% CI 1.14, 2.84), 30–39 (aOR = 1.47, 95% CI 1.02, 2.11), or 40–49 (aOR = 1.42, 95% CI 1.02, 1.98) versus ≥50 h per week; earning an annual income of <$50,000 (aOR = 0.60, 95% CI 0.38, 0.94) or ≥ $150,000 (aOR = 2.05, 95% CI 1.30, 3.23) versus $100,000–$149,999; working in an independent community pharmacy (aOR = 3.72, 95% CI 2.54, 5.44), health system (aOR = 3.81, 95% CI 2.78, 5.22), clinic-based pharmacy (aOR = 4.39, 95% CI 2.18, 8.83), academia (aOR = 5.20, 95% CI 1.97, 13.73), benefits administration (aOR = 3.64, 95% CI 1.71, 7.74), long-term home and home health/infusion (aOR = 1.71, 95% CI 1.10, 2.67), mass merchandiser community (aOR = 0.79, 95% CI 0.62, 0.99), or manufacturer and wholesale distributor (aOR = 3.46, 95% CI 1.97, 6.08) versus chain community pharmacy.

Conclusions

Overall, Virginia pharmacists reported high job satisfaction. Pharmacists working in chain community pharmacy reported lower satisfaction relative to other settings. Being female, having a high annual income, and working for less hours was associated with improved job satisfaction.

Assessment of Canadian Hospital Pharmacists' Job Satisfaction and Impact of Clinical Pharmacy Key Performance Indicators

Background

The clinical pharmacy key performance indicators (cpKPIs) are quantifiable measures of quality to advance clinical pharmacy practice and improve patient care. Although when delivered in combination they have been linked to important patient outcomes, no data are available relating to their impact on hospital pharmacists' job satisfaction.

Objectives

To determine the level of job satisfaction among Canadian hospital pharmacists and whether participation in cpKPI activities contributes to hospital pharmacists' job satisfaction.

Methods

A mixed-methods study was conducted. An electronic survey, consisting of 36 questions, was developed using a validated pharmacist job satisfaction tool and was then distributed nationally to hospital pharmacists between January 30 and March 14, 2019. Focus groups were conducted with pharmacists at Horizon Health Network in New Brunswick to further explore activities that contribute to their job satisfaction.

Results

Overall, 284 pharmacists from 9 provinces completed the electronic survey. The mean job satisfaction score among hospital pharmacists was 3.93 (standard deviation 0.85) out of 5. Job satisfaction scores increased with increases in self-identified time spent performing cpKPI activities (r = 0.148, p = 0.014). Pharmacist satisfaction increased with time spent performing medication reconciliation on admission (β = 0.140, p = 0.032) and decreased with time spent identifying and resolving drug therapy problems (β = -0.153, p = 0.030). Three focus groups, comprising a total of 13 pharmacists, were conducted; during these sessions, some cpKPIs were highlighted favourably, although pharmacists described some ambivalence toward patient education. The importance of having an impact and receiving appreciation was highlighted.

Conclusions

Canadian hospital pharmacists are generally satisfied with their jobs, and participation in cpKPI activities was found to be positively associated with hospital pharmacists' job satisfaction.

Assessment of Job Stress of Clinical Pharmacists in Ho Chi Minh City, Vietnam: A Cross-Sectional Study

Objectives: The official implementation of clinical pharmacy in Vietnam has arrived relatively late, resulting in various stressors. This study aims to evaluate job stress level and suggest viable solutions.

Methods: A cross-sectional study was conducted on clinical pharmacists (CPs) in 128 hospitals in Ho Chi Minh City (HCMC). Job stress questions were derived from the Healthcare Profession Stress Inventory (HPSI).

Results: A total of 197 CPs participated, giving a response rate of 82.4%. Participants were found to have moderate job stress with an overall mean stress score of 1.5 (0.4) and stress rate of 52.8%. The sample size was statistically adequate and the HPSI was valid and reliable. Patient care responsibility was the main stressor, especially in public hospitals, followed by job conflicts. Lack of experience, low income, and inability to participate in clinical ward rounds caused significant stress to CPs regarding job recognition and job uncertainty. More practice-oriented training programs in bachelor curricula and clinical practice should be applied to help CPs gain more experience, self-confidence, and diminish job stress.

Conclusion: CPs in HCMC have moderate stress. More practice-oriented training programs should be prioritized to lessen stress for CPs.

Assessment of Pharmacist's Knowledge and Perception toward 3D Printing Technology as a Dispensing Method for Personalized Medicine and the Readiness for Implementation

The main user of three dimensional (3D) printing for drug dispensing will be the hospital pharmacist. Yet despite the tremendous amount of research and industrial initiatives, there is no evaluation of the pharmacist’s knowledge and opinion of this technology. The present study aimed to assess knowledge and attitude among pharmacists about 3D printing technology as an innovative dispensing method for personalized medicine and the barriers to implementation in Saudi Arabia. We found that 53% of participants were aware of 3D printing technology in general, but only 14–16% of pharmacists were aware of the specific application of 3D printing in drug dispensing. Participants showed a positive perception regarding the concept of personalized medicine and that 3D printing could provide a promising solution to formulate and dispense personalized medicine in the pharmacy. It was also found that 67% of pharmacists were encouraged to adopt this new technology for drug dispensing, reflecting their willingness to learn new innovations. However, the technology cost, regulation, and the shortage of practicing pharmacists were also reported as the top barriers for implementation. Facilitating the implementation of this technology in the pharmacy practice will require a strategic plan in which pharmacists collaborate with regulatory bodies and 3D printing engineers to overcome challenges and barriers to implement such promising technology.

Evaluation of burnout among hospital and health-system pharmacists in North Carolina

PURPOSE

To assess the current state of burnout among pharmacists who work in hospital and health-system settings in North Carolina.

METHODS

The Maslach Burnout Inventory-Human Services Survey for Medical Professionals was used to assess burnout in this study. This survey measures 3 subscales of burnout: emotional exhaustion, depersonalization, and personal accomplishment. In addition to the Maslach Burnout Inventory, the survey asked questions addressing various modifiable and nonmodifiable demographic factors. To distribute the survey, an email listserv of all pharmacists licensed in the state was obtained from the North Carolina Board of Pharmacy. The survey was distributed through email in June 2018. A follow-up email encouraging participation in the survey was sent 2 weeks later. The survey was open for a total of 4 weeks.

RESULTS

The survey was delivered to 2,524 pharmacists; 380 responses were received (15.1% response rate). Of the 380 individuals who responded, 357 completed the entire survey (93.9% completion rate), and 198 pharmacists (55.5%) were at risk for burnout. Following multivariate logistic regression, 3 factors were significantly associated with increased risk of burnout: female gender, working in a primarily distribution role, and longer hours worked per week. Two factors were significantly associated with decreased risk of burnout: being aware of burnout resources and working 4 to 6 months with learners.

CONCLUSION

The results of this statewide survey revealed that more than half of hospital and health system-based pharmacists are at risk for burnout.

Pharmacist integration into general practice in New Zealand

Introduction Pharmacist integration into general practice is gaining momentum internationally, with benefits noted in reducing medication errors, improving chronic disease management and alleviating general practitioner workforce shortages. Little is known about how general practice pharmacists are working in New Zealand. Aim This study characterised the current landscape of pharmacist integration into general practice in New Zealand. Methods An online questionnaire was developed, piloted and distributed to all pharmacists in New Zealand. Results Thirty-six responses were analysed. Respondents were more likely to be female, have been pharmacists for at least 10 years and all but one held formal postgraduate clinical pharmacy qualifications. Seven pharmacists were working as pharmacist prescribers. Primary health organisations (PHOs) were the most common employer, with funding primarily derived from either PHOs or District Health Boards. Pharmacist integration into general practice appears to have progressed further in particular regions of New Zealand, with most respondents located in the North Island. Tasks performed by respondents included medication reviews, managing long-term conditions and medicines reconciliation. Increased job satisfaction compared with previous roles was reported by most respondents. Funding and a general lack of awareness about pharmacists' professional scope were seen as barriers to further expansion of the role. Discussion This study describes the characteristics of pharmacists currently working in general practices in New Zealand and provides insights into key requirements for the role. Understanding the way practice pharmacists are currently employed and funded can inform general practices considering employing pharmacists.

Gender, age, and pharmacists' job satisfaction

A comprehensive literature review was conducted on the concept of job satisfaction in the pharmacist workforce field and the facets it comprises, as well as its measurement, aiming to (i) review the nature, mechanisms, and importance of job satisfaction in the context of the pharmacist workforce, (ii) survey some of the most salient facets that configure job satisfaction, and (iii) discuss validity and measurement issues pertaining to it.

Although female pharmacists generally hold less appealing jobs, earn lower wages and salaries, and are promoted less frequently than their male counterparts, they report higher levels of job satisfaction. Age has a U-shape effect on job satisfaction, with middle-age pharmacists less satisfied than both younger and older practitioners. Workload, stress, advancement opportunities, job security, autonomy, fairness in the workplace, supervisors, coworkers, flexibility, and job atmosphere are facets contributing to pharmacists’ job satisfaction. Finally, discrepancy exists among researchers in measuring job satisfaction as a single global indicator or as a composite measure derived from indices of satisfaction with key aspects of a job.

Understanding the mechanisms that affect pharmacists’ job satisfaction is important to employers in their pursuit to respond to practitioners’ needs, decrease turnover, and increase productivity. As pharmacists’ response to work-related conditions and experiences depends on gender and age, a unique set of rewards and incentives may not be universally effective. Additional research into the dynamics of the forces shaping pharmacists’ perceptions, opinions, and attitudes is needed in order to design and implement policies that allocate human resources more efficiently within the various pharmacy settings.

Approaches to outpatient pharmacy automation: a systematic review

Purpose

To systematically review, summarise and evaluate the evidence on the effectiveness of automation systems in the outpatient and community settings.

Methods

A literature search was performed using PubMed, Embase, Cochrane Library and CINAHL databases. A pre-defined search strategy focusing on the context of implementation, function and automation was used to identify articles published over the past decade. Two researchers independently screened the search results sequentially by title, abstract and full text using pre-defined inclusion/exclusion criteria. A third researcher was consulted to resolve disagreements. Data extraction and quality assessment were performed using a standardised form.

Results

Thirteen references were selected for data extraction, of which most were conducted in Europe and North America. Improvement in medication safety was most commonly reported, with findings of up to 37% reduction in medication-related reportable occurrences. Manpower requirements were found to decrease by 0.3-1.4 full-time equivalents and productivity increased by ~4 items per person/hour. Patient waiting time and prescription filling time also decreased by 17-20 s (from an average of 19-49 s), but no reductions in workload or time savings were felt by staff. While the perception of work stress decreased, job satisfaction remained unchanged. Significant cost savings and an increase in over-the-counter sales were also noted post-automation.

Conclusion

Implementing pharmacy automation technologies in an outpatient or community pharmacy setting may reduce medication errors, increase productivity and save costs but does not affect staff satisfaction. However, the available literature remains patchy and more research in this area is needed.

Factors Associated With Burnout Among US Hospital Clinical Pharmacy Practitioners: Results of a Nationwide Pilot Survey

Background: In health care, burnout has been defined as a psychological process whereby human service professionals attempting to positively impact the lives of others become overwhelmed and frustrated by unforeseen job stressors. Burnout among various physician groups who primarily practice in the hospital setting has been extensively studied; however, no evidence exists regarding burnout among hospital clinical pharmacists. Objective: The aim of this study was to characterize the level of and identify factors independently associated with burnout among clinical pharmacists practicing in an inpatient hospital setting within the United States. Methods: We conducted a prospective, cross-sectional pilot study utilizing an online, Qualtrics survey. Univariate analysis related to burnout was conducted, with multivariable logistic regression analysis used to identify factors independently associated with the burnout. Results: A total of 974 responses were analyzed (11.4% response rate). The majority were females who had practiced pharmacy for a median of 8 years. The burnout rate was high (61.2%) and largely driven by high emotional exhaustion. On multivariable analysis, we identified several subjective factors as being predictors of burnout, including inadequate administrative and teaching time, uncertainty of health care reform, too many nonclinical duties, difficult pharmacist colleagues, and feeling that contributions are underappreciated. Conclusions: The burnout rate of hospital clinical pharmacy providers was very high in this pilot survey. However, the overall response rate was low at 11.4%. The negative effects of burnout require further study and intervention to determine the influence of burnout on the lives of clinical pharmacists and on other health care-related outcomes.

Job Satisfaction Among Staff, Clinical, and Integrated Hospital Pharmacists

Purpose: To determine whether staff, clinical, or integrated hospital pharmacists have greater job satisfaction and if sex, years worked as a pharmacist, or having children changes job satisfaction. Methods: A prospective study was performed by distributing a 63-item questionnaire to inpatient pharmacists working at 2 hospitals. Respondents mailed the completed questionnaires to the investigators. Results: Questionnaires were completed by 38 participants (mean age [SD]= 38.36 [10.97]). Fourteen (36.85%) participants who spent 0% to 40% of their time in clinical activities were categorized as staff, 10 (26.30%) who spent 41% to 60% of their time in clinical activities were integrated, and 14 (36.85%) who spent greater than 61% of their time in clinical activities were clinical pharmacists. All pharmacists reported mean satisfaction scores above 2.5, indicating that all were satisfied in their jobs. Differences were noted in the amount of satisfaction. For work environment and professional interaction, integrated pharmacists were more satisfied than staff (P < .05). For professional interaction and personal outlook, clinical pharmacists were more satisfied than staff (P < .05). Conclusion: Job satisfaction was directly related to the number of clinical activities performed. Integrated and clinical pharmacists were both more satisfied than staff pharmacists.

Assessing the relationship between pharmacists' job satisfaction and over-the-counter counselling at community pharmacies

BACKGROUND

Community pharmacies have an increasing role in self-medication and community health is dependent on the quality of counselling services provided to patients. Some studies show that pharmacists' job satisfaction affects their work quality; other studies found that higher involvement in clinical services increases pharmacists' job satisfaction.

OBJECTIVE

To test the relationship between job satisfaction and over-the-counter counselling practice at community pharmacies.

SETTING

Community pharmacies in Lithuania.

METHOD

A convenience sample (n = 305) of community pharmacists participated in the cross-sectional survey where they expressed satisfaction with job and reported on their over-the-counter counselling behaviour on self-report scales. The Partial Least Squares Structural Equation Modelling approach was employed for data analysis.

MAIN OUTCOME MEASURE

The strength of the relationship between job satisfaction and over-the-counter counselling service.

RESULTS

A bidirectional relationship between job satisfaction and over-the-counter counselling service was found. In addition, job satisfaction and over-the-counter counselling quality depended on pharmacists' age.

CONCLUSION

Organizations were recommended to create a counselling friendly environment that would increase pharmacists' job satisfaction and, in return, counselling quality. Also, additional motivation of the retired pharmacists, as well as development of counselling skills of the younger pharmacy workforce, were seen as a means to improve both organizational climate and counselling quality over the counter.

Eritrean pharmacists' job satisfaction and their attitude to re-professionalize pharmacy in to pharmaceutical care

OBJECTIVE

Job satisfaction is a very important contributing factor for a person's productivity and motivation. Naturally, if people are not satisfied with what they practice, they will probably need to change or reshape their way of practice at a certain period in time. Pharmacists are not exception to this principle and have been observed to re-professionalize pharmacy in to clinical and/or pharmaceutical care in many parts of the world. Thus, this survey aims to investigate the Eritrean pharmacists' current level of job satisfaction and their views on re-professionalization of pharmacy.

METHOD

A cross-sectional survey was conducted among all Eritrean pharmacists who reside inside Eritrea.

MAIN OUTCOME MEASURES

Opinion of pharmacists about job satisfaction and re-professionalization of pharmacy into pharmaceutical care.

RESULTS

Out of the 95 questionnaires distributed 86 were completed and returned giving a response rate of 90.5 %. Nearly three fourth of the respondents (71 %) have chosen pharmacy as their ever profession and they want to encourage their children or their close relatives to pursue it as a career. Sixty four percent of the pharmacists are either partially or fully unsatisfied to spend the remainder of their working life in a job like their current one and this has a strong statistical association with less years of experience (p = 0.007) and place of work of the younger pharmacists (p = 0.008). Majority of the study participants (86 %) believe there is a great mismatch between pharmacists' level of education and level of practice in the work area. This was significant with lower age (p = 0.002), less years of experience (p = 0.006) and later year of admission to university (p = 0.000). Ninety five percent of the pharmacists perceive that the current role of the Eritrean pharmacists needs to be redefined and re-oriented.

CONCLUSION

Although the Eritrean pharmacists are proud to be pharmacy professionals, they want to redefine and reorient their current role into pharmaceutical care.

Applying Economic Model ‘Efficiency Wage’ Concept for Pharmacists

Professional articles regarding managerial means to address pharmacist turnover generally focus on policy and psychological dimensions in lieu of relative cost analysis. We present a cost–benefit argument, based on ‘efficiency wage theory’ from the economics literature to reduce the rate of pharmacist turnover in retail establishments and hospitals. Drawing from national pharmacist data, we discuss the rationale for how much management could enhance pharmacist salaries in an organization to cost effectively reduce the turnover rate. We suggest using the approach as an adjunct to existing managerial policies aimed at reducing pharmacist turnover.

Assessment of pharmacists' job satisfaction and job related stress in Amman

BACKGROUND

The myriad changes in pharmacy practice in Jordan have transformed the pharmacist's role to be more focused on the patient and his/her therapeutic needs than on just the traditional dispensing. This, in addition to other possible factors, is believed to have influenced pharmacists' job satisfaction and stress level in different practice settings in Jordan.

OBJECTIVE

This study aimed to determine the level of job satisfaction and job related stress among pharmacists in Amman. Moreover, the main causes of dissatisfaction and stress-related factors affecting pharmacists at their working positions were also explored.

SETTING

The study was conducted in four pharmacy practice settings: independent and chain community pharmacies as well as private and public hospital pharmacies.

METHODS

The study adopted the self-administered survey methodology technique using a pre-validated pre-piloted questionnaire. The questionnaire was adapted from one previously used in Northern Ireland. Data were entered into SAS database and analysed using descriptive statistics, Chi square and regression analysis. The significance level was set at P < 0.05.

MAIN OUTCOME MEASURE

The level and factors affecting job satisfaction and job related stress as reported by participating pharmacists.

RESULTS

A total of 235 registered pharmacists in Amman were involved. The pharmacists' job satisfaction was significantly affected by the type of pharmacy practice settings (P = 0.038), pharmacists' registration year (P = 0.048) and marital status (P = 0.023). Moreover, job related stress situations like patient care responsibility have been associated significantly with the type of pharmacy practice settings (P = 0.043) and pharmacists' registration year (P = 0.013). Other job stressors like long working hours, lack of advancement, promotion opportunities and poor physician pharmacists' relationship have also been reported by participants.

CONCLUSION

The study concluded that community pharmacists in Amman are found to be less satisfied with their jobs than their hospital counterparts. Pharmacists' job satisfaction should be enhanced to improve pharmacists' motivation and competence. Consequently, this will improve their productivity and provision of pharmaceutical care.

Why do Australian registered pharmacists leave the profession? a qualitative study

BACKGROUND

Understanding why people choose to leave their professions is important to inform workforce planning to meet community needs. Poor job satisfaction has been linked to health practitioners expressing intentions to leave in other professions such as nursing, occupational therapy and medicine, but little is known about the reasons why pharmacists leave their profession.

OBJECTIVE

To explore reasons why Australian pharmacists leave the profession.

SETTING

As part of a survey of the Australian pharmacist workforce, a questionnaire was mailed to all registered pharmacists (n = 7,764) on the registers of the Pharmacy Boards of Victoria and South Australia; 1,627 (21 %) responded. Participants, who were registered but no longer working as a pharmacist, were asked to provide contact details if they were willing to be interviewed for this study; 89 (5.5 %) pharmacists accepted an invitation. A proportionate sample of 20 was selected for the interview.

METHOD

A semi-structured interview schedule was developed with probe options which encouraged participants to further explore their responses to questions. De-identified audio records of interviews were transcribed verbatim and thematically analysed.

MAIN OUTCOME MEASURE

Reasons why pharmacists leave the pharmacy profession.

RESULTS

Five themes emerged: (1) Dissatisfaction with the professional environment; (2) lack of career paths and opportunities; (3) under-utilisation of pharmacists' knowledge and skills; (4) wanting a change; and (5) staying connected with pharmacy.

CONCLUSION

These findings provide insights to the pharmacy sector, previously unexplored in Australia, and informs future pharmacist workforce planning. To retain experienced, mid-career pharmacists in the profession, strategies to increase opportunities for career progression, better use of pharmacists' knowledge and skills and involvement in patient care are required to increase job satisfaction and improve retention rates.

Use of blogs by pharmacists

PURPOSE

The characteristics of pharmacist blogs were examined.

METHODS

Internet search engines, blog aggregators, and blog rolls were used to identify pharmacist blogs. Six categories were developed to evaluate blogs, including practice-based topics, identifying information, positive language, critical language, professionalism, and miscellaneous. The most recent five posts on each pharmacist blog were reviewed. Descriptive statistics were used to characterize the results.

RESULTS

A total of 117 blogs were identified, 44 of which were designated as pharmacist blogs. No blogs contained patient-identifying information. Anonymity was maintained by 68.2% of bloggers. Bloggers practiced in community (43.1%) and noncommunity (43.1%) settings. Pharmacists most commonly used positive language to describe the profession (32%), other health care professionals (25%), and patients (25%). The highest rates of critical language were found in descriptions of patients (57%) and other health care professionals (44%). Almost half of pharmacist blogs contained explicit or unprofessional language. Overall, community practitioner blogs were substantially more likely than noncommunity practitioner blogs to use unprofessional and critical language. Twenty-five percent of pharmacist bloggers also maintained a microblog (e.g., Twitter) account.

CONCLUSION

A search using Internet search engines, blog aggregators, and blog rolls identified 117 blogs, 44 of which met the study criteria for designation as pharmacist blogs. The majority of pharmacist blogs included some type of discussion of pharmacologic therapies. Pharmacists most commonly used positive language to describe the profession, other health care professionals, and patients. The highest rates of critical language were found in descriptions of patients and other health care professionals.

HEALTH SERVICES RESEARCH METHODS IN PHARMACY: Survey research: (1) Design, samples and response

Social survey methodology is the most widely used approach by pharmacy practice researchers, accounting for a higher proportion of published papers than any other. Survey techniques have been used to address a range of research objectives in a variety of populations and settings.

Extensive hand searches of published survey research have enabled a review of the issues and problems that social survey research presents when applied in pharmacy settings, and an exploration of how they have been addressed. This review is in two parts. This first part focuses on the research questions that have been addressed by survey methods, design of the studies, sampling frames and procedures, response rates and management of non-response. A second paper will discuss the development of survey instruments, and the issues of validity, reliability and generalisability.

HEALTH SERVICES RESEARCH METHODS IN PHARMACY: Survey research: (2) Survey instruments, reliability and validity

Social surveys are an important tool in health services research. They have been used in a high proportion of pharmacy practice research studies and in a wide range of settings. Extensive hand searches of published studies has enabled a review of the issues and problems that survey methods present when applied in pharmacy practice and an exploration of how they have been addressed by researchers. It is hoped that the review will enable pharmacy practice researchers to benefit from the experience of their colleagues when conducting their own research. This is the second part of a two-part review of surveys in pharmacy practice research. The first part (IJPP, 1997;5:152) focused on research questions, study design, sampling frames and procedures, response and non-response. This second part discusses the development of survey instruments and the issues of validity, reliability and generalisability.

Job satisfaction and the association with involvement in clinical activities among hospital pharmacists in Hong Kong

OBJECTIVES

To describe the relationship between job satisfaction of hospital pharmacists and the extent of their involvement in clinical pharmacy activities, and to examine if demographics and practice characteristics are associated with the extent of involvement in clinical pharmacy activities and job satisfaction.

METHODS

A cross-sectional study was conducted by surveying with a self-administered questionnaire mailed to all full-time pharmacists employed by the Hospital Authority, Hong Kong.

KEY FINDINGS

Respondents reporting job and career satisfaction averaged near the neutral point. The results indicated an unmet expectation of work balance between clinical activities and drug distribution, with the majority of responding pharmacists desiring a shift of work balance from more drug distributive roles towards more clinical activities. The results also suggested that an unmet expectation in work balance affects job and career satisfaction, particularly in younger, frontline pharmacists.

CONCLUSIONS

Younger, frontline pharmacists reported lower job satisfaction and a greater gap of unmet expectations in their work balance. This study highlights the importance of pharmacists' involvement in clinical activities, as job enrichment would improve job satisfaction and maximise benefits towards patients and healthcare organisations.

PharmacistCARE: description of a pharmacist care service and lessons learned along the way

OBJECTIVE

To describe the PharmacistCARE program, an innovative pharmacy practice model implemented within a self-insured employer and to describe lessons learned by the authors in implementing and maintaining the program.

SETTING

University of Kentucky (UK), March 2003 to present.

PRACTICE DESCRIPTION

A free-standing pharmacist clinic located within an ambulatory care facility owned by UK HealthCare.

PRACTICE INNOVATION

PharmacistCARE, a pharmacist-provided patient care service for UK Health Plan members that includes comprehensive disease and medication therapy management.

MAIN OUTCOME MEASURES

Various lessons learned by the authors during development, implementation, and maintenance of the program.

RESULTS

The program has been recognized by the university as a positive contribution to health plan service enhancement and cost savings and has documented enhanced patient care outcomes.

CONCLUSION

The PharmacistCARE program is a unique pharmacist-provided service delivered in a free-standing pharmacist clinic that enhances health outcomes for adult members in a self-insured employer group.

Impact of an automated dispensing system in outpatient pharmacies

OBJECTIVE

To evaluate the impact of an automated dispensing system (ADS) on pharmacy staff work activities and job satisfaction.

DESIGN

Cross-sectional, retrospective study.

SETTING

Kaiser Permanente Colorado (KPCO) outpatient pharmacies in September 2005.

PARTICIPANTS

Pharmacists and technicians from 18 outpatient pharmacies.

INTERVENTION

All KPCO outpatient pharmacists (n = 136) and technicians (n = 160) were surveyed regarding demographics and work activities and pharmacist job satisfaction. Work activities and job satisfaction were compared between pharmacies with and without ADS. Historical prescription purchase records from ADS pharmacies were assessed for pre-ADS to post-ADS changes in productivity.

MAIN OUTCOME MEASURES

Self-reported pharmacy staff work activities and pharmacist job satisfaction.

RESULTS

Pharmacists who responded to the demographic questionnaire (n = 74) were primarily women (60%), had a bachelor's degree in pharmacy (68%), and had been in practice for 10 years or more (53%). Responding technicians (n = 72) were predominantly women (80%) with no postsecondary degree (90%) and fewer than 10 years (68%) in practice. Pharmacists in ADS pharmacies who responded to the work activities questionnaire (n = 50) reported equivalent mean hours spent in patient care activities and filling medication orders compared with non-ADS pharmacists (n = 33; P > 0.05). Similarly, technicians in ADS pharmacies who responded to the work activities questionnaire (n = 64) reported equivalent mean hours spent in filling medication orders compared with non-ADS technicians (n = 38; P > 0.05). An equivalent proportion of ADS pharmacists reported satisfaction with their current job compared with non-ADS pharmacies (P > 0.05). Mean productivity did not increase appreciably after automation (P >0.05).

CONCLUSION

By itself, installing an ADS does not appear to shift pharmacist work activities from dispensing to patient counseling or to increase job satisfaction. Shifting pharmacist work activities from dispensing to counseling and monitoring drug therapy outcomes may be warranted in ADS pharmacies.

Application of Rasch rating scale model to analysis of job satisfaction among practicing pharmacists

OBJECTIVE

To demonstrate the application of Rasch analysis in the study of job satisfaction among practicing pharmacists.

DESIGN

Cross-sectional survey study.

SETTING

Community independent, community chain, hospital, and other pharmacies in the United States in fall 2005.

PARTICIPANTS

790 practicing pharmacists.

INTERVENTION

Mailed survey based on past studies of job satisfaction.

MAIN OUTCOME MEASURE

Job satisfaction as measured using the Rasch rating scale model (which considers responses on Likert scales as categorical data) and traditional estimation techniques (which assume a continuum among responses on these scales by analyzing data as interval).

RESULTS

A gain in precision for the Rasch technique was observed for the constructs distributive justice, job autonomy, job ambiguity, role conflict, positive affectivity, job resources, and supervisory support. No gain in precision was found for the constructs negative affectivity and work involvement. Traditional estimates offered more precision for the constructs job repetition, promotional opportunity, and workload.

CONCLUSION

Compared with traditional estimates, Rasch estimates provided more precise scores of job satisfaction on certain subscales, especially those whose mean scores were large or responses more diverse.

Pharmacists’ Attitudes Toward Worklife: Results From a National Survey of Pharmacists

OBJECTIVES

To provide a current profile of pharmacists' attitudes toward worklife and determine how demographic, family, and practice variables influence work attitudes.

DESIGN

Cross-sectional descriptive survey.

SETTING

Nationwide sample of licensed pharmacists in the United States.

PARTICIPANTS

1,737 actively practicing pharmacists.

INTERVENTIONS

Mailed survey.

MAIN OUTCOME MEASURES

Previously validated rating scales were used to measure job satisfaction, job stress, work-home conflict, role overload, role ambiguity, and role conflict. Family variables included the number and age(s) of children and marital status; demographic variables included age, gender, race, years of experience, region, and degree; practice variables included setting, position, work status, and work activities.

RESULTS

Although 67.2% of pharmacists were satisfied with their job, more than 68% experienced job stress and role overload, and 48% experienced work-home conflict. The levels of role ambiguity, role conflict, and job stress were significantly higher in chain, mass merchandiser, and hospital settings relative to independent settings. Wanting to spend more time in consultation was most positively associated with role ambiguity, role overload, and role conflict and most negatively associated with job satisfaction. Gender, race, years of experience, marital status, and children also affected work attitudes.

CONCLUSION

Those interested in the quality of worklife of pharmacists need to develop and implement realistic methods to decrease the role stress that pharmacists continue to face. Unless role stress of pharmacists is lessened, the profession may be endangering not only the physical and mental health of its current and future practitioners, but possibly compromising patient safety as well.

Impact of a Pharmacist-Implemented Anemia Management in Outpatients with End-Stage Renal Disease in Japan

Given the absence of standard guidelines for use of recombinant human erythropoietin in patients with end-stage renal disease in Japan, in the present study, pharmacists actively managed the erythropoietin therapy, and the therapeutic and pharmacoeconomic outcome was evaluated. We compiled in-hospital guidelines for proper use of erythropoietin for outpatients with renal anemia under hemodialysis, and made recommendations, particularly about changes in the doses of erythropoietin and administration of iron preparations, to physicians. The clinical test values and the dosages of erythropoietin were monitored for 9 months and analyzed. As results of our participation, the number of renal anemia patients with over 30% of the hematocrit value as a therapeutic target increased from 7 to 32 among 41 patients. Twenty three of the 41 patients could decrease the dose of erythropoietin, and 5 patients could cease receiving the drug. Monthly total units of erythropoietin used for the 41 patients could also be decreased from 915000 units to 642000 units, resulting in considerable improvement of cost performance. Thus, active participation of pharmacists in management of renal anemia had great therapeutic and pharmacoecomic impact in Japan, as in North America.

Pharmacists' attitudes regarding quality of worklife

OBJECTIVE

To examine the quality of worklife of pharmacists across practice environments.

DESIGN

Written survey mailed to a stratified random sample of pharmacists.

PARTICIPANTS

2,014 pharmacist-members of the American Pharmaceutical Association (APhA) residing in the United States.

MAIN OUTCOME MEASURES

Work-related attitudes including job satisfaction, career satisfaction, organizational commitment, turnover intention, likelihood of voting for a union, and patient care issues.

RESULTS

Usable surveys were returned by 1,199 practicing APhA members (60% response rate). Overall, work-related attitudes were generally positive. However, clear differences were identified in quality-of-worklife perceptions associated with practice setting, area of primary responsibility, and several demographic variables. Some quality-of-worklife concerns were found in all practice settings. While a majority of respondents indicated that they would not vote for a union at their place of employment if given the opportunity, 43% of staff employee pharmacists (who would likely be targeted in any union campaign) indicated that they would definitely or probably vote for a union.

CONCLUSION

From the pharmacist's perspective, important quality-of-worklife issues include job and career satisfaction, turnover intention, and patient care concerns. The data provide a point of departure for future dialogue, action, and research aimed at understanding and enhancing the quality of pharmacists' worklife.