Qualitative Methods in Pharmacy Research

Generic Substitutions and Therapeutic Interchanges in Hospital Pharmacies: A Qualitative Study from Western Saudi Arabia

Background: The aim of the present study was to understand hospital pharmacists' views and practices regarding generic substitution and therapeutic interchange. Method: This was a qualitative study involving pharmacists from three Western Saudi governorates: Taif, Makkah, and Jeddah. It included respondents from the Ministry of Health (MoH), military and private hospitals. Pharmacists were selected using a convenient sampling technique and data were collected using a structured face-to-face interview. Results: Fifty-seven pharmacists agreed to participate in this study. In MoH and private hospitals, generic substitution is a pharmacist-initiated act, while therapeutic interchange requires physician approval. Medication unavailability, side effects, patient characteristics, outcomes, and economic status justified most substitution decisions. In military hospitals, both types of substitutions are controlled by an auto-switch policy and physicians should be informed. In all hospitals, there are policies regulating substitution. Medications eligible for interchange mentioned by pharmacists from different hospitals were comparable to some extent. Pharmacists from the private sector considered substitution a supportive economic measure for both hospitals and patients. Most pharmacists highlighted that patient convenience and physician approval are the most challenging situations in substitution practice. Conclusions: An enhanced understanding of substitution and knowledge about medications included in the hospital formulary will be valuable support to the implementation of substitution practice which responds to the patients' needs to improve their outcomes.

A Twitter analysis of World Pharmacists Day 2020 images: Sending the wrong messages

Background

Pharmacists are often depicted as dispensers of medication as opposed to health professionals who provide patient care. Our objective was to identify how pharmacists' roles were portrayed in images on Twitter for World Pharmacists Day (WPD) 2020.

Methods

A qualitative content analysis was undertaken to evaluate the images of pharmacists on WPD. Tweets were included that had a photo or image, used 1 of 5 WPD hashtags and were posted between September 24 and 26, 2020. Thematic analysis was performed independently by 2 investigators. Tweets were categorized into 5 groups: 1) drug distribution roles, 2) patient care roles, 3) no described roles, 4) not professional/unprofessional roles and 5) not relevant. Subgroup analysis was performed for the users who posted the tweets.

Results

Of the 970 tweets analyzed, only 11% of the overall tweets portrayed the patient care roles of pharmacists, whereas 51% portrayed drug distribution roles and 29% did not describe any particular roles of pharmacists. These proportions were similar between subgroups of tweeters.

Discussion

WPD is intended to promote and advocate for the pharmacy profession. The results of our study show poor messaging of pharmacists' roles and reflect a missed opportunity to showcase the full scope of pharmacy practice.

Conclusion

Based on the images tweeted on WPD 2020, the diversity of pharmacists' practice as skilled health care practitioners was lost in a sea of tweets portraying pharmacists' roles in drug distribution. We hope that pharmacists and pharmacy organizations will awaken to this self-induced problem for WPD 2021. Can Pharm J (Ott) 2021;154(5):xx-xx.

Ensuring quality qualitative research reporting in community pharmacy: a systematic literature review

OBJECTIVES

To evaluate the reporting quality for a sample of community pharmacy qualitative research articles based on the Standards for Reporting Qualitative Research (SRQR) guidelines, data interpretation and use of theory.

METHODS

A systematic literature search was conducted using Ovid MEDLINE to identify qualitative research related to community pharmacy. Data were extracted and evaluated based on the SRQR standards, data interpretation level and use of theory. Adherence to standards was analysed using descriptive statistics.

KEY FINDINGS

Eighty-one studies were retrieved through the database search (n = 81). Then, 31 studies met the inclusion criteria after screening abstracts and full texts. Twelve out of 21 SRQR were present in more than 80% of the studies. However, essential standards, such as research approach, reflexivity and trustworthiness techniques, were absent or partially present in 30 (97%) studies, 30 (97%) studies and 21 (68%) studies, respectively. Data interpretation level was descriptive in 27 (87%) studies and interpretive or partially interpretive in 4 (13%) studies. Theory was absent in 19 (60%) and implied, partially integrated or retrospectively applied in 12 (40%) of the studies.

CONCLUSION

Trustworthiness and quality of qualitative inferences within community pharmacy research could be enhanced with increasing awareness about reporting; the approach and paradigm, reflexivity, trustworthiness techniques, data interpretation level and theoretical use.

The relational dimensions of pharmaceutical care: Experience from caring for HIV-infected asylum seekers in Montréal

By describing the experience from dispensing antiretroviral drugs to asylum seekers infected with HIV in Montreal we argue for the relational dimensions of pharmaceutical care. Between 2010 and 2016, the Government of Canada changed the medical coverage for refugees and asylum seekers, leading to some uncertainty about what types of care were reimbursable for each migrant status. In Quebec, despite the compensatory coverage provided by the provincial medical insurance board (Régie d'assurance maladie du Québec, or RAMQ), this uncertainty led to a breakdown in patient followup in some establishments. The McGill University Health Centre's Chronic Viral Illness Service (CVIS) was nevertheless able to maintain continuity of care for refugees and asylum seekers living with HIV. This article looks more specifically at the pharmaceutical care provided during this period and, more particularly, at the convergence of the technical and relational dimensions. The methodology used was a qualitative case study, which made it possible to explore pharmaceutical care, by conducting qualitative interviews (n = 16). Semistructured interviews were conducted with patients and various professionals from the CVIS, including pharmacists. The cultural, administrative, and political dimensions of pharmaceutical care described here appear very important for overall patient care. Further reflection on the importance of relational dimensions of pharmaceutical care and the place and value of pharmaceutical care in the advancement of patient care is required.