Professor Kath Ryan retired from the department in the summer after being in the school for four years. She has been a valuable member of staff within pharmacy practice in her role as Professor of Social Pharmacy. During her time in Reading, she made significant impact through her multiple research interests and through her supervision of numerous PhD, MSc and undergraduate pharmacy students. She provided a wealth of research experience and her support and guidance has been greatly valued by her colleagues and students. Following her retirement, Kath will be involved in the development of the pharmacy curriculum in Kenya which demonstrates her commitment and expert contribution to pharmacy practice. We wish her the best for all her future endeavors.
Catherine Langran, Kat Hall and Dan Grant presented their work at the 10th Biennial Monash Pharmacy Education Symposium in Prato, Italy, 7-10th July.
Catherine Langran gave an oral presentation entitled “An Evaluation of Pharmacy Undergraduate Student Wellbeing”
Authors: Catherine Langran, Pari Ajgaonkar, Mona Qassim & Alicia Pena
Congratulations to Catherine, who was awarded first prize for the best talk on Education Research at the conference.
Dan Grant presented a poster snapshot on “Peer Assisted Learning – a learning opportunity and a life hack?”
Authors: Rosemary Lim, Caroline Crolla, Daniel Grant, Taniya Sharmeen & Wing Man Lau.
Kat Hall presented a poster snapshot on “An Evaluation of a certificate in business administration (CBS) programme for Mpharm students”
Authors: Kat Hall, Catherine Langran & Gavin Lawrence
Community pharmacist led medication reviews in the UK: A scoping review of the medicines use review and the new medicine services literatures
1Duncan Stewart, 2Cate Whittlesea, 3Ranjita Dhittal, 1Louise Newbould, 1Jim McCambridge
1. Department of Health Sciences, ARRC Building, University of York, Heslington, York, YO10 5DD, UK
2. School of Pharmacy, University College London, 29-39 Brunswick Square, London, WC1N 1AX, UK
3. School of Pharmacy, University of Reading, Harry Nursten Building, PO Box 226, Whiteknights, Reading, Berkshire, RG6 6AP, UK
Medicines Use Reviews (MURs) and the New Medicine Service (NMS) are services delivered by UK community pharmacists to improve adherence, improve patient understanding of their medicines and reduce medicines wastage.
In this scoping review we aim to identify, map and critically examine the nature of existing empirical evidence in peer reviewed journals relating to MUR and NMS consultations.
Systematic searches identified the available MUR and NMS empirical literature. We sought data on barriers and facilitators to conducting MUR or NMS consultations, the perceptions of pharmacists and patients, the conduct of consultations, and outcomes of consultations. Searches from 2005 (when MURs were introduced) to May 2018 were conducted in MEDLINE, PsycINFO, Embase and Scopus databases. Data were extracted into Excel for examination of study characteristics, participant characteristics, type of intervention/services delivered and key study quantitative and/or qualitative findings.
Forty-one papers from 37 studies met the inclusion criteria: 28 papers were of MURs, 10 of NMS and 3 for both services. Studies focused on the introduction and implementation of these services, with little attention to outcomes for patients; effectiveness was not evaluated beyond in a single NMS RCT. Observational data indicated that pharmacists and patients view MURs and the NMS positively, despite challenges implementing these services and apparent lack of communication between pharmacists and GPs. Consultations were reported to be short, typically 10–12 min, characterised by limited engagement with patients and their health problems. The extent and nature of advice on health behaviours during consultations or other content was rarely examined.
The research literature on MURs and the NMS has developed slowly. There is much scope for further research attention to developing more patient-centred care.
Professor Parastou Donyai, Dr. Nilesh Patel and Dr. Nicola Stoner
Reading School of Pharmacy, University of Reading, Reading, RG6 6UB. UK
Background: Depending on the researchers’ epistemological position, meta-syntheses of qualitative studies have used different approaches that include grounded theory synthesis. Numerous stand-alone qualitative studies have examined non-adherence to long-term hormonal treatment in breast cancer but no qualitative synthesis on this topic existed.
Objective: To theorise about why and how women experience non-adherence to hormonal treatment in breast cancer using published qualitative reports.
Methods: Qualitative reports were retrieved using 10 databases that included PubMed, CINAHL and PsycINFO. Primary reports written in English that encompassed qualitative descriptions of women’s non-adherence to hormonal therapy in the management of breast cancer were included. In total 21 articles published 2010-2018 were included. A first order interpretation of quotes (n= 767) in these publications was first completed and then compared against the original authors’ analyses. Quotations and interpretations were reinterpreted in NVivo using open, axial and selective coding to develop new categories. Causal conditions, actions/interactions, consequences and mediating factors were then identified for each of three emerging categories using the paradigm model.
Results: Three main categories were identified describing the 1) initial consideration of hormone therapy; 2) adhering to prescribed treatment; and 3) stopping hormone therapy. The core category explored whether and where the patient’s decision to take the medication was akin to Hobson’s choice or a horned dilemma. Hobson’s choice describes a situation where only one real viable option is offered, and encapsulates the decision
faced by many at the start of the treatment. A horned dilemma in contrast is facing two equally bad options and relates to later experiences of having to tolerate medication side effects or stop the treatment and risk losing the prophylactic cover afforded by the
Discussion: It was possible to uncover a world of collectively shared experiences and understandings in this area by examining commonalities in existing published papers. The core category explained the difficulties women face with the initial decision to accept long term hormonal treatment and then the everyday challenge of continuing with the treatment or stopping it prematurely.
Dr Rosemary Lim1, Professor Kath Ryan1 and Dr Clare Crowley2
1 Reading School of Pharmacy, University of Reading, Reading, RG6 6UB. UK
2 Oxford University Hospitals NHS Foundation Trust, Oxford, OX3 9DU, UK
Introduction: To achieve optimal blood glucose levels, intravenous (IV) insulin infusion is considered the treatment of choice for critically ill patients and non-critically ill patients who are unable to eat. An emerging approach to safety, called Resilient Health Care (RHC), proposes that it is necessary to understand in depth the variability in healthcare practitioners’ performance to help transition to a more adaptive organisation which is able to withstand every day clinical work changes and keep focus on how work can be performed successfully as well as how work has failed. This study will focus on one aspect of RHC, understanding how healthcare practitioners imagine work is performed.
Aim: To explore and understand how healthcare practitioners use IV insulin infusions based on their knowledge of related guidelines.
Methods: An analysis of eleven IV insulin infusion guidelines used at the Oxford University Hospitals NHS Foundation Trust was conducted. An inductive thematic analysis was used to analyse the content of the documents and a Hierarchical Task Analysis (HTA) was used to represent the use of IV insulin infusion in a hierarchy of goals, sub-goals, operations and plans. HTA was a way for describing the function of the goals
and activities described in the guidelines.
Results: Eight themes were identified: perform hand hygiene, identify patient, identify problem, prescribe, prepare, administer, monitor, and stop. Although the documents provided details of specific processes there were some contradictions, anomalies and lack of information. In the HTA, the top level goal is to control blood glucose in hospitalised patients using IV insulin infusion. The themes identified in the thematic analysis became the sub-goals in the HTA. For each of these sub-goals, plan(s) for operationalising them was identified. Subsequent levels in the HTA were further broken down into operations/sub goals at the lower levels and were described in terms of measurable performance
Conclusion: A HTA was developed that showed a framework for analysing the use of IV insulin infusion. The output of the HTA was extremely useful and forms the input for the process of understanding RHC. Further research will explore how variables other than the guidelines might affect the control of blood glucose using IV insulin infusion.