Issues in Conducting Randomized Controlled Trials of Health Services Research Interventions in Nonacademic Practice Settings: The Case of Retail Pharmacies

Weinberger, Morris; Murray, Michael D.; Marrero, David G.; Brewer, Nancy; Lykens, Michael; Harris, Lisa E.; Newell, A. Jeffrey; Collins, Joyce; Tierney, William M.

doi:10.1034/j.1600-0560.2002.66.x

Cited by 24 publications

(13 citation statements)

References 15 publications

(13 reference statements)

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“…However, many of the factors that facilitate pharmacist provision of effective direct patient care services in inpatient and ambulatory care settings are rarely present in community pharmacy settings. The dispensing process (i.e., filling prescriptions) drives the workflow in most community pharmacies (Weinberger et al, 2002a). Successfully incorporating high-quality clinical services into the dispensing process is challenging.…”

Section: Introductionmentioning

confidence: 99%

The Effect of Community Pharmacy–Based Interventions on Patient Health Outcomes

et al. 2012

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Many studies have demonstrated the beneficial effects that pharmacist-provided patient care services can have on patient health outcomes. However, the effectiveness of patient care services delivered by pharmacists in community pharmacy settings, where organizational barriers may affect service implementation or limit effectiveness, remains unclear. The authors systematically reviewed the literature on the effectiveness of pharmacist-delivered patient care services in community pharmacy settings in the United States. Of the 749 articles retrieved, 21 were eligible for inclusion in the review. Information concerning 134 outcomes was extracted from the included articles. Of these, 50 (37.3%) demonstrated statistically significant, beneficial intervention effects. The percentage of studies reporting favorable findings ranged from 50% for blood pressure to 0% for lipids, safety outcomes, and quality of life. Our findings suggest that evidence supporting the effectiveness of pharmacist-provided direct patient care services delivered in the community pharmacy setting is more limited than in other settings.

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Section: Introductionmentioning

confidence: 99%

The Effect of Community Pharmacy–Based Interventions on Patient Health Outcomes

et al. 2012

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“…13 Studies of emergency contraception undertaken in pharmacies have routinely achieved response rates lower than 10% 10,14-17 and this has similarly been attributed to moral opposition to EHC, time constraints, sensitivity of the issues, and unwillingness to add to the administrative burden.…”

Section: Discussionmentioning

confidence: 99%

Involving pharmacists in sexual health research: experience from an emergency contraception study

Black

Anderson²,

Kubba³

et al. 2009

Journal of Family Planning and Reproductive Health Care

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Background Community pharmacists are expanding their sphere of activity within primary health care, increasing their role not only in health care but also research. Methods and resultsWe describe the challenges encountered in carrying out a pilot study of women obtaining emergency hormonal contraception through different providers, including pharmacies, highlighting deficiencies in understanding and experience of the research process, which impacted on the study in substantial ways. 41 IntroductionPharmacists can make an important contribution to public health by improving access to emergency hormonal contraception (EHC). 1 UK health authorities saw the Crown report's recommendation regarding introduction of patient group directions (PGDs) as an opportunity for community pharmacists to supply EHC free of charge. 2 This was supported by funding from Health Action Zone (HAZ) schemes, set up in areas of deprivation across the UK to address health inequalities, 3,4 which encourage health care providers to find innovative and collaborative ways of increasing health gain. 5 In January 2001, following establishment of the PGD schemes, levonorgestrel EHC (Levonelle ® ) was deregulated to a pharmacy (P) status in the UK and became available in all community pharmacies. The PGD services provided EHC free of charge, while other pharmacies charged a fee (£24.99 in 2008). Since deregulation, women have shown increasing preference for pharmacy over clinical provision of EHC. 6 The expansion of pharmacists' roles into sexual health has been accompanied by research to evaluate these developments. Methods used to assess pharmacy EHC supply have included questionnaire surveys, focus groups and mystery shopper studies. 7,8 Some studies have used population-based samples; 9 others have recruited through pharmacists at the point of provision. 10Involving pharmacists in sexual health research: experience from an emergency contraception study In this paper we describe some methodological difficulties encountered in a pilot study investigating women's experience of obtaining EHC through pharmacies and clinical services. We discuss how these difficulties threatened continuation and validity of the research to help mitigate the risk of similar problems impeding future research in this important area. Emergency contraception studyThe methodology of this pilot study is described fully elsewhere. 11 We recruited a cohort of women obtaining EHC through two types of services between 2002 and 2003 in the inner city South London boroughs of Lambeth and Southwark, with the aim of investigating short-term impact within different service models. We asked medical staff and pharmacists to recruit women at the time they presented. Willing volunteers recorded their contact details on an information sheet and were contacted and interviewed 4 months later. Of the five pharmacies taking part in the study, two were involved in the HAZ scheme and three were selling EHC over the counter (attendance was lower at these premises compared to th...

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“…It is well accepted that the characteristics of innovators are different from those of later adopters, 70 and this may further reduce the generalisability of findings. While Weinberger et al have commented on the difficulty of conducting trials of services in the community pharmacy setting, 71 it is clear that to improve the generalisability and applicability of these models, larger and more representative samples need to be used in future research.…”

Section: Discussionmentioning

confidence: 99%

Implementing cognitive services in community pharmacy: a review of models and frameworks for change

Roberts

Benrimoj

Chen

et al. 2006

International Journal of Pharmacy Practice

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Objective To investigate models and frameworks for the implementation of cognitive pharmaceutical services (CPS) in community pharmacy. Method Relevant literature published in English was identified through searches of online databases (no date limits), texts, conference proceedings, and bibliographies of identified literature. Literature that involved a discussion of models or frameworks for community pharmacy practice change in relation to the implementation of CPS was selected for review. Many of the identified studies were conceptual in nature, and although they were selected in the same way as the empirical research papers, were not able to be critically reviewed in an equivalent manner. A narrative, rather than systematic review, was considered more appropriate. Key findings Many of the identified models focused on specific services, seeming to overlook the complexity of the implementation process. Many relied on behavioural theories, with an assumption that changing pharmacists' knowledge, skills or attitude will automatically result in successful change, often ignoring organisational aspects of change. Models that included business aspects remain largely untested, and where testing occurred sample sizes were generally small and populations conveniently or purposively sampled, limiting the generalisability of the findings. Conclusion The factors affecting change are more than just those confined to the individual pharmacist who is providing a service, and the implementation process is more complex, involving a range of organisational factors. Research is needed to identify the key elements of a framework for how new CPS should be implemented and delivered.

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Issues in Conducting Randomized Controlled Trials of Health Services Research Interventions in Nonacademic Practice Settings: The Case of Retail Pharmacies

Cited by 24 publications

References 15 publications

The Effect of Community Pharmacy–Based Interventions on Patient Health Outcomes

The Effect of Community Pharmacy–Based Interventions on Patient Health Outcomes

Involving pharmacists in sexual health research: experience from an emergency contraception study

Implementing cognitive services in community pharmacy: a review of models and frameworks for change

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