Overcoming our nature and nurture

Abstract

C P J / R P C • j a n u a r y / f e b r u a r y 2 0 1 7 EDITORIAL Editorial 682438C PHXXX10.1177/1715163516682438C P J / R P CC P J / R P C research-article2016Overcoming our nature and nurtureIn our last editorial, 1 we discussed whether it is the personality traits of pharmacists (i.e., we attract the wrong type of people into pharmacy), their professional culture and working environment (i.e., we put them in a culture that is not conducive to new models of patient care) or some combination of these factors that is holding back the advancement of our profession. Ultimately, we cannot point to one culprit for why the available patient care opportunities have not been more widely adopted. More research into this area is certainly warranted. However, in the meantime, every day those in academic pharmacy work with pharmacists and student pharmacists who need solutions for how to move the profession forward now. They need to know how to deal with our suboptimal culture and work environment. We would like to propose 2 targeted approaches for working with both pharmacists and pharmacy students to help move the profession forward. Use the concepts of knowledge translationAccording to the Canadian Institutes of Health Research, knowledge translation (KT) is the process of the application of knowledge to "provide more effective health services and products, and strengthen the health care system. " 2 More practically, KT is "ensuring that stakeholders are aware of and use research evidence to inform their health and health care decision-making. KT research and principles can help to bridge those gaps more effectively and sustainably. For example, a recent study evaluated the ability of a variety of printed educational materials to affect the number of thiazides prescribed to patients newly diagnosed with hypertension. 4 After examining the prescribing habits of 4504 physicians, who were caring for more than 23,500 patients, no difference in thiazide prescribing was detected between those physicians receiving no education material, those receiving an insert (a short article in a newsletter), those receiving an outsert (a postcard-sized card with a targeted educational message) and those receiving both the insert and outsert. 3 We need to move past the relatively simplistic assumption that education is enough to bridge the gap between research and practice. Another recent study evaluated the successful implementation of the Accelerated Chest pain Risk Evaluation (ACRE) tool in emergency departments using the Theoretical Domains Framework.5 This study concluded, based on the responses of stakeholders, that it is likely that all domains of the framework, including intentions, knowledge and optimism, were important in the successful implementation of this risk assessment tool. 5 Without the application of this framework, obtaining an understanding of why the implementation was successful would have been impossible. By obtaining this knowledge, it is now possible to develop a theoretically based project to test empirically the...

General Practice Clinical Pharmacist Standards of Practice for Delivery of Polypharmacy and Chronic Disease Medication Reviews: A Consensus Study.

“…Research from America, Canada and the UK suggests there are several factors affecting pharmacist's ability to take on new responsibilities such as independent prescribing in particular (in the UK) and integrating new roles of pharmacists into multidisciplinary teams [49][50][51][52][53][54]. These are lack of con dence due to lack of clear role de nition and lack of peer and management/ structure support and/ or integration into multi-disciplinary team.…”

The last 10 years of pharmacy practice, as told through CPJ editorials

“…Barriers to a full scope of practice 9,10,11,24,25,27,37,41,43,54,55,57,59 : This has been a favourite topic, because many of the barriers are self-induced. Someone has to talk about them openly if we are to change things.…”

“…Meagen Rosenthal and Zubin Austin on barriers to practice change—our nature vs nurture. 24,25 We also review the tension between employers and pharmacists with regards to patient care and staffing, 27,57 a leadership crisis in pharmacy, 37 poor professional identity, 41,59 remuneration, 43 our images shared on social media that show drug distribution rather than images of patient care 54 and stigma. 55…”

“…We suggest a lot of new areas for care that need pharmacists: hypertension, 2,28,43,47 services to the elderly, 8 diabetes, 13 natural disasters, 22,45 vaccine hesitancy, 51 HPV 52 and the need for better follow-up by pharmacists. 32 • Barriers to a full scope of practice 9,10,11,24,25,27,37,41,43,54,55,57,59 :…”