| 1. |
- Carlsson, Jenny Rubensdotter, et al.
(författare)
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Drug experts of the future, today? : Depiction of the pharmacist profession in Swedish professional and lay print media
- 2012
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Ingår i: Research in Social and Administrative Pharmacy. - : Elsevier BV. - 1551-7411 .- 1934-8150. ; 8:2, s. 133-144
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Tidskriftsartikel (refereegranskat)abstract
- Background: The Swedish pharmacy market is presently being reregulated. The state-owned pharmacy monopoly company was divided and sold during 2009, and certain nonprescription medicines are now allowed in nonpharmacy settings. The changes will likely affect the pharmacist's role and the image of the community pharmacist in society. This change may affect how pharmacists are seen by society at large, and therefore, a baseline showing how pharmacists are depicted before the reregulation is of great value. Objectives: The aim of this study was to describe how the pharmacist profession is depicted in print media in Sweden, with a focus on community pharmacy. Methods: A deductive qualitative content analysis with material from print media was conducted, using professional criteria as a framework. Swedish print media from October 2005 to October 2008 were searched and all relevant articles included. Results: A total of 139 articles were included. Most articles came from professional journals, that is, journals directed toward pharmacist or related professions. The results show that the pharmacist profession is not highly visible and that this lack of visibility is disappointing to pharmacists. Conclusions: Society, as reflected in print media, does not display an awareness of the pharmacist role in Sweden. Although this is disappointing for the profession, it allows pharmacists to influence the depiction and hence their position in society.
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| 2. |
- Frisk, Pia, et al.
(författare)
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Selection bias in pharmacy-based patient surveys
- 2014
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Ingår i: Pharmacoepidemiology and Drug Safety. - : Wiley. - 1053-8569 .- 1099-1557. ; 23:2, s. 128-139
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Tidskriftsartikel (refereegranskat)abstract
- PurposeTo evaluate if there is a selection bias in drug utilization surveys on prescription drugs regularly conducted in Swedish pharmacies, to describe the direction of this potential bias and discuss the implications for the results. MethodsAge and gender distributions within patient survey samples from drug utilization surveys conducted during 2006-2010 are compared to the age and gender distribution of all Swedish patients, receiving the same drug or drugs, as given by the Swedish Prescribed Drug Register. The differences between the proportions of patients within the age and gender segments of each pair of survey/register data were calculated. ResultsIn 25 (81%) out of 31 included surveys, patients aged 75 years or older are significantly underrepresented, as they are less likely to visit the pharmacy to collect their prescription drugs themselves and thus disqualify for the interviews. Data on women show similar results as overall survey data, whereas the underrepresentation of the oldest age group among men appears in a lower proportion of the surveys, 67%. The general consequence is a selection towards a healthier survey sample, but the consequences in the individual surveys vary, depending on what drug is being studied. ConclusionPharmacy-based patient surveys provide a convenient data collection method for patient self-reported data, but patients aged 75 years or older are consistently underrepresented. In surveys where this may influence the main research question, data should also be collected with other methods reaching the oldest patients.
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| 3. |
- Granas, Anne Gerd, et al.
(författare)
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Lost in translation? : Comparing three Scandinavian translations of the Beliefs about Medicines Questionnaire.
- 2014
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Ingår i: Patient Education and Counseling. - : Elsevier BV. - 0738-3991 .- 1873-5134. ; 96:2, s. 216-21
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: The "Beliefs about Medicines Questionnaire" (BMQ) assess balance of necessity and concern of medicines. The BMQ has been translated from English to many languages. However, the original meaning of statements, such as "My medicine is a mystery to me", may be lost in translation. The aim of this study is to compare three Scandinavian translations of the BMQ. (1) How reliable are the translations? (2) Are they still valid after translation?METHODS: Translated Norwegian, Swedish and Danish versions of the BMQ were scrutinized by three native Scandinavian researchers. Linguistic differences and ambiguities in the 5-point Likert scale and the BMQ statements were compared.RESULTS: In the Scandinavian translations, the Likert scale expanded beyond the original version at one endpoint (Swedish) or both endpoints (Danish). In the BMQ statements, discrepancies ranged from smaller inaccuracies toward completely different meaning. Some dissimilarities reflect different cultural beliefs about medicines.CONCLUSION: When translating questionnaires, bilingual researchers should scrutinize translations across similar languages to address content validity across different countries and languages.PRACTICE IMPLICATIONS: Our findings are of relevance to other BMQ translations in non-English countries, as direct comparisons between different translations might not be reliable or valid.
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| 4. |
- Hammar, Tora, 1984-
(författare)
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eMedication – improving medication management using information technology
- 2014
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Medication is an essential part of health care and enables the prevention andtreatment of many conditions. However, medication errors and drug-relatedproblems (DRP) are frequent and cause suffering for patients and substantial costsfor society. eMedication, defined as information technology (IT) in themedication management process, has the potential to increase quality, efficiencyand safety but can also cause new problems and risks.In this thesis, we have studied the employment of IT in different steps of themedication management process with a focus on the user's perspective. Sweden isone of the leading countries when it comes to ePrescribing, i.e. prescriptionstransferred and stored electronically. We found that ePrescribing is well acceptedand appreciated by pharmacists (Study I) and patients (Study II), but that therewas a need for improvement in several aspects. When the pharmacy market inSweden was re-regulated, four new dispensing systems were developed andimplemented. Soon after the implementation, we found weaknesses related toreliability, functionality, and usability, which could affect patient safety (StudyIII). In the last decade, several county councils in Sweden have implementedshared medication lists within the respective region. We found that physiciansperceived that a regionally shared medication list generally was more complete butoften not accurate (Study IV). Electronic expert support (EES) is a decisionsupport system which analyses patients´ electronically-stored prescriptions in orderto detect potential DRP, i.e. drug-drug interactions, therapy duplication, highdose, and inappropriate drugs for geriatric or pediatric patients. We found thatEES detected potential DRP in most patients with multi-dose drug dispensing inSweden (Study V), and that the majority of alerts were regarded as clinicallyrelevant (Study VI).For an improved eMedication, we need a holistic approach that combinestechnology, users, and organization in implementation and evaluation. The thesissuggests a need for improved sharing of information and support for decisionmaking, coordination, and education, as well as clarification of responsibilitiesamong involved actors in order to employ appropriate IT. We suggestcollaborative strategic work and that the relevant authorities establish guidelinesand requirements for IT in the medication management process.
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| 5. |
- Kälvemark Sporrong, Sofia, et al.
(författare)
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Trends in pharmacy staff's perception of patient safety in Swedish community pharmacies after re-regulation of conditions.
- 2014
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Ingår i: Pharmacy Practice. - : SciELO Espana/Repisalud. - 1885-642X .- 1886-3655. ; 12:4, s. 502-
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: All changes in the regulation of pharmacies have an impact on the work carried out in pharmacies and also on patient safety, regardless of whether this is the intention or not.OBJECTIVE: To compare staff apprehension regarding some aspects of patient safety and quality in community pharmacies prior to and after the 2009 changes in regulation of the Swedish community pharmacy market.METHODS: Questionnaires targeted at pharmacy staff before and after the changes in regulation (in 2008, 2011/12, and 2012/13 respectively) used four identical items, making comparisons of some aspects possible.RESULTS: All four items demonstrated a significant decrease in the first survey after the changes as compared to before. In the second survey significant differences were found on the two items representing safety climate whereas the items representing team climate and management showed no significant differences.CONCLUSIONS: The comparison carried out in this study indicates a negative effect in Swedish community pharmacies on safety and quality issues, as experienced by pharmacy staff. It is recommended that the possible effects of healthcare reforms are assessed before implementation, in order to counteract conceivable decline in factors including patient safety and working conditions.
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| 6. |
- Masterton, Malin, 1979-, et al.
(författare)
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Ethical Review Boards are poor advocates for patient perspectives
- 2014
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Ingår i: Research Ethics. - : SAGE Publications. - 1747-0161 .- 2047-6094. ; 10:3, s. 169-181
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Tidskriftsartikel (refereegranskat)abstract
- In medical research, patients are increasingly recognized with ‘lay knowledge’ but their views are poorly researched. The study objective was to investigate patients’ attitudes to medical research. This is in comparison to lay and expert members on ethical review boards (ERB), as their task is to evaluate the risk−benefits of research, which are ultimately grounded in attitudes and values. From focus-group interviews with patients suffering from chronic inflammatory diseases, a postal questionnaire was developed and sent to patient members of the Swedish Rheumatism Association (n = 1195) and to all ERB board members in Sweden (N = 583). Response rates were 65 percent and the surveys were conducted in Jan−May 2011. Agreement across the groups included priority for medical research on diagnostic and early detection of disease. A key difference was expert and lay ERB members giving higher priority to basic research/research on lifestyle and prevention (primarily benefiting future patients), whereas patients prioritized research on daily function. On this significant point, lay members did not share the opinion of this patient group, indicating that they may be poor representatives for patients’ views. These results call for further research: how can patient perspectives be included in ERB discussions and in what way should patients’ values influence the research agenda.
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| 7. |
- Masterton, Malin, 1979-, et al.
(författare)
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Patients’ attitudes towards animal testing : “To conduct research on animals is, I suppose, a necessary evil”
- 2014
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Ingår i: BioSocieties. - : Springer Science and Business Media LLC. - 1745-8552 .- 1745-8560. ; 9:1, s. 24-41
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Tidskriftsartikel (refereegranskat)abstract
- A strong argument for the practice of animal testing in medical research is the potential benefit to patients in getting improved pain relief, minimising morbidity and mortality. However, patients’ opinions on the ethics of animal testing are seldom sought, despite their role as principal stakeholders. This study compared the attitudes of patients and researchers on animal testing. Focus-group interviews were held with patients suffering from chronic inflammatory diseases, resulting in a questionnaire that was distributed January–May 2011. The questionnaire was posted to patient members of the Swedish Rheumatism Association (n=1195) and to all scientific experts serving on Ethical Review Boards in Sweden (n=364), with response rates of 65 per cent and 60 per cent, respectively. Results show that patients hold a positive stance towards animal testing, but with many caveats, and the level of support is comparable to those held by the general public found in national surveys. A clear majority of researchers were positive towards animal testing, and large statistical differences between patients and researchers were found regarding their attitudes towards testing animals commonly held as pets (P<0.001). Women were more critical than men regarding which species are used for what purposes (P<0.001). Researchers need to be aware that their more positive attitude towards animal testing is not shared to an equal degree with patients, who are the intended end-users and beneficiaries of medical research. The moral basis for using animals in research needs to be further discussed by all stakeholders.
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| 8. |
- Montgomery, Anna, 1974-, et al.
(författare)
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Receiving a pharmaceutical care service compared to receiving standard pharmacy service : How do patients in Sweden differ with regard to perceptions of medicine use and the pharmacy encounter?
- 2010
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Ingår i: Research in Social and Administrative Pharmacy. - Pittsburgh : ELSEVIER. - 1551-7411 .- 1934-8150. ; 6:3, s. 185-195
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Tidskriftsartikel (refereegranskat)abstract
- Background: Qualitative research has shown that gaining control of medicine treatment, increased feelings of safety and empowerment are central concepts in patients’ perceptions of a pharmaceutical care (PC) service provided in Sweden. However, little is known about the relationship between patient-perceived outcomes and the level of community pharmacy services that they receive. Objective: To describe and compare patients who had previously received a PC service and patients who had received a standard pharmacy service (SS) with regard to their perceptions of medicine use and the pharmacy encounter. Methods: Cross-sectional survey design comparing matched groups of patients who were previously selected to receive a PC service or who had received a standard service. Patients who were 60 years or older and used 5 or more prescription medicines concomitantly were included in the survey. Questionnaires included questions about feelings of safety in drug therapy, general health, drug-related problems (DRPs), medication beliefs, adherence and experiences of pharmacy encounters. Results: Patients receiving the PC service used more prescription medicines, had poorer self-reported health, and felt less safety in their medicine therapy, than did patients in SS. PC patients reported that they felt safer with medications, felt a genuine interest from the pharmacist, received important information, and felt more prepared to see the doctor after having spoken to the pharmacist, than did patients in SS. DRPs reported to a greater extent by patients receiving the PC service included difficulties opening containers, worries about side effects, experiences of side effects, worries about drug-drug interaction and inadequate treatment effects. Adherence and medication beliefs showed no statistical difference between groups. Conclusion: Patients receiving a PC service are a worried, vulnerable and information seeking group. In comparison to patients receiving SS, the PC patients are more insecure about their medicine therapy, although talking to a pharmacist increased their self-reported feelings of safety and provided better preparation for visits to the doctor.
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| 9. |
- Montgomery, Anna T., et al.
(författare)
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Counselling behaviour and content in a pharmaceutical care service in Swedish community pharmacies
- 2010
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Ingår i: Pharmacy World & Science. - : Springer Science and Business Media LLC. - 0928-1231 .- 1573-739X. ; 32:4, s. 455-463
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Tidskriftsartikel (refereegranskat)abstract
- Objective To characterise the counselling behaviour of practitioners providing a pharmaceutical care (PC) service in community pharmacy, and to describe the content of the consultations. Setting Community pharmacies in Sweden. Methods Non-participant observations, including audio recording, of five practitioners in five different pharmacies counselling 16 patients, were analysed qualitatively using an iterative, stepwise, interpretivist approach. Main outcome measure Descriptions of counselling behaviour and content of consultations. Results The counselling behaviour was characterised by attempts to understand the patients' narratives by listening and asking questions and a willingness to help. The computer often had an important role in consultations, being used for documentation and as a supportive tool for identification of drug-drug interactions. The practitioners often took command in the initial phase of the consultation, and omitted to determine the patients' most urgent drug-related needs. However, counselling behaviour that identified and focused on the patient's needs, giving the computer little attention during the consultation was also observed. Practitioners provided vague descriptions of the purpose and outline of the service. Consultations included a wide variety of issues, which potentially could help patients' achieve optimal outcomes of medical treatment. Conclusion The practitioners provided important advice and different forms of support to patients. Focus on the computer screen limited their abilities to practise patient centred care.
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| 10. |
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