As last year, The Pharmaceutical Journal is publishing the practice research supplement to coincide with its coverage of the British Pharmaceutical Conference. The supplement contains a complete reprint of all the practice research submissions and the following short review provides a taster of the work that was presented
The Pharmaceutical Journal's "fly on the wall" is pleased to report that Cardiff's International Arena provided a splendid venue for this year's practice research sessions. The Welsh capital broke all records by hosting a total of 90 professional practice research papers, 50 per cent up on last year. Like last year, papers were presented as posters, oral presentations and within a "discussion forum".
The pages that follow provide a taster of the work that was presented. They are but a snapshot of the overall high quality of the submissions.
No distinction is made between posters and oral presentations in these columns, and readers would perhaps find it useful to read this article in conjunction with the PJ supplement. However, an attempt has been made to group the papers loosely using sub-headings. Supplement page numbers are given in parenthesis.
Each year, the BPC provides a forum for sharing information on pharmacy service developments and new roles. This year, Lau, from the Welsh Centre for Postgraduate Pharmaceutical Education, presented a study (R26) where a pharmacist facilitated the audit of one general medical practice's antimicrobial prescribing. This study is timely, given the recent publication of the Standing Medical Advisory Committee (SMAC) report on antimicrobial resistance. Two GP practices were involved in the study. Both employed the same "prescribing pharmacist", who was responsible for developing the practice's formularies and guidelines for treating infections. For the purposes of the study, a local community pharmacist was recruited by one of the practices to participate in formulary development meetings on antibiotic prescribing that were facilitated by the "prescribing pharmacist". The community pharmacist subsequently generated a monthly drug usage report from the pharmacy's computerised patient medication records on antibiotics dispensed by this practice and regularly presented the results at a monthly meeting with the GPs. The effectiveness of the pharmacist's interventions was measured against analysis of the Prescribing Audit Report and Catalogue (PARC) from both practices three months after the pharmacist's interventions and compared with the same three months of the previous year. The study found that the practice which had had the input from the community pharmacist exhibited more rational prescribing in relation to antibiotics, and demonstrated better adherence to the five key areas for change on antibiotic prescribing ("Rules of 5") that both practices had agreed on at the beginning of the study period. Lau provided a number of examples to support the differences observed between the two practices and concluded that the study demonstrated that the drug usage report provided prescribing information to the GPs quickly, and could be used effectively to complete the prescribing audit loop by shortening the lag phase (compared with the PARC data which had a lag time of several months). Although the results from this small study may not be generalisable, they do demonstrate that the community pharmacist has an important role in encouraging change in prescribing behaviour.
In contrast, achieving better control of blood pressure was the endpoint measure of success following an intervention by community pharmacists in the study conducted by Blenkinsopp et al from the department of medicines management at Keele university (R16). A randomised controlled trial, involving 20 community pharmacists and 261 patients from one health authority was conducted to assess the effect of a pharmacist's intervention on patients whose blood pressure was uncontrolled prior to the study. The intervention involved individual question-and-answer sessions between a pharmacist and individual patient and this was repeated three times at approximately two-monthly intervals. Unfortunately, only 100 (50 intervention and 50 control) patients out of the original cohort recruited could be included in the final analysis since only just under 70 per cent of the 43 medical practices involved in the study provided pre- and post-study data on individual blood pressure readings. But even with this setback, the research showed that the community pharmacists' interventions had a significant effect on blood pressure control: almost 80 per cent of intervention patients became controlled compared with just over 45 per cent in the control group. It is heartening to demonstrate conclusively that pharmacists can not only have a positive effect in reducing costs in a practice, as demonstrated in the paper by Lau, but also have a positive effect on clinical indicators and potentially improve patients' health gain.
Needham (Castle Hill hospital) and Wong (University of Bradford) also concluded from their study (R32) that a community pharmacist's intervention can bring positive benefits to patients. Fifteen community pharmacists were recruited to identify the pharmaceutical care problems of cancer patients with a life expectancy of less than 12 months, who were registered with one of the 15 pharmacies. At the end of the recording period, an expert panel reviewed a total of 100 clinical interventions and categorised them according to the likely effect they would have had on the patient, or their appropriateness. The panel agreed that 53 per cent of the interventions would have had a positive effect on patient care, and another 28 per cent were classed as "worthwhile but effected no change". As well as the intervention and the outcome per se, this study raises an interesting question about the benefits that the chronically ill or long-term sick can accrue from being registered with one community pharmacy.
Specialist clinics also provide an outlet for pharmacists to contribute effectively to the pharmaceutical care of patients; they may also be more convenient for patients.
The results of a small study conducted by Hughes (Welsh school of pharmacy), and John and Swithenbank (Neath general hospital), showed that the potential saving on inpatient bed days per annum was around 268 days if patients who had been diagnosed with a deep vein thrombosis could be managed on an outpatient basis in a pharmacist-led DVT clinic (R66). Patients' case notes were reviewed to compare the effectiveness of warfarin initiation by medical staff and pharmacists. It was found that it took longer for those patients who were loaded in the DVT clinical to reach an INR of 2 and above, but they were better controlled during the first 10 days than the sample of inpatients. A patient satisfaction survey was administered to 10 of the 28 patients who were referred to the DVT clinic during the study period; most reported that they were pleased not to have had to stay in hospital for their treatment, and that they were satisfied with the level of information received about their treatment at the outpatient clinic.
In contrast, Arris, from the Robert Gordon university, Aberdeen, and Harrison, a practising GP from Aberdeen, questioned the establishment of pharmacist-managed anticoagulant clinics within primary care (R14). Their study looked at whether a well-managed, general practice-based model, operating without the use of a structured clinic, could adequately manage patients on anticoagulant therapy. A practice policy for warfarin management was agreed and one GP in the practice was given chief responsibility for warfarin patients. The GP subsequently made recommendations based on the INR results. A "warfarin register" was opened for all patients taking the drug. A pharmacist reviewed the warfarin policy 12 months after its implementation, and also the patients' medical notes to establish current control and whether patients had been within the therapeutic range for warfarin for three out of their five latest INR measurements. Overall, the researchers concluded that a practice policy provided as good anticoagulant management as that reported from clinics managed by hospital doctors and pharmacists.
Always a controversial topic, and featuring very much in the pharmaceutical press at the moment, is the role of community pharmacists in the provision of emergency (postcoital) contraception. Two papers focused on this issue at the conference this year. Anjana Patel, an independent pharmaceutical consultant from Harrow, assessed the provision of emergency contraception by asking 10 community pharmacists to record details of emergency contraception "events" over a four-week period (R61). Prior to the study the pharmacists attended a two-hour briefing session on emergency contraception, after which they were provided with an information pack consisting of data collection forms and a prompt sheet for them to use with patients to aid counselling on hormonal emergency contraception. Of the 37 events, 32 involved providing information when Shering PC4 was dispensed. In this context, all the pharmacists provided information on the timing of dose, and 31 of the 32 on side effects. The number of women who were advised on barrier methods, the action to take in the event of problems, and the usage of information leaflets was low (20, 22 and 23, respectively, out of the 32 events); the other five events related to requests for general information on emergency contraception services or methods or both, and two interventions related to legal requirements for a prescriptions for PC4. The study found that all the pharmacists were keen to provide an effective emergency contraception service. However, given the small sample size, it is not possible to conclude that these findings would apply to the majority of pharmacists.
The second study on postcoital contraception (R31) was carried out by researchers from the school of health sciences, University of Sunderland (Taylor, Blackwell and Cooper), and the Durham and Teesside pharmacy practice unit (Holden). They set out to test the hypothesis that "pharmacists' perceptions of the merits of deregulation may be affected by their geographical location". This hypothesis was postulated on the basis of the fact that some areas of the country have higher incidences of abortion and pregnancy than others, and consequently, hormonal emergency contraception (HEC) may be more widely prescribed in some areas than others. Of an original sample of 3,999 UK pharmacists, around a quarter were identified as being community pharmacists. The replies on their views concerning HEC deregulation were analysed on a geographic location basis. The most significant correlation was found between the proportion of males in the sample and overall willingness to supply deregulated HEC; there was no evidence of a significant correlation between mean age and willingness to supply deregulated HEC determined by location. The researchers concluded that the original hypothesis could not be supported and that the study showed an apparent homogeneous expression of support for the concept of HEC deregulation.
These two studies provide useful evidence to support the role of community pharmacists in providing this service. Interestingly, in their paper on general practitioners' awareness of the appropriate and inappropriate use of over-the-counter products (R29), Hughes, Bell and McElnay (Queens university, Belfast) found that significantly more male GPs were in favour of the deregulation of postcoital contraception than their female colleagues. However, overall, most of the GPs in the study felt that it should remain a prescription-only medicine. Further fuel for the continuing debate!
Although the writer of these columns may have a gender-bias in observing the fact, it was noticeable that women's health issues, particularly the menopause and osteoporosis, provided the focus for around 7 per cent of all the presentations made at the conference. McAree and Scott from the Queens University, Belfast, looked at pharmacists' attitudes to the provision of advice to women, with a specific focus on women's health issues (R62). Forty-seven per cent of the starting sample, who were sent a self-completion questionnaire, responded. High levels of knowledge (range 62–90 per cent) were reported by the pharmacists on contraception methods, hormone replacement therapy, osteoporosis, and ovulation prediction and fertility. However, vaginal atrophy, the use of ovulation and induction agents, peri- and post-menopausal contraception, and breast self-examination were areas about which some pharmacists admitted to having no knowledge at all. In general, it was found that discussing women's health issues in the pharmacy was significantly less embarrassing for female pharmacists than male pharmacists, as one might expect. One has to agree with the researchers' conclusion that it is of concern that some pharmacists admitted to having no knowledge of a number of common and important health issues.
The three papers that focused on HRT looked at a number of different issues. "Worth their weight in gold", a direct quote relating to symptoms of the menopause from the study carried out by researchers from Keele university (Mayes, Blenkinsopp and Black), provided an insight into the reasons why women do not use HRT, or stop it shortly after its initiation (R33). Semistructured interviews were conducted with 20 women, who self-selected to take part in the study, to explore their understanding of, and attitudes towards HRT, and their information needs. Most of the sample viewed the menopause as a natural process and something that had to be "coped with"; the experiences of the women's mothers appeared to influence this type of thinking. Only five of the sample had ever been prescribed HRT, but all of these had either stopped it, or never used it at all. It emerged that risk factors such as breast cancer were not associated with any reluctance to use HRT. The findings of this small study suggest that women currently do not know enough about HRT to make an informed choice about treatment; for example, its role in the prevention of osteoporosis was not understood by the women. This study provides one example of where gaps in knowledge need to be addressed so that patients can fully participate in decisions about their health to achieve the aims of the concordance model.
It is likely that pharmacists who have a special interest in women's health and HRT may be able to overcome women's negative health beliefs about the menopause and its treatment. Researchers from the menopause clinic and research unit, Harrow (Tanna and Pitkin) and King's College London (Anderson and Greene) studied the impact of a structured training programme for community pharmacists to enable them to provide counselling and information and advice on HRT (R4). A nurse counsellor and specialist "menopause pharmacist" were involved in the training, which included discussion and observation sessions, providing the 20 community pharmacists who took part in the study with "on the job" training. An eight-week HRT prescription intervention study followed, during which a control group of 20 community pharmacists who had not undergone training was used for comparison. The researchers found that the trained group of pharmacists were more likely to be proactive (initiating inquiries rather than responding to queries initiated by the customer or GP), and were more likely to focus on important aspects of the HRT prescription than the non-trained cohort. This pilot is important in that it demonstrates the effectiveness of additional training to confer "specialist knowledge" in individual pharmacists.
However, all the training in the world will be wasted if, ultimately, the end user, ie, the patient, accrues no benefit or is dissatisfied with the service. The same team of researchers, but also including Protti (menopause clinic and research unit, Harrow), sent a postal questionnaire to 160 patients who attended a menopause clinic run by a specialist pharmacist to assess patients' acceptance and satisfaction with the service (R62). The sample was split into two groups: one group had access to the specialist pharmacist (group 1) at the clinic, and the other group had no access. Overall, 80 per cent of the patients rated the care received at the clinic as "good to excellent", but 10 per cent of patients in group 1 rated their care as "excellent". Of the group that had access to the pharmacist, the vast majority (87 per cent) said that they found the discussion relevant to their needs, and almost all (96 per cent) indicated that they found the specialist knowledgeable, approachable, caring and available. Of the 10 per cent in the control group who said that they were still unclear after having spoken to the doctor, they all indicated that they would have liked to have spoken to the pharmacist, but a quarter admitted that they did not know what a specialist pharmacist did. The intervention by the specialist pharmacist also appears to have had a knock-on effect on the role of the community pharmacist, the researchers reporting (although not specific about numbers) that far more patients in the intervention group subsequently had a discussion with their community pharmacist about the menopause and HRT than in the control group. The study shows that patients will accept that pharmacists are able to perform this role, but there is a need to ensure that the pubic is better informed about "specialist pharmacists" and what they do.
Moving on to osteoporosis, two researchers from the Queens university, Belfast (Shirley and Scott) used a self-completion questionnaire, distributed via 60 community pharmacists, to determine female customers' knowledge of osteoporosis and its prevention, and to assess the availability of information on osteoporosis (R42). Two hundred and seventy women aged between 40 and 60 years completed the questionnaire, which, as well as asking questions on risk factors, symptoms of osteoporosis, incidents and preventative measures, included a question on social class and whether the respondent had a friend or relative with osteoporosis. A diet low in calcium was identified by most women as a risk factor for osteoporosis, but it is worrying, given the age range of the sample, that few associated the lack of oestrogen during the menopause with the disease. Walking or other weight-bearing exercises were mentioned by just over half in relation to preventive measures. Their main sources of information about osteoporosis had been the media or women's magazines, but, obviously, respondents found this unsatisfactory since over 90 per cent of them expressed the view that they were keen to obtain more information. The researchers reported a significant difference in the extent of knowledge of osteoporosis demonstrated by respondents in social classes 1 and 2 (better knowledge) compared with those in classes 3, 4 and 5. Although the community pharmacists acted only as "middlemen" in this study, the authors suggest that information should be more readily available on osteoporosis from this source since few of the women in the sample had talked to their GP about the condition.
Of course, it is not only postmenopausal women who are at increased risk of osteoporosis. Patients with chronic diseases such as asthma and inflammatory bowel disease, where long-term treatment with oral corticosteroids may be necessary, are also at risk. McCaig, Bell and Bolger (Robert Gordon university, Aberdeen) and Davidson (Aberdeen Royal infirmary) reported on a follow-up study of previous work into the extent of prophylaxis against osteoporosis in a group of inpatients on oral corticosteroids (R18). A previous study in 1994 in the same hospital had found that only 5.6 per cent of patients on oral corticosteroids received prophylaxis. The latest study, conducted on 75 patients, found that prophylaxis is currently being received by just over one-third of patients. They also found that prophylaxis was being given to a higher percentage of high risk patients, ie, postmenopausal women and those taking high-dose corticosteroid drugs, than found in the previous study. The findings from the study are good news, not only for improved patient care, but also in relation to the prevention of a disabling condition which can be costly to the health service in terms of long-term management and treatment.
In this age of multimedia technology and with the recent introduction of NHS Direct, information on health issues and minor ailments is more commonly becoming available at the touch of a button. A touchscreen system for over-the-counter self-medication was the subject of study for Opaleke and Goodyer from King's College London (R55). Their pilot study aimed to establish the type of information people might require regarding self-medication on coughs and colds, and the effect that the system had on the community pharmacy environment. Customers visiting the single pharmacy where the study took place were free to use the touchscreen system for six weeks. The researchers were able to track the information that was accessed using an internal tracking device in the computer. Data from 80 users over the six weeks showed that around one third of them accessed information on side effects, followed by indications at 29 per cent. Warnings, pharmaceutical forms and ingredients of preparations, dose and cost were accessed by 13 per cent, 18 per cent, 11 per cent and 16 per cent of users, respectively. None viewed the general information on coughs and colds and only a few printed out the fact sheet that was available. A survey of staff opinions indicated their general acceptance of the system, although they had some reservations, in particular about their role and that of the pharmacist being superseded by the touchscreen. The observational analysis of customers identified users to be among the younger age group (although researchers do not define what they mean by younger). There was a general reluctance among customers to use the system unless encouraged to do so by the staff, perhaps indicating that pharmacy customers prefer (at least for the moment until they get used to the technology) the traditional human approach.
Baker, Cairns, Deshmukh, Kendall and Mackay (University of Sunderland) surfed the worldwide web for sites that provide advice on the management of diarrhoea in children, and subsequently evaluated it for accuracy and consistency (R44). The reliability of data collected on the following areas was compared with treatment guidelines issued by the World Health Organisation: information on fluid intake, oral rehydration solutions and food; treatment with medication; and advice on when to refer to a physician. What the researchers found is frightening, but perhaps an opportunity for the pharmacy profession to remarket high street pharmacists as an accurate source of information on minor ailments. Of the 32 websites found, only 13 provided complete and accurate information on the management of this very common condition and several instances of contradictory messages between individual websites were found; for example, one site advocated that referral to a doctor was not necessary at all while another indicated that referral should be made immediately for all cases of diarrhoea, irrespective of age. The researchers also found that information on medication was inconsistent from one site to another. The researchers pointed out that in a quarter of the websites, the source of the information was undisclosed, and the dates of publication of information were included in just over half of the sites. Commercial bias is suggested as a reason for omitting the source of the information, making it very difficult for the public to be reassured that the information is correct. It seems that diarrhoea in children is not the only area where inaccuracies and inconsistencies are appearing on the web since this paper also cites work done by another research group on the treatment of childhood fever which reported equally unacceptable findings.
So, if the profession can feel comfortable (at least in the short term) in the knowledge that the computer is unlikely imminently to result in the demise of the pharmacist's role, then issues around recruitment and retention of pharmacists remain important. Researchers from Worthing and Southlands Hospitals NHS trust (McPherson) and the University of Brighton (Davies, Bewick and Bhudia) surveyed hospital pharmacists employed in the South Thames region to identify levels of job and career satisfaction in hospital pharmacists, demographic factors affecting job and career satisfaction, and attitudinal variables affecting job and career satisfaction (R48). Forty-five per cent of the pharmacists who were sent a questionnaire responded (n=232), of whom 174 were female. Just over two-thirds of the pharmacists said that they were satisfied with their job and with their career. Female respondents and pharmacists with postgraduate qualifications appeared to be most satisfied. The researchers identified that the variables most strongly associated with job satisfaction were job role and supervision. This indicates that employers need to allow pharmacists to develop in challenging roles which optimise their knowledge and skills, while providing adequate support to do this.
This ties in well with the results of a study undertaken jointly by Keele university (Boardman and Blenkinsopp) and Aston university (Jesson and Wilson). Of around the one in three pharmacists who reported being dissatisfied with their work, one of the reasons for their negative feelings was that they perceived that their expert knowledge was underutilised, and that they felt under-valued, with low job satisfaction (R45). Long hours and stress resulting from the need for multitasking in community pharmacy were also issues for some pharmacists. In contrast, pharmacists who had developed their role to work with GP practices reported that their work was professionally rewarding, providing increased job satisfaction and professional challenge. These two studies provide an important message for employers. Hopefully, these messages will be taken on board and will ultimately help to address the current crisis that is recognised with regard to recruitment and retention within British pharmacy services, before it is too late.
Kanth and Syms of the University of Portsmouth introduced their paper by advocating that pressures resulting from manpower shortages can be partly alleviated by recruitment of more mature (over 21 years of age) individuals into higher education (R57). At the present time in the UK, mature students represent approximately 14 per cent of the total annual entry into pharmacy degree courses. Kanth and Syms's paper explored the various motivations and life experiences which have helped steer mature applicants into the pharmacy profession. To do this, they surveyed 42 middle and final year mature students studying at two schools of pharmacy in the south of England. The majority of respondents (73 per cent) were under 30 years of age, and the remainder were no older than 45 years, with female respondents outnumbering their male colleagues by two to one. Approximately two-thirds of the respondents had worked in pharmacy-related employment prior to embarking on a pharmacy degree, and others had entered the course having already obtained a first degree in a science or health-related topic. One potential advantage of having a large percentage of the student population who have already worked in pharmacy-related employment, is that they are more likely to have a more realistic knowledge of the profession they are entering and what it can offer. Consequently, they may be less likely to become dissatified and leave the profession. One interesting finding from the research was that, of the proportion of the sample who had worked in pharmacy-related employment, none had received sponsorship from their previous employers to enable them to embark on the degree course. Perhaps it would be prudent for employers to be more encouraging in this respect, and reap the long-term benefits of obtaining highly motivated and experienced staff.
Boardman et al (see above) found that even the more recently qualified pharmacists felt that their expert knowledge is underutilised and their potential contribution to healthcare is undervalued by both patients and other professionals. The findings from the study (R51) presented by Ward and Seston (school of pharmacy and pharmaceutical sciences, University of Manchester) and Bagley and Wilson (Centre for Pharmacy Postgraduate Education) are interesting in this respect because they found that many pharmacists at this stage in their career consider themselves to be at the peak of their clinical or pharmaceutical knowledge, so perhaps employers and the profession as a whole need to develop strategies to capture this before disillusionment sets in. However, this research was not particularly looking at this in relation to workforce issues: the main aim of the study was to explore newly registered pharmacists' attitudes to the current provision of continuing education (CE) and to identify key factors that act as barriers to participation in CE. Eight focus groups identified competing demands on their time, both in and out of work, as the main barrier. Disillusionment with further study was also a factor since the pharmacists felt that a break from study was needed to help them consolidate what they had learned through formal education. They also felt that learning from experienced pharmacists was probably the most useful way of developing skills in communication and applying clinical knowledge in practice, rather than formal CE activities. Perhaps a portfolio method of recording their experiences to allow reflective thinking is one way forward?
Of course, it is not only pharmacists who must keep up to date with changes affecting their professional role. Individuals working in a support capacity, who are assisting patients with their medication, should be adequately trained to enable them to provide a safe service. A project (R64) carried out by Community Health South London NHS trust and the London Borough of Lewisham social services (Taylor, Harris and Sanford) looked at the range of activity currently provided by home care workers and supervisors in relation to their clients' medication needs, and the extent to which the medication policy and practice notes developed within the borough were used. The method involved an observational analysis of home carers' practices. This was carried out by a pharmacist on 40 accompanied visits. The pharmacist was satisfied that, in 19 of the cases, medication practices were carried out according to guidelines, and only minor variations were observed in another eight. Medication record-keeping was observed to be the area where home carers experienced most difficulty and, subsequently, changes to the borough's policy and recording system have been implemented. The results are encouraging, and are likely to have been influenced by the fact that 36 of the 40 home carers had received "medication training" of some sort at some time.
However, bearing this in mind, researchers from the Welsh Centre for Postgraduate Pharmaceutical Education (Lau, Davies, Rose and Temple) identified in their introduction to their study that the National Union of Public Empoyees home carer survey of 1993 indicated that over a third of home carers were administrating medication without receiving formal medication training (R55). Lau et al's survey aimed to describe the current level of pharmacists' involvement in training for home carers on the safe use of medicines, and to identify the appropriate support needed for pharmacists to provide the training. One hundred and eighty-four pharmacists working in independent community pharmacies were interviewed to find out about their contact with home carers, experience they had in training social care staff, whether special training support packs were needed, and their expected remuneration for providing the training. Only three of the pharmacists reported to have previously trained home carers, but the vast majority (97 per cent) said that they would welcome a special training support pack to enable them to do so. A fee in the range of £40 to £60 per hour was considered as acceptable by most of the pharmacists. Given that the Government hopes to develop a training strategy within an NVQ framework for social care staff, it is perhaps the right time for pharmacists to come forward and offer their services in this respect in relation to the safe use of medicines in the community.
An educational outreach programme is perhaps one way in which training can be provided. Boardman, Thompson and Chapman (Keele university) undertook a study (R44) involving prescribing for patients in nursing homes where the nursing home staff and the patients' GPs received an education programme. Following the programme, a survey of the recipients, showed that on a scale of 1 to 5 (5 being the most positive rating), nursing home staff rated usefulness of topics discussed, the relevance to work in the nursing home, the importance of evidence to support information presented, and the usefulness of education visits from pharmacists as 4 and above (range 4.1–4.5). This suggests that this method of training could be developed further on a larger scale for this group of health care workers.
It is perhaps stating the obvious that all the good work reported in these sessions at the conference required co-operation from those who were identified as having a key role in answering the research question of a particular study. In many of the projects, the survey sample comprised pharmacists or pharmacy organisations who had volunteered to take part, so it is vital that researchers nurture the vast amount of goodwill that exists in the profession to enable it to move forward using supporting research. The report of the Pharmacy Practice R&D Task Force proposed that a research network be established as a means of enabling robust, national, generalisable research to be conducted within community pharmacy. Nicolson, Cantrill, Hassell, Seston and Noyce from the University of Manchester explored the feasibility of establishing a research panel of community pharmacists (R54). Various methods were used to recruit the research panel, which ultimately included pharmacists from independent pharmacies, local chains and national multiples. Each panellist received an annual retention fee and an "incentive" related to customer recruitment for the two projects they were involved in. The researchers also explored the attitudes of pharmacy staff who participated in the panel, and found that the time required for data collection was not such a problem as they had expected at the beginning of the study. Staff also reported that their involvement in the two projects had increased their knowledge of specific therapeutic areas, increased their job satisfaction and
improved customer relations. They also reported that they had an increased awareness of patients' perspectives and the need for consistent questioning of customers with specific conditions. These preliminary results of this study are encouraging, and the research group should be congratulated for developing a simple method to enable pharmacists to participate in research as part of their daily practice.
Ms Black is senior lecturer and postgraduate course development manager in the department of medicines management at Keele university