Innovations in Pharmacy through Practice-Based Research

The overall purpose of this article is to serve as an invitation for submissions to the 'Practice-Based Research' section of INNOVATIONS in pharmacy. To provide background about this section of the journal, this paper describes: (1) the concept of innovations that we will apply, (2) the practice-based research domain, and (3) the use of practice-based research networks for this area of inquiry. We propose that uncertainty surrounding an innovation often will result in the postponement of the decision regarding its adoption until further evidence can be obtained. Such evidence often is gathered through considering the advice and experiences of opinion leaders and members of social systems who have adopted the innovation. We invite authors to present ideas, arguments, and evidence for innovations in pharmacy that arise out of practice-based research. We propose that this journal will be an excellent communication vehicle for providing convincing arguments and sound evidence in favor of innovations. Discourse regarding new ideas in such a format can further develop the ideas, create a critical mass of evidence, and be used for convincing others that the innovation should be adopted. We welcome submissions to the INNOVATIONS in pharmacy, PRACTICE-BASED RESEARCH content area that: (1) provide convincing arguments and sound evidence in favor of innovations for pharmacy, (2) are based upon practice-based research from case studies of single patients on one end of the continuum to findings from large populations of patients on the other end of the continuum, and/or (3) introduce innovations for practice-based research networks. We encourage articles from all perspectives and from all methods of inquiry. Type: Invitatio

Understanding the meaning of medications for patients: The medication experience

Objective: To understand and describe the meaning of medications for patients. Methods: A metasynthesis of three different, yet complementary qualitative research studies, was conducted by two researchers. The first study was a phenomenological study of patients’ medication experiences that used unstructured interviews. The second study was an ethnographic study of pharmaceutical care practice, which included participant observation, in-depth interviews and focus groups with patients of pharmaceutical care. The third was a phenomenological study of the chronic illness experience of medically uninsured individuals in the United States and included an explicit aim to understand the medication experience within that context. The two researchers who conducted these three qualitative studies that examined the medication experience performed the meta-synthesis. The process began with the researchers reviewing the themes of the medication experience for each study. The researchers then aggregated the themes to identify the overlapping and similar themes of the medication experience and which themes are sub-themes within another theme versus a unique theme of the medication experience. The researchers then used the analytic technique, “free imaginative variation” to determine the essential, structural themes of the medication experience. Results: The meaning of medications for patients was captured as four themes of the medication experience: a meaningful encounter; bodily effects; unremitting nature; and exerting control. The medication experience is an individual’s subjective experience of taking a medication in his daily life. It begins as an encounter with a medication. It is an encounter that is given meaning before it occurs. The experience may include positive or negative bodily effects. The unremitting nature of a chronic medication often causes an individual to question the need for the medication. Subsequently, the individual may exert control by altering the way he takes the medication and often in part because of the gained expertise with the medication in his own body. Conclusion: The medication experience is a practice concept that serves to understand patients’ experiences and to understand an individual patient’s medication experience and medication-taking behaviors in order to meet his or her medication-related needs

ACTION RESEARCH AS A TOOL FOR TRANSFORMATION OF THE PHARMACIST'S PRAXIS IN PRIMARY CARE

Objective: Describe and discuss the use of action research in the Pharmaceutical Assistance restructuring of primary care in the city of Lagoa Santa/MG (Brazil), for the implementation of comprehensive medication management services.Methods: An action research project, based on fortnightly thematic discussions with a group of ten pharmacists, was used as a management tool to foster the engagement and critical reflection of pharmacists involved in the construction of their clinical practice in primary care.Results: Action research encouraged pharmacists to think about their practices and to perceive the need for a clearer definition of their roles and responsibilities in primary care. The collective development allowed pharmacists to recognise their weaknesses and strengths, identifying themselves as professionals capable of assuming co-responsibility for the pharmacotherapy of the patient. The re-organization of the service was necessary to provide support for actions related to the logistic of medicines, so pharmacists could dedicate time to their clinical practice.Conclusion: Action research can be an effective instrument of reflection, motivation and empowerment for the pharmacist team to meet the challenges of the Brazilian Unified Health System (Sistema Único de Saúde, SUS)

From theory to practice: Experience of implementation of pharmaceutical care in Minas Gerais, Brazil

A atenção farmacêutica é uma prática centrada no paciente que tem como objetivo primário prevenir e resolver problemas relacionados ao uso de medicamentos. As discussões acerca dessa prática vêm ganhando o centro das discussões entre pesquisadores, formuladores de políticas e profissionais farmacêuticos. Entretanto, o que vem acontecendo é que o discurso está sobressaindo em relação à prática. O presente trabalho buscou, a partir das experiências de farmacêuticos, descrever o processo de implantação de um serviço de atenção farmacêutica em farmácia comunitária. Utilizou método qualitativo e as técnicas da observação participante e entrevistas semi-estruturadas. Os resultados revelam quatro etapas vividas pelos farmacêuticos durante o processo e desvela os aspectos fundamentais da implantação da atenção farmacêutica em farmácia comunitária fornecendo uma trilha que poderá ser contemplada por profissionais farmacêuticos interessados em seguir esse caminho profissional.Pharmaceutical care is a patient-centered practice whose goal is to prevent and resolve drug therapy problems. Even though pharmaceutical care was accepted by the profession of pharmacy as its new professional mandate, for the most part, there is much more discourse than practice as it relates to taking care of real patients. This study aimed to describe the process of implementation of pharmaceutical care in a community pharmacy from the perspectives of pharmacists. It was used qualitative methodology and the methods of participant observation and semi-structured interviews. The results unravel four stages experienced by pharmacists during the implementation process. This study unveil fundamental aspects of the implementation of pharmaceutical care in community pharmacy offering a trail that can be take into account by pharmacists who are willing to follow this professional path.Colegio de Farmacéuticos de la Provincia de Buenos Aire

From theory to practice: Experience of implementation of pharmaceutical care in Minas Gerais, Brazil

A atenção farmacêutica é uma prática centrada no paciente que tem como objetivo primário prevenir e resolver problemas relacionados ao uso de medicamentos. As discussões acerca dessa prática vêm ganhando o centro das discussões entre pesquisadores, formuladores de políticas e profissionais farmacêuticos. Entretanto, o que vem acontecendo é que o discurso está sobressaindo em relação à prática. O presente trabalho buscou, a partir das experiências de farmacêuticos, descrever o processo de implantação de um serviço de atenção farmacêutica em farmácia comunitária. Utilizou método qualitativo e as técnicas da observação participante e entrevistas semi-estruturadas. Os resultados revelam quatro etapas vividas pelos farmacêuticos durante o processo e desvela os aspectos fundamentais da implantação da atenção farmacêutica em farmácia comunitária fornecendo uma trilha que poderá ser contemplada por profissionais farmacêuticos interessados em seguir esse caminho profissional.Pharmaceutical care is a patient-centered practice whose goal is to prevent and resolve drug therapy problems. Even though pharmaceutical care was accepted by the profession of pharmacy as its new professional mandate, for the most part, there is much more discourse than practice as it relates to taking care of real patients. This study aimed to describe the process of implementation of pharmaceutical care in a community pharmacy from the perspectives of pharmacists. It was used qualitative methodology and the methods of participant observation and semi-structured interviews. The results unravel four stages experienced by pharmacists during the implementation process. This study unveil fundamental aspects of the implementation of pharmaceutical care in community pharmacy offering a trail that can be take into account by pharmacists who are willing to follow this professional path.Colegio de Farmacéuticos de la Provincia de Buenos Aire

A PRÁTICA CLÍNICA DO FARMACÊUTICO NO NÚCLEO DE APOIO À SAÚDE A FAMÍLIA

Resumo Este estudo teve como objetivo compreender os elementos essenciais do processo de sistematização da prática clínica de uma farmacêutica da atenção primária à saúde com base no referencial teórico-metodológico da atenção farmacêutica, que subsidia o serviço clínico de gerenciamento da terapia medicamentosa. Tratou-se de pesquisa qualitativa autoetnográfica, construída de forma colaborativa entre os autores, de outubro de 2014 a outubro de 2015, nos Centros de Saúde da Prefeitura Municipal de Belo Horizonte, onde uma das autoras trabalha. Os dados foram produzidos por meio de observação participante, diários de campo, reflexões e entrevistas semiestruturadas com farmacêuticos que desenvolviam prática clínica na atenção primária à saúde. Os resultados evidenciaram que os principais elementos para sistematização da prática clínica passam pela ‘construção de uma nova identidade profissional na equipe multiprofissional’ e pela ‘incorporação de novas atividades na rotina de trabalho’ que, combinadas, resultam em uma ‘proposta de integração de um serviço de gerenciamento da terapia medicamentosa nos fluxos das unidades de saúde’. Dessa forma, para que o farmacêutico possa legitimar o seu papel no cuidado do paciente, é preciso mudar, transformar, reorganizar e reconstruir a sua prática

O uso de inibidores de apetite por mulheres: um olhar a partir da perspectiva de gênero The use of apetite inhibitors by women: an insight based on the gender perspective

O presente estudo teve como objetivo compreender os motivos que levam mulheres adultas a utilizar medicamentos inibidores do apetite e verificar, a partir da ótica de gênero, como se estabelece a relação dessas mulheres com seus próprios corpos. Orientado pelos princípios da pesquisa qualitativa, utilizou como técnicas de construção de dados a entrevista semiestruturada e a observação direta. Participaram como informantes do estudo seis mulheres usuárias de anorexígenos. Os resultados apontaram que as imagens, a publicidade e as redes sociais contribuem significativamente para a criação de padrões de aparência física e de "estilos de vida", cujo modelo preconiza a boa aparência (corpo magro) e a felicidade conjugal. O corpo magro é representado como algo capaz de alterar condições, ou seja, pessoa gorda = pessoa infeliz; e pessoa magra = pessoa feliz. O estudo mostra que é no corpo como lócus que o papel socialmente destinado às mulheres será produzido e reproduzido.<br>The scope of this study was to understand the motives that lead adult women to use appetite inhibitors and to establish, from a gender perspective, how these women relate to their own bodies. It was structured around the principles of qualitative research, and the methods of data collection were semi-structured interviews and direct observation. The informants were six women who used appetite inhibitors. The results indicated that images, publicity and social networks contribute significantly to the creation of new standards of physical appearance as well as lifestyles, which establish appearance (a slim body) and a happy marriage as the desired model. The slim body is represented as something able to alter the temperament of the individual, in other words a fat person is an unhappy person and a slim person is a happy person. The study shows that it is in the body per se that the social role destined for women is produced and reproduced