OUR LADY OF FATIMA UNIVERSITY

COLLEGE OF PHARMACY
Valenzuela. Quezon City. Antipolo. Pampanga. Cabanatuan. Laguna

Culture, Economic Status,

Gender and Sexuality in
Pharmaceutical Care
WEEK 13-14
PSAP 311

Name of Lecturer
Instructor- College of Pharmacy
COURSE FACILITATOR
OBJECTIVES:

At the end of this unit, the students

are expected to:
▷ Identify and manage the effects of
culture, economic status, gender
and sexuality to pharmaceutical
care.

2
WEEK 13 & 14

3
CULTURE, ECONOMIC STATUS,
GENDER AND SEXUALITY IN
PHARMACEUTICAL CARE

▷ The structures of the healthcare systems in

different countries have a lot of similarities
but also a lot of differences.

▷ The system is the sum of historical

development, culture and economic
factors. In some countries there are
actually several different systems in place
within the healthcare system.
4
DEMOGRAPHIC FACTORS

▷ Several important differences have been

reported between different age groups
and between genders. However, few
reports have been able to validate the
reasons for these differences.

5
DEMOGRAPHIC FACTORS
▷ It is well known that women report more symptoms
and that they have a lower threshold of pain and
discomfort and are more likely to seek care.
▷ Men are more hesitant than women to admit having
symptoms and to seek medical care for these
symptoms.
▷ This can be a result of perceived sex-role stereotypes –
men should be tough and independent and ignore or
endure pain. Women use physician services more than
men in all age groups except for the first few years of
life. Regardless of this, men have a higher mortality
and shorter life expectancy at all ages.
6
DEMOGRAPHIC FACTORS
▷ In general, young children and the elderly
use physician services more often than
adolescents and young adults.
▷ Age differences in health behavior cannot
be explained by biological ageing alone.
▷ Elderly people have different views on
health and illness, symptoms, healthcare
use and drugs.

7
DEMOGRAPHIC FACTORS
▷ There is a danger in labelling all elderly people as
having similar attitudes concerning health issues, but,
as with younger persons, among the elderly there are
also a wide variety of views on health and treatment.
▷ Certain ideas are more prevalent among the elderly
than the young. The differences can partly be
explained by so-called cohort effects, meaning people
of the same age have been exposed to the same kind of
experiences and attitudes in society and therefore are
also likely to share certain behavioral characteristics.

8
SOCIOECONOMIC POSITION
▷ Socioeconomic position refers to the
indicators that signify a person’s status is
society. Status is most frequently gained
through the ownership of resources, power,
and skills that can be used to accumulate
wealth or exert influence.

9
SOCIOECONOMIC POSITION
▷ In every society, political, cultural, and institutional
factors determine the ways in which socioeconomic
status influences health, with the steepest gradients
found in the most unequal societies.

▷ As a discipline, social epidemiology is founded on the

hypothesis that although the direction and strength of
relationships between morbidity and mortality and
socioeconomic position vary, the underlying
relationship persists.
▷
10
SOCIOECONOMIC POSITION
▷ For example, socioeconomic status affects low
birth weight, injuries, asthma, diabetes,
depression, cancer, stroke, and other diseases.

▷ In addition, a gradient occurs whereby children

from families of lower socioeconomic status
have been found to be markedly more likely to
suffer from injuries, ear infections, or chronic
illness and to be less physically active than
children from families of higher socioeconomic
status. 11
INCOME
▷ Income is a key indicator that captures the
resources used to meet basic needs and
determines an individual’s material
conditions, which have direct implications
for health.
▷ For example, a family with high income can
afford both health insurance and a
physician’s copayment and will seek care
immediately if a child has an asthma attack.
12
INCOME
▷ A low income family without insurance
must pay full price for medical attention,
which may cause them to delay seeking
help until the child is much sicker.
▷ Income is often difficult to measure in
health research because some people are
reluctant to report household income,
regarding it as a private matter or cause of
shame.
13
EDUCATION
▷ Education is an easily measured indicator of
socioeconomic status that most people
freely reveal to health researchers.
▷ Education is a marker of socioeconomic
status even when individuals are not in the
labor force. Education is also rather stable
over the lifespan, whereas income fluctuate
based on current employment status.

14
OCCUPATION
▷ Occupation is an important indicator of
socioeconomic position because it is the
obvious and stable link between individuals
and economic processes.

▷ Occupation also forms the link between the

measures of education and income.

15
OCCUPATION
▷ Unfortunately, occupational classification
systems may not capture important
nuances such as formal and informal roles,
which may relate directly to benefits and
security and the workplace environment.
▷ Given the large number of occupation in
every society, type of work may also be
hard to organize into meaningful
categories.
16
CULTURAL ASPECTS

▷ To avoid making inaccurate generalizations about an

individual’s culture, consider the culturally
supported boundaries within which an individual
makes choices.

▷ Open discussion with a client about health care

beliefs will be the most useful approach to include
cultural influences in health care strategies.

17
CULTURAL ASPECTS

▷ In order to better understand how an

individual’s cultural background will affect
pharmaceutical care, three general areas will
be considered:
○ health care perspectives and beliefs
○ traditional medicines and therapies
○ communication patterns.

18
Health Perception and
Treatment Choices

▷ The role of social structure and family members can

strongly influence one’s health care choices.
▷ Being aware of family members’ traditional roles in
health care decision-making can help us recognize
patterns and prevent potential conflicts.
▷ For example, in a some Hispanic families the
grandmother or mother is responsible for making
health care decisions, whereas the father may be
responsible for most other decisions. In some
Southeast Asian cultures the oldest male in the
family makes health care decisions
19
Health Perception and
Treatment Choices

▷ Most cultures embrace a standard protocol for

treatment of illnesses. The severity of the illness
generally dictates who is sought for treatment.
Oftentimes an elder family member is consulted for
minor illnesses.
▷ Once a condition progresses, however, approaches
to treatment diverge among cultures. For many
people with strong religious beliefs, a priest or
church leader may be consulted at any stage in an
illness. Prayer may be an important part of the
healing process, or an essential element of health
maintenance
20
Health Perception and
Treatment Choices

▷ As with conventional medicine, the treatment

sought will correspond with what the patient
perceives as the cause of the illness. The patient
who thinks an illness has been caused by a curse or
spell may begin treatment with prayer, or by seeking
advice from a spiritualist or traditional healer.

21
Health Perception and
Treatment Choices

▷ In some cases treatment may not be sought at all

because the condition is considered shameful. For
example, mental illness can be considered
disgraceful in Vietnamese culture, and a patient may
be reluctant to acknowledge and seek treatment for
such problems.
▷ Allowing the client to discuss his beliefs about an
illness in a non-threatening environment will allow
incorporation of his beliefs and practices in to a
reasonable and collaborative care plan.

22
Traditional Medicine and
Therapies

▷ As pharmacists we are especially concerned with

alternative treatments that patients are using. In a
multicultural population we face even more
challenges with a patient’s use of home remedies
that may include herbs and foods as well as
traditional healing therapies and rituals.

▷ In addition, a patient’s perception of prescribed

Western medicines may also influence his
commitment to treatment.

23
Traditional Medicine and
Therapies

▷ It has become commonplace to ask patients about

nonprescription and alternative medicine use. We
have come to recognize commonly used herbal
remedies, and can often screen for potential
interactions or problems before they arise.

▷ When eliciting home remedies or less common

herbal treatments used by some patients, it may be
difficult to assess their role in therapy.

24
Traditional Medicine and
Therapies

▷ Many Asian people have a vast array of herbal

remedies available to them from their herbalist,
traditional Chinese pharmacist, or brought directly
from their homeland.

▷ Often the patient is unable to provide the

practitioner with an accurate description or English
name of the herb or mixture. Under these
circumstances it is important to gather as much
information as possible about the herb’s intended
use, its possible action, and potential adverse effects
and drug interactions. 25
Traditional Medicine and
Therapies

▷ If a real potential for interaction or adverse effects

exists, the practitioner may need to convince the
patient to discontinue the herbal remedy for a
period of time.

26
Traditional Medicine and
Therapies

▷ Pharmacists may be less concerned with traditional

therapies that do not include foods or herbs, but
they need to be acknowledged nonetheless.
Acupuncture, coining, prayer, and voodoo may not
have potential for drug interactions; however, being
aware of a patient’s practices and preferences can
improve overall understanding of his health care.

27
Communication

▷ Terms such as G.I., anti-inflammatory, b.i.d.,

hypopigmentation, and range of motion become a
part of our “everyday” language, often to the
detriment of our patients. As pharmacists we
frequently hear patients expressing their frustration
with not being able to understand what the doctor
just told them. Yet pharmacists often fall into the
same trap. Paying attention to the “language” we use
when speaking with patients is a first step to
bridging communication barriers

28
Communication

▷ Communication perhaps the most common, yet

least recognized, communication barrier is that
between medical professionals and lay people. As
we are educated and acculturated into the medical
profession, we spend a substantial amount of time
with others who have similar interests, educational
level, and specialized language.

29
Communication

▷ Expecting pharmacists to become fluent in all the

languages of the clients they serve is impractical.
However, it may be useful to learn simple phrases in
languages of non-english speaking clients who
commonly visit the pharmacy.

▷ Learning how to say a typical greeting demonstrates

interest in improving communication and learning
about your clients.

30
Communication

▷ Nonverbal communication practices are another

barrier to effective communication. Behavioral
scientists have found that 55-95 percent of a
message communicated may be nonverbal.

▷ Aspects to consider in nonverbal communication are

eye contact, personal space and touch, and facial
expression.

31
Communication

▷ Anglo Americans typically perceive eye contact as

an expression of interest and sign of honesty. In
many Middle Eastern and Asian cultures, however,
eye contact is considered a sign of disrespect.

▷ Being aware of cultural influences on eye contact

can help a health care provider avoid judgment
about a client’s character.

32
Communication

▷ Facial expressions have the potential for being

misleading. Nodding and saying yes may seem an
indication of understanding; however, in some
Southeast Asian cultures it simply indicates the
person is paying attention and being polite.

▷ Requesting that the patient demonstrate

understanding by repeating what has been told can
ensure that the correct message has been received.

33
References:

▷ Rickles, Social and Behavioral

Aspects of Pharmaceutical Care,
2010

34
Thanks!
Any questions?
You can find me at:
@username
[email protected]

35
OUR LADY OF FATIMA UNIVERSITY
COLLEGE OF PHARMACY
Valenzuela. Quezon City. Antipolo. Pampanga. Cabanatuan. Laguna

Advocacy
WEEK 15
PSAP 311

Name of Lecturer
Instructor- College of Pharmacy
COURSE FACILITATOR
Introduction to
Advocacy
Advocacy

• Advocacy can be defined as an activity by an

individual or group to plead a case, support a cause,
or to recommend a course of action related to
patient-care, political, economic, social, or
institutional issues.

Our Lady of Fatima University

College of Pharmacy
Advocacy
• Advocacy can also be defined, in relation to pharmacy, as an
ongoing commitment to advancing the awareness of the
value that a pharmacist provides to the health and wellbeing
of society by actively supporting and communicating that
vision concisely to opinion leaders, elected officials, decision
makers, potential partners and any other audience in order
to influence their perspective and ultimately have them
speak and/or act on your behalf.

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College of Pharmacy
Advocacy

• When attempting to define the advocacy responsibilities for

pharmacy, it is instructive to examine the guidance from
other healthcare professional organizations regarding
advocacy.
• One role professional organizations play is to help define the
moral and ethical responsibilities of the profession.

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College of Pharmacy
Advocacy

• Pharmacists should stay informed of issues that affect

medication-related outcomes and advocate on behalf of
patients, the profession, and the public.
• These issues may include legal, regulatory, financial, and
other health policy issues, and this obligation extends
beyond the individual practice site to their broader
communities.

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College of Pharmacy
Advocacy in Pharmacy:
Public Relations
Perspective
Advocacy in Pharmacy
• Pharmacists have a responsibility to advocate on behalf of their
patients for the right to safe and effective medication.
• Key target groups for advocacy
• Pharmacists
• Other health care professionals
• Patients
• The community

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College of Pharmacy
Fellow Pharmacists as key target group

• Interaction with other pharmacists and pharmacies may

sometimes be challenging because of perceptions of
competition, but always remember that working together
with the other is the very way we can create practice change.

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College of Pharmacy
Advocacy Strategy
1. Attend conferences not only for the content but also to
meet other pharmacists and then stay in contact with
them.
2. When you read or hear of a pharmacy that is doing a type
of clinical service that you are interested in, contact them
and ask questions.
3. Follow journals, blogs and articles and look for ways to
apply what has been successful for other pharmacists to
what you are trying to do as a pharmacist yourself.
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College of Pharmacy
Fellow Pharmacists as key target group

• Divided, the profession lacks the harmony and

consistency to truly change practice and the way we
are seen by our key stakeholders; however, united, the
possibilities of where our profession will go are
endless.

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College of Pharmacy
Physicians and Other Healthcare
Professionals as key target group

• Physicians and other health care professionals are an

important group on whom pharmacists need to focus
advocacy efforts. This group is the key to developing solid
interprofessional relationships and can support our
profession when advocating both for and to patients.

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College of Pharmacy
Advocacy Strategy
• Community Setting
• One simple way of building these relationships is by making
frequent prescriptions. Use this phone call or visit as an
opportunity to introduce yourself with your designation and any
pertinent details about yourself.
• Inform the practitioners of the services provided by your
pharmacy, as well as any special areas of training or interest you
have.

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College of Pharmacy
Advocacy Strategy
• Hospital Setting
• This can also be achieved in the same way as the community
setting by taking opportunities to introduce yourself and explain
your practice to other practitioners in the hospital, including
nurses, physicians, dietitians and others.
• Another idea for pharmacists in a hospital setting, as well as
possibly community pharmacies or family health teams, is to
organize a journal club or presentation for other practitioners to
attend.

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College of Pharmacy
Patients as key target group

• Possibly the most difficult and important group to

advocate to about our role on the health care team.

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College of Pharmacy
Advocacy Strategy: Verbal patient
interaction tips

• The ultimate goal is to increase your patients’ awareness

about your role in their health. Keep in mind that we want
them to know who we are, what we do and what we can do.
• Take any chance you have to explain to your patients the
steps you have gone through to complete the service you
have provided.

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College of Pharmacy
Advocacy Strategy: Verbal patient
interaction tips
• This can be applied to simple dispensing, medication
assessments, injections, pharmacist prescribing, over-the-
counter recommendations and much more.
• For example, when counselling patients on a new
medication, make them aware that you have checked for any
drug interactions with their medications, that this is not one
of the medications they are allergic to, or that a dose
seemed incorrect so you clarified with their physician.

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College of Pharmacy
Advocacy Strategy: Nonverbal strategic
communication tools can be used

• Create a poster or pamphlet

• Describe the services your pharmacy provides, as well
as the areas of a pharmacist’s expertise and what role
a pharmacist can play in patients’ health.

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College of Pharmacy
Advocacy Strategy: Nonverbal strategic
communication tools can be used

• When patients receive an intangible service (one that is not

associated with a physical product, such as a medication assessment),
always provide some type of tangible item along with it.
• Examples: A business card, information sheet or note about the
service they just received; for example, a checklist of information
covered during the patient consult, such as what the medication is
for, how to take the medication, side effects and so on.

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College of Pharmacy
Advocacy Strategy: Nonverbal strategic
communication tools can be used
• Identify yourself
• This is a simple and easy, yet crucial, thing to do. Make sure that you
are distinguished from other staff and pharmacy assistants or
technicians in a community setting.
• Done by wearing a name tag that includes your title, wearing a lab
coat, dressing differently from other staff and simply introducing
yourself as a pharmacist to the patient at the beginning of any
interaction.
• This is just as important in a hospital setting, as it can be difficult for
patients and other health care professionals to identify a pharmacist.
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College of Pharmacy
The Community: Strategy
• Can be done through newspapers and other widespread
promotional communication.
• Look for opportunities within your community to be
involved.
• For example, outreach can include giving presentations about
relevant pharmacy topics to high school students or long-term
care residents.
• This informative and educational interaction can also be used as
promotion for your pharmacy, to improve the perception and
reputation of pharmacists as a whole.

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College of Pharmacy
The Community: Strategy

• The media still continue to portray pharmacists in a

dispensing-focused way, so try to use images within your
pharmacy and/or on your website or social media pages that
are of pharmacists in more clinical roles, such as completing
a medication review or taking a patient’s blood pressure.

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College of Pharmacy
Advocacy in Pharmacy
Practice and Its Impact on
Legislation
Pharmacists as advocate for policy
improvements
• Pharmacists must also advocate on behalf of the profession
through legislative, regulatory, and public health policy
efforts.
• The profession of pharmacy is governed by legislation and
regulations that are constantly changing.
• By bringing their expertise as medication specialists into
legislative and regulatory negotiations, pharmacists can
influence decisions to promote safe and effective health care
policy and delivery.
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College of Pharmacy
Pharmacists as advocate for policy
improvements
• Therefore, it is important to develop leadership and expertise in
advocacy.
• Many of the elements of professional citizenship, as they relate to
leadership and advocacy, are rooted in current core curricular
competencies including:
• communication with health care professionals and patients regarding rational
drug therapy, wellness, and health promotion;
• identification, assessment, and correction of medication- related problems;
• retrieval, evaluation, and management of professional information and
literature; and
• collaboration with other health professionals.

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College of Pharmacy
Legislative advocacy
• It is fundamental to the future of pharmacy.
• Primary responsibilities of current and future pharmacists
• To promote public health through provision of population-based care, health
and wellness initiatives, and disease prevention strategies
• The profession must advocate for change and be instrumental in guiding and
shaping public health policy.
• Critical for the expansion of pharmacist-provided services and creation of new
practice opportunities for the influx of highly trained pharmacy graduates
entering the workplace

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College of Pharmacy
Advocacy Development Practices

1. Active participation in legislation

2. Community outreach
3. Integration of advocacy throughout the curriculum

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College of Pharmacy
Challenges to Effective
Advocacy
Challenges to Effective Advocacy
• Advocacy is a component of leadership and an essential
competency for the future of pharmacy.
• However, there are challenges that must be addressed.
1. Pharmacists are pushed away from provider roles
2. Pharmacist organizations are fragmented
3. Pharmaceutical organizations have different goals
4. Conflicts of interest undermine public trust in pharmacy

Our Lady of Fatima University

College of Pharmacy
End of Presentation
Advocacy
Social and Administrative Pharmacy (PSAP 311)
College of Pharmacy
Our Lady of Fatima University
OUR LADY OF FATIMA UNIVERSITY
COLLEGE OF PHARMACY
Valenzuela. Quezon City. Antipolo. Pampanga. Cabanatuan. Laguna

Managed Care
WEEK 16
PSAP 311

Name of Lecturer
Instructor- College of Pharmacy
COURSE FACILITATOR
Introduction to
Managed Care
Introduction to Managed Care
• A growing number of pharmacists are practicing in what
could be referred to as “nontraditional” practice roles or
settings.
• Pharmacists in such roles contribute directly to patient care
(at the individual patient and population levels) and may
have direct interactions with patients and healthcare
professionals, but not necessarily face-to-face.

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College of Pharmacy
Introduction to Managed Care
• Pharmacists are also involved in providing care to animals. Veterinary
pharmacists receive special training in veterinary pharmacology and
therapeutics and must be proficient at compounding, which is a key
service for animal patients.
• Managed care is one of these nontraditional practice roles.

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College of Pharmacy
Managed Care

• It is a body of clinical, financial and organizational

activities designed to ensure the provision of
appropriate health care services in a cost-efficient
manner

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College of Pharmacy
Managed Care
• It is a broad term and encompasses many different types of
organizations, payment mechanisms, review mechanisms
and collaborations” and “is often misunderstood, as it refers
to numerous aspects of healthcare management, payment
and organization.
• In the purest sense, all people working in healthcare and
medical insurance can be thought of as ‘managing care.’

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College of Pharmacy
Managed Care Organizations
• A generic term applied to a managed care plan;
• Includes a health maintenance organization (HMO),
preferred provider organization (PPO), exclusive provider
organization (EPO), health plan, or prescription benefit
management company (PBM), although the MCO may not
conform exactly to any of these formats.

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College of Pharmacy
Health Management Organizations
(HMO)

• A form of health insurance in which its members prepay a

premium for the HMO’s health services, which generally
include inpatient and ambulatory care.
• For the patient, it means reduced out-of-pocket costs (eg, no
deductible), reduced paperwork (eg, insurance forms), and
only a small co-payment for each office visit.

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College of Pharmacy
Pharmacy Benefit Management
Company (PBMs)
• These are organizations that manage pharmaceutical benefits for
managed care organizations, other medical providers or employers,”
engage in numerous activities to promote managed care principles,
including “benefit plan design, creation/administration of retail and
mail service networks, claims processing and managed prescription
drug care services such as drug utilization review, formulary
management, generic dispensing, prior authorization and disease and
health management.”

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College of Pharmacy
Introduction to Managed Care
• Although the roles of managed care organizations (MCOs)
and PBMs include directing patients to equivalent and
affordable therapeutic options, patients are sometimes
surprised by insurance coverage denials, higher-than-
expected copayment amounts, or automatic generic
substitution.
• This surprise can result in a patient view that managed care
is simply a barrier to prescription drug access.

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College of Pharmacy
Introduction to Managed Care

• Patients interact with managed care primarily at the

point of medication dispensing—positioning
pharmacists as mediator and educator about
managed care to a large portion of the public.

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College of Pharmacy
Pharmacists in
Managed Care
Pharmacists in Managed Care

• A pharmacist in a managed care practice provides a markedly

different type of professional activity, and as a result,
additional competencies are required.
• For a pharmacist working in this environment, patients are
monitored as a population database and pharmacist care is
directed through database review and querying.

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College of Pharmacy
Pharmacists in Managed Care

• Economic and clinical outcomes are weighed against, and

with each other, to make appropriate decisions for a
“population” of patients.
• Pharmacists practicing in managed care organizations,
including health plans and PBMs, are responsible for a broad
range of clinical, quality-oriented drug management services.

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College of Pharmacy
Role of a Pharmacist in a MCO
1. Drug distribution and dispensing
2. Patient safety
3. Clinical program development
4. Communication with patients, prescribers and pharmacists
5. Drug benefit design
6. Business management
7. Cost management

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Drug distribution and dispensing
• Through their own pharmacies: pharmacists provide enhanced
pharmaceutical services, beyond traditional dispensing, because they
are members of a fully integrated patient care system
• Through community pharmacies: broad-based networks of
contracting pharmacies interface with managed care pharmacists to
provide online eligibility and claims processing
• Through mail order: pharmacists assess legitimacy of prescriptions,
eligibility for coverage, appropriateness and safety of the medication
for the patient

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College of Pharmacy
Patient safety
• Drug Utilization Review (DUR) is a process that identifies potential
prescription-related problems such as drug-drug interactions,
duplication of drugs, known allergies, under or overdosing or
inappropriate therapy
• Prior Authorization (PA) is an approval process that encourages
proper use of medications and discourages inappropriate prescribing
• Monitoring Programs for certain drugs that require lab-based
monitoring for dosage adjustment
• Quality Assurance (QA) programs that enhance patient safety and
improve patient drug use
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Clinical program development
• Use evidence-based clinical and research data to
create disease management programs
• Evaluate scientific evidence in order to select
appropriate drugs for a patient population through a
Pharmacy and Therapeutics (P&T) Committee
• Design and conduct outcomes based research in order
to help patients achieve the desired results from their
drug therapy
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Communication with patients, prescribers
and pharmacists
• Helps prescribers choose drugs that will meet
patients’ needs and qualify for coverage
• Provide and educate patients about their individual
prescription history
• Provide a dispensing pharmacist with a patient’s drug
profile in order to identify potential adverse drug
reactions or duplicate therapies

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College of Pharmacy
Drug benefit design
• Determining if a formulary (approved list of medications that
the plan will cover) should be used, and whether it should be
“restricted” or “open”; and the use of patient cost-sharing
structure for generic, covered brand-name drugs and non-
formulary drugs
• Determine if a “participating” pharmacy network should be
established and what the criteria for QA would be
• Determine criteria and procedures for drug utilization

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Business management

• Negotiate with manufacturers for discounts on drug

prices for clients in exchange for moving market share
• Provide clients with customized clinical reporting that
meet their population needs

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Cost management
• Encourage prescribers to make cost effective drug
choices
• Identify compliance and noncompliance with
prescribing guidelines; assess physician performance;
identify prescribing patterns that require
improvement

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College of Pharmacy
End of Presentation
Managed Care
Social and Administrative Pharmacy
College of Pharmacy
Our Lady of Fatima University
 OUR LADY OF FATIMA UNIVERSITY
COLLEGE OF PHARMACY
Valenzuela. Quezon City. Antipolo. Pampanga. Cabanatuan. Laguna

Research on Social and

Administrative Pharmacy
WEEK 17
PSAP 311

Name of Lecturer
Instructor- College of Pharmacy
COURSE FACILITATOR
 Research on Social and
Administrative Pharmacy
Social and Administrative Pharmacy (PSAP 311)
College of Pharmacy
Our Lady of Fatima University
Research Areas on Social
and Administrative
Pharmacy
Research Areas on Social and
Administrative Pharmacy

• Social and administrative pharmacy places its interest in the

organization of pharmacy practice and the provision of
evidence for decision-making in all areas related to
pharmacy policy and advocacy.

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College of Pharmacy
Research Areas on Social and Administrative
Pharmacy (According to FIP)
• Pharmacoeconomics • Professional society management
• Outcomes research • Evaluation research
• Research administration • Evidence-based practice
• Quality assurance • Health planning
• Pharmacoepidemiology • Regulatory affairs
• Quality-of-life studies • Health policy investigations
• Epidemiology
• Patient satisfaction

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Pharmacoeconomics
• Defined as the description and analysis of the costs of drug
therapy to health care systems and society—it identifies,
measures, and compares the costs and consequences of
pharmaceutical products and services.
• Pharmacoeconomic studies categorize costs into four types:
direct medical, direct nonmedical, indirect, and intangible.

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Outcomes research
• It tends to describe research that is concerned with the
effectiveness of public-health interventions and health
services; that is, the outcomes of these services.
• Attention is frequently focused on the affected individual -
with measures such as quality of life and preferences - but
outcomes research may also refer to effectiveness of health-
care delivery, with measures such as cost-effectiveness,
health status and disease burden.

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Quality assurance
• Can be defined as "part of quality management focused on
providing confidence that quality requirements will be
fulfilled."
• Also, QA can be defined as all the planned and systematic
activities implemented within the quality system that can be
demonstrated to provide confidence that a product or
service will fulfill requirements for quality."

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Pharmacoepidemiology
• The study of the use and effects of drugs in large numbers of
people.
• It is a growing discipline that applies epidemiological
techniques to study drug use in a large population

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Quality-of-life studies
Quality of life
• An individual's perception of their position in life in the context of the
culture and value systems in which they live and in relation to their
goals, expectations, standards and concerns.
• It is a broad ranging concept affected in a complex way by the
person's physical health, psychological state, personal beliefs, social
relationships and their relationship to salient features of their
environment.

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Epidemiology

• It is the study of the factors that determine the occurrence

and distribution of diseases in populations
• often be divided into infectious and chronic disease
epidemiology.

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Patient satisfaction

• Obtained using patient satisfaction surveys

• A patient satisfaction survey can demonstrate that a practice
is interested in quality and in doing things better; helps to
identify ways of improving practice which will ultimately
translate into better care of patients

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Evaluation research

• Refers to a research purpose rather than a specific method.

This purpose is to evaluate the impact of social interventions
such as new treatment methods, innovations in services, and
a host of others.

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Evidence-based practice
• The conscientious and judicious use of current best evidence
in conjunction with clinical expertise and patient values to
guide health care decisions.
• Best evidence includes empirical evidence from randomized
controlled trials; evidence from other scientific methods
such as descriptive and qualitative research; as well as use of
information from case reports, scientific principles, and
expert opinion.

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Health planning
• The orderly process of defining health problems, identifying
unmet needs and surveying the resources to meet them,
establishing priority goals that are realistic and feasible, and
projecting administrative action, concerned not only with
the adequacy, efficacy and efficiency of health services but
also with those factors of ecology and of social and individual
behavior that affect the health of the individual and the
community"

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Regulatory affairs
• A profession developed from the desire of governments to
protect public health by controlling the safety and efficacy of
products in areas including pharmaceuticals, veterinary
medicines, medical devices, pesticides, agrochemicals,
cosmetics and complementary medicines, and by the
companies responsible for the discovery, testing,
manufacture and marketing of these products wanting to
ensure that they supply products that are safe and make a
worthwhile contribution to public health and welfare.

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Health policy investigations
• Refers to decisions, plans, and actions that are undertaken to
achieve specific health care goals within a society.
• An explicit health policy can achieve several things: it defines
a vision for the future which in turn helps to establish targets
and points of reference for the short and medium term.
• It outlines priorities and the expected roles of different
groups; and it builds consensus and informs people.

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Research SAP: A
Focus on Patients
Research in SAP: A Focus on Patients

• As mentioned, patient-related studies can be

conducted within the context of social and
administrative pharmacy.

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Patients’ attitude towards pharmacy
profession
• Since patients are essential partners in determining priorities
and resource allocation in the healthcare system,
considerable efforts have been made to shift the focus of
pharmacy profession from drug dispensing to patient-
oriented care.
• In a cross-sectional study conducted in a teaching hospital in
Jordan, a team of researchers determined patients’ attitude
towards pharmaceutical care services among the general
population and their willingness to pay for this service.
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Patients’ attitude towards pharmacy
profession
• They found out that most of the participants showed a positive
attitude towards pharmaceutical care services, with an average
attitude.
• The majority of participants expressed their interest in pharmacists
checking their medications at least once per month.
• Most of the participants believed that the pharmacist should be
reimbursed for providing a pharmaceutical care service that would
potentially reduce medication-related problems (MRPs) by 50%.

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Patients’ attitude towards pharmacy
profession
• Of these, about 93.3% of the participants were willing to pay
out of their pockets an average maximum amount of $3.95
for the pharmaceutical care services they may receive to
reduce 50% of the risk of MRPs.
• The study revealed that Jordanian people have a supportive
attitude regarding pharmacists’ abilities in providing
pharmaceutical care services in addition to dispensing.

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Patients and Medication Adherence
• The issue on medication adherence is also another area to
explore in SAP research.
• Poor adherence to long-term therapies is a public health
concern that affects all populations.
• Little is known about the context of adherence in chronic
diseases for the uninsured population.

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Patients and Medication Adherence
• In a study published in the journal Research in Social and
Administrative Pharmacy in 2018, which evaluated
medication adherence and barriers among low-income,
uninsured adults recently initiating new therapy for a chronic
disease, it was found that medication non-adherence was
common among low-income, uninsured patients initiating
therapy for chronic conditions.
• Several modifiable barriers highlight opportunities to
address medication non-adherence through multidisciplinary
interventions.
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Patient Preferences
• Determining patient preferences about the pharmacy service they
receive is crucial for pharmacies in order to develop strategies to
improve their services.
• Patients select healthcare providers and facilities based on a complex
array of factors.
• To help patients with their preferences, pharmacy-level quality
metrics have been discussed as a way to help direct patients towards
high-quality pharmacies.
• Limited research has been conducted on the potential impact of
quality metrics on the pharmacy selection process.
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Patient Preferences
• In a paper published in 2018, a group of researchers measured the
relative strength of patient preferences for community pharmacy
attributes and described associations between patient
sociodemographic and health characteristics and pharmacy
preferences.
• They found out that the participants expressed the strongest
preferences for competence-based pharmacy attributes, including
DDI-specific and overall quality measures.
• They also noted that women ascribed higher utility to 5-star DDI and
overall quality ratings than men.

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Patient Preferences
• Also, results showed that rural respondents and those with
inadequate health literacy expressed stronger preferences for patient-
pharmacist relationships than those in suburban areas and with
adequate health literacy, respectively.
• These results suggest that the participants may perceive medication
safety to be a key role of community pharmacists.
• Future research on patient expectations of and preferences for
community pharmacies can inform ways to effectively encourage
patient engagement with pharmacists to improve health outcomes.

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Research SAP: The
Pharmacy Practice
Research in SAP: The Pharmacy
Practice

• The practice of pharmacy is faced with a lot of challenges.

• In order to overcome and solve such challenges, researches
are conducted to have a better perspective of a particular
problem so that solutions can be presented.

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Pharmacists and the Traditional and
Complementary Medicine Products

• Traditional medicine (TM) and complementary medicine (CM)

products have played an increasingly important role in the business of
pharmacy for over two decades in a number of countries.
• With a focus on the quality use of all medicines including
complementary medicines, there have been a number of initiatives to
encourage the integration of TM/CM products into professional
practice.

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Pharmacists and the Traditional and
Complementary Medicine Products
• Recent studies report that many of the barriers that prevent
such integration remain.
• In 2017, researchers published a study which explored the
pharmacists' perspective regarding how barriers to the
integration of TM/CM products into the professional practice
of pharmacy could be resolved.

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Pharmacists and the Traditional and
Complementary Medicine Products
• In that study, the participating pharmacists proposed that
five key stakeholders – professional pharmacy organizations,
universities, government, pharmacy owners, and
pharmacists – enact developments that require a
collaborative effort on education and training; building the
evidence base; developing reliable and accessible
information resources; and workplace support for best
practice.

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Reluctance Among Pharmacists in
Conducting Research

• The role of pharmacists in healthcare has evolved towards

patient-centered care.
• Pharmacy practice-based research is essential to the
advancement of practice; however, literature addressing
attitudes and involvement of pharmacists in practice
research indicates reluctance among them.

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Reluctance Among Pharmacists in
Conducting Research
• In a systematic review published in 2014 which summarized
and evaluated the views and attitudes of pharmacists
regarding their involvement in pharmacy practice research as
well as the barriers and enablers to such research, they
found that pharmacists recognize the value of research in
advancing pharmacy practice and indicate their willingness
to be involved in independent research and in practice-based
research networks (PBRNs).

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Reluctance Among Pharmacists in
Conducting Research
• However, the lack of time, training and support were
identified as the greatest limitations to participation in
practice research.
• These findings therefore have important implications on
promoting research capacity building through the
development of PBRNs involving academic and pharmacy
practitioners as well as informal research training programs.

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The Use of Technology in Gathering Data
• It could be quite difficult to obtain data from pharmacists when
conducting studies about pharmacy practice.
• In 2018, a team of researchers in the Netherlands assessed the
amount of time community pharmacists spend on different activities
(i.e., professional, semi-professional or non-professional) and how
these activities are divided over the workweek.
• In order to do so, a smartphone application was developed to register
the activities of participating pharmacists.

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The Use of Technology in Gathering Data
• The application randomly alerted pharmacists to record their
activities.
• Results indicated that the Dutch community pharmacists spent 51.5%
of their time on professional activities, 35.4% on semi-professional
activities, and 13.1% on non-professional activities.
• The proportion of time devoted to cognitive pharmaceutical services
(CPS) decreased during the workweek, whereas the time spent on
traditional task increased.

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The Use of Technology in Gathering Data
• With the results presented, this shows that it is feasible to
collect work-sampling data using smartphone technology.
• In practice, the transition to CPS is hampered by competing
traditional tasks, which prevents community pharmacists
from profiling themselves as pharmaceutical experts in daily
practice.

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End of Presentation
Research on Social and Administrative Pharmacy
Social and Administrative Pharmacy (PSAP 311)
College of Pharmacy
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