Skip to main content
Top
Published in: Human Resources for Health 1/2018

Open Access 01-12-2018 | Research

Conceptualising production, productivity and technology in pharmacy practice: a novel framework for policy, education and research

Authors: D Baines, I Bates, L Bader, C Hale, P Schneider

Published in: Human Resources for Health | Issue 1/2018

Login to get access

Abstract

Context and background

People and health systems worldwide face serious challenges due to shifting disease demographics, rising population demands and weaknesses in healthcare provision, including capacity shortages and lack of impact of healthcare services. These multiple challenges, linked with the global push to achieve universal health coverage, have made apparent the importance of investing in workforce development to improve population health and economic well-being. In relation to medicines, health systems face challenges in terms of access to needed medicines, optimising medicines use and reducing risk.
In 2017, the International Pharmaceutical Federation (FIP) published global policy on workforce development (‘the Nanjing Statements’) that describe an envisioned future for professional education and training. The documents make clear that expanding the pharmacy workforce benefits patients, and continually improving education and training produces better clinical outcomes.

Aims and purpose

The opportunities for harnessing new technologies in pharmacy practice have been relatively ignored. This paper presents a conceptual framework for analysing production methods, productivity and technology in pharmacy practice that differentiates between dispensing and pharmaceutical care services. We outline a framework that may be employed to study the relationship between pharmacy practice and productivity, shaped by educational and technological inputs.

Method and results

The analysis is performed from the point of view of health systems economics. In relation to pharmaceutical care (patient-oriented practice), pharmacists are service providers; however, their primary purpose is not to deliver consultations, but to maximise the quantum of health gain they secure. Our analysis demonstrates that ‘technology shock’ is clearly beneficial compared with orthodox notions of productivity or incremental gain implementations. Additionally, the whole process of providing professional services using ‘pharmaceutical care technologies’ is governed by local institutional frames, suggesting that activities may be structured differently in different places and countries.

Discussion and Conclusion

Addressing problems with medication use with the development of a pharmaceutical workforce that is sufficient in quantity and competence is a long-term issue. As a result of this analysis, there emerges a challenge about the profession’s relationship with existing and emerging technical innovations. Our novel framework is designed to facilitate policy, education and research by providing an analytical approach to service delivery. By using this approach, the profession could develop examples of good practice in both developed and developing countries worldwide.
Literature
6.
go back to reference Almarsdóttir AB, Traulsen JM. Rational use of medicines--an important issue in pharmaceutical policy. Pharm World Sci. 2005;27:76–80.CrossRef Almarsdóttir AB, Traulsen JM. Rational use of medicines--an important issue in pharmaceutical policy. Pharm World Sci. 2005;27:76–80.CrossRef
8.
10.
go back to reference Bates DW, Cullen DJ, Laird N, Petersen LA, Small SD, Servi D, et al. Incidence of adverse drug events and potential adverse drug events. Implications for prevention. ADE Prevention Study Group. J Am Med Assoc. 1995;274:29–34.CrossRef Bates DW, Cullen DJ, Laird N, Petersen LA, Small SD, Servi D, et al. Incidence of adverse drug events and potential adverse drug events. Implications for prevention. ADE Prevention Study Group. J Am Med Assoc. 1995;274:29–34.CrossRef
11.
go back to reference Gurwitz JH, Field TS, Harrold LR, Rothschild J, Debellis K, Seger AC, et al. Incidence and preventability of adverse drug events among older persons in the ambulatory setting. J Am Med Assoc. 2003;289:1107–16.CrossRef Gurwitz JH, Field TS, Harrold LR, Rothschild J, Debellis K, Seger AC, et al. Incidence and preventability of adverse drug events among older persons in the ambulatory setting. J Am Med Assoc. 2003;289:1107–16.CrossRef
12.
go back to reference Johnson JA, Bootman JL. Drug-related morbidity and mortality– a cost of illness model. Arch Int Med. 1995;155:1949–56.CrossRef Johnson JA, Bootman JL. Drug-related morbidity and mortality– a cost of illness model. Arch Int Med. 1995;155:1949–56.CrossRef
13.
go back to reference Schneider PJ, Gift MG, Lee YP, Rothermich EA, Sill BE. Cost of medication-related problems at a university hospital. Am J Health-Syst Pharm. 1995;52:2415–8.PubMed Schneider PJ, Gift MG, Lee YP, Rothermich EA, Sill BE. Cost of medication-related problems at a university hospital. Am J Health-Syst Pharm. 1995;52:2415–8.PubMed
14.
go back to reference Bates DW, Spell N, Cullen DJ, Brudrick E, Laird N, Peterson LA, et al. The cost of adverse drug events in hospitalized patients. J Am Med Assoc. 1997;277:307–11.CrossRef Bates DW, Spell N, Cullen DJ, Brudrick E, Laird N, Peterson LA, et al. The cost of adverse drug events in hospitalized patients. J Am Med Assoc. 1997;277:307–11.CrossRef
15.
go back to reference Classen DC, Pestotnik SL, Evans RS, Lloyd JF, Burke JP. Adverse drug events in hospitalized patients – excess length of stay, extra costs, and attributable mortality. J Am Med Assoc. 1997;277:301–6.CrossRef Classen DC, Pestotnik SL, Evans RS, Lloyd JF, Burke JP. Adverse drug events in hospitalized patients – excess length of stay, extra costs, and attributable mortality. J Am Med Assoc. 1997;277:301–6.CrossRef
16.
go back to reference Hepler CD, Strand LM. Opportunities and responsibilities in pharmaceutical care. Am J Hosp Pharm. 1990;47:533–43.PubMed Hepler CD, Strand LM. Opportunities and responsibilities in pharmaceutical care. Am J Hosp Pharm. 1990;47:533–43.PubMed
17.
go back to reference Patterson ES, Cook RI, Render ML. Improving patient safety by identifying side effects from introducing bar coding in medication administration. J Am Med Inform Assoc. 2002;9:540–53.CrossRef Patterson ES, Cook RI, Render ML. Improving patient safety by identifying side effects from introducing bar coding in medication administration. J Am Med Inform Assoc. 2002;9:540–53.CrossRef
18.
go back to reference Koppel R, Metlay JP, Cohen A, Abaluck B, Localio AR, Kimmel SE, et al. Role of computerized physician order entry systems in facilitating medication errors. J Am Med Assoc. 2005;293:1197–203.CrossRef Koppel R, Metlay JP, Cohen A, Abaluck B, Localio AR, Kimmel SE, et al. Role of computerized physician order entry systems in facilitating medication errors. J Am Med Assoc. 2005;293:1197–203.CrossRef
19.
go back to reference Penna RP. Pharmaceutical care: pharmacy’s mission for the 1990s. Am J Health Syst Pharm. 1990;47:543–9. Penna RP. Pharmaceutical care: pharmacy’s mission for the 1990s. Am J Health Syst Pharm. 1990;47:543–9.
20.
go back to reference Baines D. Pharmaceutical care: the blueprint for modern pharmacy. Presc. 2014;25:14–6.CrossRef Baines D. Pharmaceutical care: the blueprint for modern pharmacy. Presc. 2014;25:14–6.CrossRef
21.
go back to reference Hepler CD. Unresolved issues in the future of pharmacy. Am J Health Syst Pharm. 1988;45:1071–81. Hepler CD. Unresolved issues in the future of pharmacy. Am J Health Syst Pharm. 1988;45:1071–81.
22.
go back to reference Baines D, Hale C. Is there an appropriate framework for examining UK pharmacy practice. Pharm J. 2005;275:687–8. Baines D, Hale C. Is there an appropriate framework for examining UK pharmacy practice. Pharm J. 2005;275:687–8.
23.
go back to reference Baines D, Hale C. New framework for analysing pharmacy practice. Pharm J. 2005;274:56–7. Baines D, Hale C. New framework for analysing pharmacy practice. Pharm J. 2005;274:56–7.
24.
go back to reference Allemann SS, van Mil JF, Botermann L, Berger K, Griese N, Hersberger KE. Pharmaceutical care: the PCNE definition 2013. Int J Clin Pharm 2014; 36:544–555.CrossRef Allemann SS, van Mil JF, Botermann L, Berger K, Griese N, Hersberger KE. Pharmaceutical care: the PCNE definition 2013. Int J Clin Pharm 2014; 36:544–555.CrossRef
25.
go back to reference Houle SK, Grindrod KA, Chatterley T, Tsuyuki RT. Paying pharmacists for patient care: a systematic review of remunerated pharmacy clinical care services. Can Pharm J (Ott). 2014;147:209–32.CrossRef Houle SK, Grindrod KA, Chatterley T, Tsuyuki RT. Paying pharmacists for patient care: a systematic review of remunerated pharmacy clinical care services. Can Pharm J (Ott). 2014;147:209–32.CrossRef
26.
go back to reference Kimber MB, Peterson GM. Telepharmacy—enabling technology to provide quality pharmacy services in rural and remote communities. J Pharm Pract Res. 2006;36:128–33.CrossRef Kimber MB, Peterson GM. Telepharmacy—enabling technology to provide quality pharmacy services in rural and remote communities. J Pharm Pract Res. 2006;36:128–33.CrossRef
27.
go back to reference Peterson CD, Anderson HC Jr. The North Dakota telepharmacy project: restoring and retaining pharmacy services in rural communities. J Pharm Technol. 2004;20:28–39.CrossRef Peterson CD, Anderson HC Jr. The North Dakota telepharmacy project: restoring and retaining pharmacy services in rural communities. J Pharm Technol. 2004;20:28–39.CrossRef
28.
go back to reference Gumpper BS, Siska MH, Pharm BS, Everson J, Mahaney LM. Technology-enabled practice: a vision statement by the ASHP section of pharmacy informatics and technology. Am J Health Syst Pharm. 2009;66:1573–7.CrossRef Gumpper BS, Siska MH, Pharm BS, Everson J, Mahaney LM. Technology-enabled practice: a vision statement by the ASHP section of pharmacy informatics and technology. Am J Health Syst Pharm. 2009;66:1573–7.CrossRef
29.
go back to reference Siska MH, Tribble DA. Opportunities and challenges related to technology in supporting optimal pharmacy practice models in hospitals and health systems. Am J Health Syst Pharm. 2011;68:1116–26.CrossRef Siska MH, Tribble DA. Opportunities and challenges related to technology in supporting optimal pharmacy practice models in hospitals and health systems. Am J Health Syst Pharm. 2011;68:1116–26.CrossRef
30.
go back to reference Baines D. Dispensing: it’s time to let go. Pharm J. 2015;294:113–4. Baines D. Dispensing: it’s time to let go. Pharm J. 2015;294:113–4.
31.
go back to reference Bates DW, Teich JM, Lee J, Seger D, Kuperman GJ, Ma’Luf N, et al. The impact of computerized physician order entry on medication error prevention. J Am Med Inform Assoc. 1999;6:313–21.CrossRef Bates DW, Teich JM, Lee J, Seger D, Kuperman GJ, Ma’Luf N, et al. The impact of computerized physician order entry on medication error prevention. J Am Med Inform Assoc. 1999;6:313–21.CrossRef
32.
go back to reference Bugnon O, Hugentobler-Hampaï D, Berger J, Schneider MP. New roles for community pharmacists in modern health care systems: a challenge for pharmacy education and research. CHIMIA Int C. 2012;66:304–7.CrossRef Bugnon O, Hugentobler-Hampaï D, Berger J, Schneider MP. New roles for community pharmacists in modern health care systems: a challenge for pharmacy education and research. CHIMIA Int C. 2012;66:304–7.CrossRef
33.
go back to reference Baines D. Community pharmacies deserve a renaissance. Int Pharm J. 2015;33:46–7. Baines D. Community pharmacies deserve a renaissance. Int Pharm J. 2015;33:46–7.
34.
go back to reference Rogers E. M: diffusion of innovations. New York: Free Press; 2003. Rogers E. M: diffusion of innovations. New York: Free Press; 2003.
35.
go back to reference Birenbaum A. Reprofessionalization in pharmacy. Soc Sci Med. 1982;16:871–8.CrossRef Birenbaum A. Reprofessionalization in pharmacy. Soc Sci Med. 1982;16:871–8.CrossRef
36.
go back to reference Petrakaki D, Barber N, Waring J. The possibilities of technology in shaping healthcare professionals: (Re/De-) professionalisation of pharmacists in England. Soc Sci Med. 2012;75:429–37.CrossRef Petrakaki D, Barber N, Waring J. The possibilities of technology in shaping healthcare professionals: (Re/De-) professionalisation of pharmacists in England. Soc Sci Med. 2012;75:429–37.CrossRef
Metadata
Title
Conceptualising production, productivity and technology in pharmacy practice: a novel framework for policy, education and research
Authors
D Baines
I Bates
L Bader
C Hale
P Schneider
Publication date
01-12-2018
Publisher
BioMed Central
Published in
Human Resources for Health / Issue 1/2018
Electronic ISSN: 1478-4491
DOI
https://doi.org/10.1186/s12960-018-0317-5

Other articles of this Issue 1/2018

Human Resources for Health 1/2018 Go to the issue