Shenton, Julie Jane Louise (2020) An exploration of hospital pharmacists’ attitudes and opinions towards undertaking research. Doctoral thesis, Keele University.

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Abstract

Background
Research in the NHS is essential to provide evidence to improve services and patient outcomes. The Government’s continued commitment to research has been made clear through the inclusion of research in key NHS policy documents including the Health and Social Care Act 2012, the NHS Constitution and, more recently, the NHS Long Term Plan. Alongside these policy documents there is also an increasing body of evidence demonstrating the impact of research on improved quality of care. Therefore, as employees of the NHS, pharmacists working in the hospital sector in the UK need to engage with research not only because of the importance of research to the NHS but also to provide the evidence base to advance the practice of pharmacy. However, engagement within the profession is limited despite the Royal Pharmaceutical Society identifying research to be a professional expectation of pharmacists.
Objectives
This research aimed to explore the attitudes and opinions of hospital pharmacists to undertaking research to understand better the drivers, drawbacks, barriers and enablers to engagement of pharmacists employed in this sector and to explore the characteristics of research-active pharmacy departments.
Methods
An initial feasibility study was undertaken with a cohort of six chief pharmacists of secondary care NHS Trusts in the West Midlands, representing four acute Trusts and two mental health Trusts. Semi-structured interviews were conducted with participants to explore their attitudes and opinions. This feasibility study informed the research approach taken for the main research study which used a mixed methods research design and comprised two phases - an initial qualitative phase conducted using case study research methodology followed by a subsequent quantitative phase employing survey research.
For the case study research, four case study sites were identified each representing an acute secondary care teaching hospital NHS Trust in England where the pharmacy department had comparatively high levels of research activity among pharmacists together with a model of support for pharmacists to undertake research. At each case study site, individual semi-structured face-to-face interviews were conducted with the chief pharmacist and a cohort of research-active pharmacists. Interviews were audio-recorded and transcribed verbatim, with thematic analysis used to analyse the data. The survey phase of the research was undertaken to establish how widely the case study research findings were shared among chief pharmacists of acute secondary care NHS Trusts in England. To conduct the survey, a structured questionnaire was developed based on the case study research findings, and the questionnaire was distributed as a self-administered web-based survey.
Results
Lack of time and difficulty obtaining funding appeared to be the most significant barriers to engagement, as well as lack of personal competence in research and organisational culture i.e. research not being prioritised. A lack of understanding and awareness of research within the profession was also identified, as was a lack of appreciation of the value of research in relation to improving practice. Key enablers identified included allowing pharmacists time to conduct research, whether that be through research being integrated into pharmacists’ roles or through funding enabling individuals’ roles to be backfilled, and pharmacists having access to individuals with research expertise within their departments. Gaining research expertise through postgraduate qualifications was also identified as an enabler. Research experience was identified as a significant driver for pharmacists to undertake further research, as was a pharmacy department having a culture for research. Drawbacks identified related to the impact of research on service delivery, and the difficulty associated with backfilling posts with funding from research grants.
The pharmacy departments in the case study phase of the research all had a culture for research which was evident through research being made visible within departments via promotion of research opportunities and promotion of research activity, the existence of departmental research forums, and having departmental leadership for research. All four case study sites had mechanisms in place to support pharmacists to undertake research. These included allowing pharmacists time to conduct research and employing a lead pharmacist for research who had research expertise. The leadership of the chief pharmacist appeared to be key to developing a research culture within the department and to ensuring such mechanisms of support were in place. All of the case study sites also had a culture for research at Trust level. However, the influence of the Trust culture on pharmacy-led research was unclear, although it was recognised to potentially make such research easier to undertake suggesting it removed some of the contextual barriers to engagement.
Conclusions
To increase engagement with research among pharmacists in the hospital sector, pharmacists need time to conduct research and need access to research expertise. The leadership of the chief pharmacist appears to be key to pharmacists employed in this sector having this support. Pharmacists also need to better understand the importance of research to their practice and how to engage with research. To achieve this there needs to be a culture change at professional level. In addition, pharmacists lack the knowledge and skills to undertake research from their undergraduate degree. Exposing pharmacists to research early in their careers may not only equip them with the knowledge and skills to undertake research but, as research experience was identified as a driver for engagement, it would have the potential to instil in them a desire to undertake further research throughout their career.

Item Type: Thesis (Doctoral)
Subjects: R Medicine > RM Therapeutics. Pharmacology
Divisions: Faculty of Medicine and Health Sciences > School of Pharmacy and Bioengineering
Contributors: Fitzpatrick, Ray (Thesis advisor)
Depositing User: Lisa Bailey
Date Deposited: 03 Jul 2020 11:26
Last Modified: 03 Jul 2020 11:26
URI: https://eprints.keele.ac.uk/id/eprint/8330

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