An Investigation Of The Pharmacist Patient Relationship As Social Exchange

Pharmacists face ethical choices constantly -- sometimes dramatic life-and-death decisions, but more often subtle, less conspicuous choices that are nonetheless important. Among the topics confronted are assisted suicide, conscientious refusal, pain management, equitable distribution of drug resources within institutions and managed care plans, confidentiality, and alternative and non-traditional therapies. Veatch and Haddad's book, first published in 1999, was the first collection of case studies based on the real experiences of practicing pharmacists, for use as a teaching tool for pharmacy students. The second edition accounts for the many changes in pharmacy since 1999, including assisted suicide in Oregon, the purchasing of less expensive drugs from Canada, and the influence of managed care on prescriptions. The presentation of some cases is shortened, most are revised and updated, and two new chapters have been added. The first new chapter presents a new model for analyzing cases, while the second focuses on the ethics of new drug distribution systems, for example hospitals where pharmacists are forced to choose drugs based on cost-effectiveness, and internet based pharmacies.

A consistent branch of research in health communication has been focused on the study of the pharmacist - patient relationship. In past decades, the pharmacist and his role in the health care setting has shifted from a product oriented approach, where the primary focus was the production and compound of medicines, to a more patient oriented approach, with main focus becoming the understanding and caring for clients and the problems they bring to their health care providers. As a consequence, research in the health communication field, with a focus on community pharmacy settings needs to examine strategies to get the pharmacist closer to the clients, developing a long - term relationship, and adopting a more patient- oriented information approach to move closer to the needs of the client. The main purpose of my doctoral thesis is to examine the pharmacist - client relationship focusing in particular on the attempt to integrate the Stages of Change Model (Prochaska and DiClemente, 1983), with two models currently in use to describe relationship development in the pharmacy context, in order to identify strategies that can support the pharmacists in building a relationship of loyalty with their clients in the future. I hypothesized that targeting health information according to the level of the relationship clients are in could produce the necessary loyalty to commit to the pharmacist and to enhance the long run acceptance and effectiveness of the health message. In particular, the empirical section is devoted to understanding how to produce the necessary loyalty that can lead to better future response for the therapeutic and health needs of the client. The hypothesis was tested in the context of Tessin pharmacist - client relationship by means of a three phase study: an explorative study, a descriptive study, and finally an intervention study. Using the data collected in the descriptive study, two models of relationship development were tested: one static and one dynam.

Encyclopedia of Pharmacy Practice and Clinical Pharmacy, Three Volume Set covers definitions, concepts, methods, theories and applications of clinical pharmacy and pharmacy practice. It highlights why and how this field has a significant impact on healthcare. The work brings baseline knowledge, along with the latest, most cutting-edge research. In addition, new treatments, algorithms, standard treatment guidelines, and pharmacotherapies regarding diseases and disorders are also covered. The book's main focus lies on the pharmacy practice side, covering pharmacy practice research, pharmacovigilance, pharmacoeconomics, social and administrative pharmacy, public health pharmacy, pharmaceutical systems research, the future of pharmacy, and new interventional models of pharmaceutical care. By providing concise expositions on a broad range of topics, this book is an excellent resource for those seeking information beyond their specific areas of expertise. This outstanding reference is essential for anyone involved in the study of pharmacy practice. Provides a ‘one-stop’ resource for access to information written by world-leading scholars in the field Meticulously organized, with articles split into three clear sections, it is the ideal resource for students, researchers and professionals to find relevant information Contains concise and accessible chapters that are ideal as an authoritative introduction for non-specialists and readers from the undergraduate level upwards Includes multimedia options, such as hyperlinked references and further readings, cross-references and videos

Pharmacists' roles are evolving from dispensing to providing patient-centred care. Appropriate patient-pharmacist communication is important in achieving patient-centred care aims. The research in this dissertation explored audiotaped recordings of pharmacist-patient interactions to determine communicative practices and how pharmacist and patient use strategic communication to achieve instrumental and interpersonal goals. In the first published study of this dissertation, recorded interactions provided insight into the extent of biomedical versus patient-centred communication in patient-pharmacist exchanges. Studies were identified by searching: Medline, Embase, International Pharmaceutical Abstracts (IPA), Web of Science, and Academic Search Complete. Inclusion criteria were that studies were published in English. Key search terms included: "audio recording", "video recording", "communication", "patient counselling", "patient interaction", "discourse analysis", "conversation analysis", "narrative analysis", and "content analysis". The review the included 41 studies found that biomedical and patient centred communication focused researches were framed within quantitative, qualitative methods, including conversational analysis. Twenty-three studies presented evidence of a biomedical model, whereas eight studies characterized a patient-centred focus. Respect, dignity, autonomy, and acknowledgment affect patient-pharmacist communication process and no study explored the effect of neither these factors nor the social context on this communication process. In the second study in this thesis, the advantages of using face-work theory to analyze patient-pharmacist interactions were identified. The second study described the concept of face and the three types of face needs. Pharmacists and patients demonstrated these three types of face needs during their interaction with each other and the third study in this thesis explored how these face needs are negotiated and challenged by both parties. The study used an exploratory descriptive design to identify the major contexts of expressing and negotiating face in audio-recorded community pharmacist-patient interactions. Its results explained how certain speech acts linked with face needs in order to avoid or mitigate face threat and how successful pharmacist-patient relationships are established when both pharmacist and patient have mutual understanding of their face needs. The research results contained in this dissertation contribute to knowledge about how pharmacists combine instrumental communication strategies to achieve patience centred goals for patient education, medication assessment and self-care management. Simultaneously, pharmacists attend to interpersonal face needs in the domains of competence, autonomy and solidarity, because without attention to these facets of interaction, instrumental goals are more difficult to achieve. Although the data from the empirical studies in this dissertation are limited by sample size and audio-only recording format, this research provides a unique insight into face-work interaction in the context of pharmacy practice. Face-Work Theory provides a useful mechanism by which to understand how professional pharmacy interactions are most effective when mutual face needs are supported and actual or potential face threats are avoided or mitigated. These findings may be useful to guide pharmacy education to support patient centred practice. Further research using video-recorded pharmacy interactions is required to confirm and extended these findings.

This long awaited Third Edition fully illuminates the patient-centered model of medicine, continuing to provide the foundation for the Patient-Centered Care series. It redefines the principles underpinning the patient-centered method using four major components - clarifying its evolution and consequent development - to bring the reader fully up-to-