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Biomedical subjects

Paul Bissell

Publications and source records attributed to Paul Bissell.

8 recordsLinked to original sources
PubMed2006

Pharmacogenetics, the next challenge for pharmacy?

This commentary draws attention to and raises awareness of forthcoming pharmacogenetic technologies amongst the pharmacy profession. It aims to stimulate debate around the potential role that the pharmacy profession can play in the introduction of pharmacogenetic technologies into primary healthcare. This commentary discusses potential new roles for pharmacists involving pharmacogenetic technologies, giving attention to the way the profession may need to adapt to accommodate these.

Education, Pharmacy↗
PubMed2006

Narratives about illness and medication: a neglected theme/new methodology within pharmacy practice research. Part I: conceptual framework.

This paper sets out a conceptual and theoretical framework relevant to developing research in the area of narratives about medication. Drawing on an understanding and critique of the psychological, sociological and anthropological literature in the area of patients' narratives about health and illness, we argue that pharmacy practice researchers need to acknowledge and appreciate the insights that can come from engaging with narrative. We provide a critique of the current limitations of pharmacy practice research as applied to patient's use of medication and suggest that an appreciation of narrative might provide another window on the world of patients' experiences.

Attitude of Health Personnel↗
PubMed2005

A qualitative study of pharmacists' perspectives on the supply of emergency hormonal contraception via patient group direction in the UK.

AIM: To investigate pharmacists' views and experiences of supplying emergency hormonal contraception (EHC) via a group prescribing protocol in community pharmacies in the UK. DESIGN: Qualitative study using depth interviews. SETTING: Community pharmacists in Manchester, Salford and Trafford (Greater Manchester), and Lambeth, Southwark and Lewisham (London) Health Action Zones in the UK. PARTICIPANTS: Forty-four community pharmacists supplying EHC in Manchester, Salford and Trafford, and Lambeth, Southwark and Lewisham (London). RESULTS: Pharmacists were broadly very positive about their experiences supplying EHC via the group prescribing protocol. Pharmacists identified many benefits of the EHC schemes for clients, in particular, improved access to EHC at no cost to clients. The confidential nature of the scheme was also seen as an advantage as was the scope for referral to other service providers. Pharmacists also believed that the scheme had benefits for the profession in terms of enhanced professional standing. However, their concerns included the extent of repeated use of EHC, the possible impact on contraceptive behaviors and sexually transmitted infections and its impact on male coercive sexual behavior. CONCLUSIONS: Although pharmacy supply of EHC may improve access for some clients and is perceived as a popular service, research into the implications of the schemes as identified in this study need to be conducted.

Anecdotes as Topic↗
PubMed2004

The Scope of pharmacy ethics-an evaluation of the international research literature, 1990-2002.

This paper attempts to provide a critical overview of international published discourse relating to ethical issues in pharmacy practice from 1990 to 2002. We found that there is little research literature specifically addressing ethics in pharmacy practice and almost none addressing fundamental philosophical issues or values for pharmacy ethics. There is no dedicated journal for pharmacy ethics. Most material relating to pharmacy ethics is articulated as codes or pronouncements from professional bodies, as opinion or reflection in textbooks and in debate such as letters and articles. However, this should not be taken to mean that pharmacy and ethics are strangers; simply that such matters are not frequently analysed in published pharmacy literature. The presumption is usually that most matters of pharmacy ethics are very familiar and require no exploration or explanation. Where the research literature does target ethical issues, the most common method is to employ "the scenario approach". This term describes the technique of using a vignette or scenario from actual pharmacy practice and then exploring a variety of possible options to identify one or more defensible solutions. The vast majority of scenarios related to the delivery of healthcare per se; rather fewer derived from delivery of healthcare in a commercial environment. One notable exception to this approach is the body of work by Latif and colleagues on moral reasoning and community pharmacy practice. Our review suggests there is a need for the knowledge base in pharmacy ethics to be systematised and integrated into the wider scheme of general healthcare ethics. The principal areas in which research is needed include, how best to teach and assess "ethical competence" before practice; how to develop and update this competence in practising pharmacists; and how the business environment, particularly where there are corporate values and reward systems in operation, affects ethical competence. In addition, general research in pharmacy practice may benefit from a greater awareness and enquiry as to the ethical issues raised by the projects being undertaken.

Ethics, Pharmacy↗
PubMed2004

From compliance to concordance: barriers to accomplishing a re-framed model of health care interactions.

As a framework for organising health care interactions, compliance and adherence have come in for increasing criticism in recent years. It has been suggested that interactions with patients should not be viewed simply as opportunities to reinforce instructions around treatment: rather, they should be seen as a space where the expertise of patients and health professionals can be pooled to arrive at mutually agreed goals. This concept-known as concordance-is attracting increasing interest in health services research within the UK. In this paper, we seek to empirically explore the relevance of a re-framed consultation through qualitative interviews with a small group of English speaking patients of Pakistani origin with a diagnosis of type 2 diabetes. We suggest that the focus of many respondents in this study on material and structural factors limiting diabetic regimen integration and the emphasis on a 'doctor-centred' model of health care interactions represent distinct problems for the accomplishment of the concordance project. However, given that some patients sought greater understanding and appreciation by health professionals of the subjective aspects of living with diabetes, if it is evaluated at the level of health care relationships, rather than health outcomes (such as improved compliance) concordance may well be a significant development for those who suggest that respect for the patients agenda is a fundamental aspect of health care.

Asian People↗
PubMed2004

Using semi covert research to evaluate an emergency hormonal contraception service.

OBJECTIVE: The aim of our study was to evaluate whether the patient group direction protocol for supply of emergency hormonal contraception was being adhered to, that pharmacists were undertaking their professional duties appropriately and to evaluate how women researchers felt that the service was being delivered. METHOD: Semi covert research was used, two women researchers posed as clients seeking emergency contraception in a sample of participating community pharmacies. They used two rehearsed scenarios about unsafe sexual intercourse and missed doses of the oral contraceptive pill. All transactions were tape recorded and the recordings were used to produce the findings. The two women researchers posing as clients were also asked to record their feelings and experiences concerning the service on leaving the pharmacy. MAIN OUTCOME MEASURE: Adherence to the patient group direction protocol and women's perceptions of service provision. RESULTS: In both scenarios the protocol was largely adhered to and emergency contraception was supplied appropriately. The length of each consultation for both scenarios was between 10-15 min. The women reported that the pharmacists had been courteous, polite and non judgemental. The consultations were carried out in a private area or in the dispensary. The women had no concerns about confidentiality. CONCLUSION: Whilst there are clear limitations of this study in terms of the size of the sample, our results do highlight the fact that the PGD protocol was being utilised appropriately in most cases. In addition, neither woman reported any instances of judgmental or negative attitudes and commented favourably on the scope for discussion about emergency hormonal contraception and other important issues with the pharmacist.

Adolescent↗
PubMed2003

Supplying emergency contraception via community pharmacies in the UK: reflections on the experiences of users and providers.

This paper discusses findings from an evaluation of a scheme to provide free emergency hormonal contraception (EHC) via community pharmacies in the North-West of England. Drawing on interview data with pharmacists taking part in the scheme and focus groups with users, we tentatively suggest that the scheme was largely well received. The benefits of the service, cited by both pharmacists and users, included enhanced access to EHC, at times when it was needed, and at no cost to the user. In particular, users noted a welcome absence of judgmental attitudes when accessing the service. Pharmacists too were positive about the service, not least because they believed that it conferred enhanced professional status. However, both users and pharmacists had a number of major concerns about the schemes, centring on the potential for misuse, changes in contraceptive behaviour and the impact on sexually transmitted infections. We conclude that more research is needed to explore these issues.

Adult↗