Therapeutic decision-making in primary care pharmacy practice.

Clinical reasoning Information gathering Judgement Pharmacy practice Primary care Therapeutic decision-making

Journal

Research in social & administrative pharmacy : RSAP
ISSN: 1934-8150
Titre abrégé: Res Social Adm Pharm
Pays: United States
ID NLM: 101231974

Informations de publication

Date de publication:
02 2021
Historique:
received: 12 11 2019
revised: 04 04 2020
accepted: 04 04 2020
pubmed: 20 4 2020
medline: 29 7 2021
entrez: 20 4 2020
Statut: ppublish

Résumé

Therapeutic decision-making is a core element of pharmacy practice, however, little has been documented about how it is enacted in practice and how it can be theorised. This study aims to contribute to pharmacy education and practice theory by investigating the correspondence between explanations from primary care pharmacists in clinical practice roles about how they make decisions related to medicines therapy and a theoretical model of therapeutic decision-making. In this qualitative study, interview data from 10 pharmacists in primary care settings were analysed using a general inductive approach. The emergent themes were compared to a theoretical model of therapeutic decision-making. Eight themes were identified from the explanations of how participants were making therapeutic decisions in practice. The themes were found to correspond to at least one of the four steps of therapeutic decision-making in the model. Themes corresponding to the information gathering step were described most vividly, whereas, the themes corresponding to the reasoning, judgement, and decision steps were less well-articulated. These findings suggest that the theoretical model can be useful to interpret empirical data about therapeutic decision-making in practice. These findings might provide a means for pharmacists to adopt language to better describe the steps in their therapeutic decision-making process to others, and especially, their colleagues and patients. Findings can be used by pharmacy educators to design learning opportunities for students about therapeutic decision-making.

Sections du résumé

BACKGROUND
Therapeutic decision-making is a core element of pharmacy practice, however, little has been documented about how it is enacted in practice and how it can be theorised.
OBJECTIVE(S)
This study aims to contribute to pharmacy education and practice theory by investigating the correspondence between explanations from primary care pharmacists in clinical practice roles about how they make decisions related to medicines therapy and a theoretical model of therapeutic decision-making.
METHODS
In this qualitative study, interview data from 10 pharmacists in primary care settings were analysed using a general inductive approach. The emergent themes were compared to a theoretical model of therapeutic decision-making.
RESULTS
Eight themes were identified from the explanations of how participants were making therapeutic decisions in practice. The themes were found to correspond to at least one of the four steps of therapeutic decision-making in the model. Themes corresponding to the information gathering step were described most vividly, whereas, the themes corresponding to the reasoning, judgement, and decision steps were less well-articulated.
CONCLUSIONS
These findings suggest that the theoretical model can be useful to interpret empirical data about therapeutic decision-making in practice. These findings might provide a means for pharmacists to adopt language to better describe the steps in their therapeutic decision-making process to others, and especially, their colleagues and patients. Findings can be used by pharmacy educators to design learning opportunities for students about therapeutic decision-making.

Identifiants

pubmed: 32305268
pii: S1551-7411(19)31093-9
doi: 10.1016/j.sapharm.2020.04.005
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

326-331

Informations de copyright

Copyright © 2020 Elsevier Inc. All rights reserved.

Auteurs

Megan G Anakin (MG)

Education Unit, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand. Electronic address: megan.anakin@otago.ac.nz.

Stephen B Duffull (SB)

School of Pharmacy, University of Otago, Dunedin, New Zealand.

Daniel F B Wright (DFB)

School of Pharmacy, University of Otago, Dunedin, New Zealand.

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Classifications MeSH