Pastoral power in the community pharmacy: A Foucauldian analysis of services to promote patient adherence to new medicine use

Waring, Justin; Latif, Asam; Boyd, Matthew; Barber, Nick; Elliott, Rachel A.

doi:10.1016/j.socscimed.2015.11.049

Cited by 31 publications

(56 citation statements)

References 27 publications

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“…A few, however, based their analyses on existing theoretical frameworks, including Normalisation Process Theory 28 , Damschroders' consolidated framework for implementation research 29 , Donabedian's structure-process-outcome approach 30 and Foucault's concept of pastoral power. 31 Summaries of the papers and their methodologies are included in tables 2 and 3. Tables 2 and 3) Four key overlapping constructs were identified by translating and combining primary data and secondary concepts from individual studies i.e.…”

Section: (Insert Figure 1)mentioning

confidence: 99%

“…The accounts of CPs across all studies confirmed the perceived value and opportunity within the existing or potential role of CP in supporting people with LTCs. Perceived benefits included reducing pressure on GP 33 ; improving the profile and professional status of CP [31][32][33][34][35] ; patient monitoring and education 29 35 ; improved clinical outcomes 33 35 and perceived patient reassurance and satisfaction. 34 35 There was also evidence of a culture amenable and accepting of change, 34 35 whereby extension to the traditional dispensing role is valued and desired, perceived to meet patient need, contributes to job satisfaction 28 29 35 and helps to demonstrate the worth and skills of the CP profession.…”

Section: Pharmacist and Other Health Professional Perspectivesmentioning

confidence: 99%

“…36 38-40 There was evidence of a lack of clarity about the role of the pharmacist or purpose of CP services, 40 particularly when these contradicted expected and traditional perceptions of the pharmacist encounter. 31 The role of the pharmacist was usually conceptualized, not in isolation, but in relation to beliefs about other roles and responsibilities within the wider healthcare system, primarily those of the GP. There were, nevertheless, positive examples indicating that some patients welcomed LTC support from CPs.…”

Section: Lay Perspectivesmentioning

confidence: 99%

See 2 more Smart Citations

A qualitative synthesis of pharmacist, other health professional and lay perspectives on the role of community pharmacy in facilitating care for people with long-term conditions

Hall

Donovan

Wilkes

2018

Research in Social and Administrative Pharmacy

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There is acknowledged potential for an extended role in CP to support the care of people with LTCs. To ensure the likelihood of successful engagement with patients and positive health outcomes, developments should acknowledge influences within and beyond the CP setting. Potential overlap with other healthcare services should be explicitly addressed, ensuring this is framed and delivered as valued reinforcement with clearly defined boundaries of responsibility.

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Section: (Insert Figure 1)mentioning

confidence: 99%

Section: Pharmacist and Other Health Professional Perspectivesmentioning

confidence: 99%

Section: Lay Perspectivesmentioning

confidence: 99%

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A qualitative synthesis of pharmacist, other health professional and lay perspectives on the role of community pharmacy in facilitating care for people with long-term conditions

Hall

Donovan

Wilkes

2018

Research in Social and Administrative Pharmacy

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“…For example, advice‐giving roles have been interpreted as forms of ‘pastoral’ care with patients engaged in confessional and self‐regulatory behaviour (Waring et al . ). However, the changing social relationship between patients and pharmacists in the context of these new services remains under‐theorised.…”

Section: Introductionmentioning

confidence: 97%

‘I expected just to walk in, get my tablets and then walk out’: on framing new community pharmacy services in the English healthcare system

Latif

Waring

Watmough

et al. 2018

Sociology Health & Illness

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Reconfiguration of the healthcare division of labour is becoming increasingly attractive in the context of increased patient demand and resource constraints. One example is the introduction of extended roles for pharmacists to provide patients additional support to manage their medicines, while also reducing work pressures experienced by other health professionals. Understanding how such policies are framed by those delivering and receiving care has been under-theorised. Using Goffman's frame theory, we examine one newly introduced community pharmacy service (New Medicines Service (NMS)) to illustrate how a policy intended to support patient medicine-taking through the extended roles of pharmacists is framed and where this deviates from its proposed aims. Three themes emerged: (i) the spatial-material artefacts; (ii) existing discursive culture and practice around medicine-taking; and (iii) the NMS interactions that shape and govern framing and subsequent interpretation of the NMS. Our study offers an explanatory and dynamic view of the framing process with important lessons for reconfiguring medicine management policy and practice. As well as illustrating framing as being variegated, complementary or conflicting, it also shows how this plurality and fragility had consequences for patient engagement and sense-making. The consequences for engagement and recommendations for implementing future initiatives are discussed.

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“…Despite most UK pharmacies conducting hundreds of MUR and NMS consultations per year, (43 273 018 were conducted 2007/8–2017/18 ), there are only two observational studies of how these services are performed in practice . As Latif’s observational data on the delivery of MURs was collected prior to 2012 when the MUR lifestyle advice requirement was introduced, even less is known about how alcohol fits into these services in practice .…”

Section: Introductionmentioning

confidence: 99%

Missing in action: Insights from an exploratory ethnographic observation study of alcohol in everyday UK community pharmacy practice

Morris

Madden

Gough

et al. 2019

Drug and Alcohol Review

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Introduction and Aims. This paper reports on an exploratory ethnographic observation study which aimed to understand how alcohol fits into routine service provision in the New Medicine Service (NMS), Medication Use Reviews (MUR) and pharmacists' everyday practices in UK community pharmacies. Design and Methods. Observations were undertaken in five community pharmacies featuring nine community pharmacists. This involved observation of 16 MURs and 15 NMS consultations and informal interviews with pharmacists as they conducted their work. Fieldnotes were subjected to a constructionist thematic analysis. Results. Pharmacists were underprepared and unconfident in discussing alcohol in medicine consultations. Most pharmacists raised alcohol consumption in the MUR and NMS as part of a 'lifestyle check'. They reported that alcohol was difficult to raise, and to discuss and that people were reluctant to talk about their drinking. Their main concern was that raising the topic would alienate customers. Discussion and Conclusions. These findings raise questions regarding a range of issues about how pharmacists discuss alcohol in medicines consultations, why they lack a clear sense of purpose in doing so and therefore where alcohol fits into UK community pharmacy practice. [Morris S, Madden M, Gough B, Atkin K, McCambridge J. Missing in action: Insights from an exploratory ethnographic observation study of alcohol in everyday UK community pharmacy practice. Drug Alcohol Rev 2019;38:561-568]

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Pastoral power in the community pharmacy: A Foucauldian analysis of services to promote patient adherence to new medicine use

Cited by 31 publications

References 27 publications

A qualitative synthesis of pharmacist, other health professional and lay perspectives on the role of community pharmacy in facilitating care for people with long-term conditions

A qualitative synthesis of pharmacist, other health professional and lay perspectives on the role of community pharmacy in facilitating care for people with long-term conditions

‘I expected just to walk in, get my tablets and then walk out’: on framing new community pharmacy services in the English healthcare system

Missing in action: Insights from an exploratory ethnographic observation study of alcohol in everyday UK community pharmacy practice

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