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Tully, M
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Publications (10 of 16) Show all publications
Södergård, B., Höfer, S., Halvarsson, M., Sönnerborg, A., Tully, M. & Kettis, Å. (2007). A structural equation modeling approach to the concepts of adherence and readiness in antiretroviral treatment. Patient Education and Counseling, 67(1-2), 108-116
Open this publication in new window or tab >>A structural equation modeling approach to the concepts of adherence and readiness in antiretroviral treatment
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2007 (English)In: Patient Education and Counseling, ISSN 0738-3991, E-ISSN 1873-5134, Vol. 67, no 1-2, p. 108-116Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE: The objective of this secondary analysis of data from a cross-sectional, nation-wide survey, was to test a hypothesized model with two latent concepts (readiness and adherence), based on the theory of trigger events. A secondary objective was to compare this model with two simpler models, without the concept of readiness. METHODS: Data consisted of a consecutive sample of 828 HIV patients > or = 18 years on antiretroviral treatment at 30 out of 32 HIV Clinics in Sweden (response rate 97.5%). Structural equation modeling (SEM) was used to test the models against the empirical data. Chi2 test was used to compare fit between models. RESULTS: The hypothesized model, with two latent concepts (readiness and adherence), fitted the data best (chi(2)=223.508, d.f.=129, p-value<0.0001, GFI=0.970, CFI=0.913, RMSEA=0.030), and significantly better than the models with adherence as the only latent concept. CONCLUSION: Although the SEM technique could not rule out that other models might also fit the data equally well, the hypothesized model, where readiness and adherence were two separate latent concepts, fitted data the best. This supports readiness as a distinct factor that influences adherence and hence treatment outcome. Increased attention should therefore be attached to interventions that focus on the individual' readiness for behavioural change, i.e. factors amendable to change and that can be addressed by the patients themselves. PRACTICE IMPLICATIONS: Based on these results it seems necessary to shift focus from adherence to readiness, especially in conditions where treatment can be postponed such as antiretroviral treatment.

Keywords
Acquired immunodeficiency syndrome, Highly active antiretroviral therapy, HIV, Patient compliance, Readiness, Sweden
National Category
Pharmaceutical Sciences
Identifiers
urn:nbn:se:uu:diva-15133 (URN)10.1016/j.pec.2007.02.010 (DOI)000248014200016 ()17509807 (PubMedID)
Available from: 2008-02-05 Created: 2008-02-05 Last updated: 2018-01-12Bibliographically approved
Ljungberg, C., Kettis Lindblad, Å. & Tully, M. (2007). Hospital doctors' views of factors influencing their prescribing. Journal of Evaluation In Clinical Practice, 13(5), 765-771
Open this publication in new window or tab >>Hospital doctors' views of factors influencing their prescribing
2007 (English)In: Journal of Evaluation In Clinical Practice, ISSN 1356-1294, E-ISSN 1365-2753, Vol. 13, no 5, p. 765-771Article in journal (Refereed) Published
Abstract [en]

Rationale, aim and objective Factors influencing doctors in prescribing of drugs have mostly been studied in primary care. Studies performed in hospital care have primarily focused on new drugs, not prescribing in general. An in-depth understanding of the prescribing process in the more specialized secondary care is not only important for secondary care itself, but because it also influences prescribing in primary care. The aim of this study is therefore to identify factors that secondary care doctors believe influence them in prescribing drugs, using a qualitative approach.

Method Semi-structured interviews were conducted with 15 hospital doctors in different medical specialities and the interviews were analysed from an interpretivist perspective. The information gathered was on how prescribing decisions were made in general and how the doctors chose a specific drug therapy, including information sources used.

Results According to our interviews, the hospital doctors took patient-specific factors and cost into consideration when prescribing, informed by different written information sources and commercial verbal information. Personal practice, colleagues and therapeutic tradition at the hospital or clinic, were influential in the prescribing of drugs. The themes identified should not to be seen as individual influences; many of them probably act in combination.

Conclusions If changes in prescribing behaviour are desired, factors warranting more attention include understanding how to influence therapeutic traditions and the doctor's personal habits for prescribing. The importance of clinical experience and information exchange with colleagues should not be underestimated in providing information about drugs to hospital doctors.

Keywords
doctor, hospital, interview, prescribing, qualitative, secondary care
National Category
Pharmaceutical Sciences
Identifiers
urn:nbn:se:uu:diva-11408 (URN)10.1111/j.1365-2753.2006.00751.x (DOI)000249253700010 ()17824870 (PubMedID)
Available from: 2007-09-12 Created: 2007-09-12 Last updated: 2018-01-12Bibliographically approved
Montgomery, A., Kälvemark-Sporrong, S., Henning, M., Tully, M. P. & Kettis, Å. (2007). Implementation of a pharmaceutical care service: prescriptionists', pharmacists' and doctors' views. Pharmacy World & Science, 29(6), 593-602
Open this publication in new window or tab >>Implementation of a pharmaceutical care service: prescriptionists', pharmacists' and doctors' views
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2007 (English)In: Pharmacy World & Science, ISSN 0928-1231, E-ISSN 1573-739X, Vol. 29, no 6, p. 593-602Article in journal (Refereed) Published
Abstract [en]

Objective  To identify prescriptionists’, pharmacists’ and doctors’ perceptions and experiences of a pharmaceutical care service supported by patient medication records (PMRs). Method  Qualitative study employing focus group interviews with 16 prescriptionists and five pharmacists, and semi structured telephone interviews with 11 doctors. Main outcome measures  Prescriptionists’, pharmacists’ and doctors’ views, experiences and perceptions of a pharmaceutical care service on Swedish community pharmacies. Results  The provision of pharmaceutical care aided by PMRs had a positive influence on the prescriptionists’ and pharmacists’ daily work, and on their view of their professional role. They assumed greater professional responsibility, and described greater use of their pharmaceutical knowledge, greater confidence in practice and an increased awareness of their counselling role. They appreciated that the pharmaceutical care service provided an over-all picture of patients’ drug use, allowed for follow-up on counselling and made the prescriptionists’ and pharmacists’ competence tangible for patients. Perceived problems with the pharmaceutical care service included being time-consuming, record keeping being difficult, difficulty in getting understanding/support from colleagues and managers, and difficulty involving doctors. The majority of the doctors reported that they had not taken an active interest in the project, and their opinions of the pharmaceutical care service varied. Conclusion  When prescriptionists and pharmacists apply the pharmaceutical care concept and work with PMRs, the patients are more likely to meet confident professionals that are more aware of the individual behind the drug therapy. This will hopefully contribute to informed, motivated medicine users that feel secure in their interactions with their pharmacy and receive, not only drugs, but treatment support. For such a service to be effective, however, it is vital to ensure that the doctors are fully co-operative.

Keywords
Adult, Community Pharmacy Services, Cooperative Behavior, Female, Focus Groups, Humans, Interprofessional Relations, Male, Medical Records, Middle Aged, Pharmacists, Physicians, Prescriptions, Drug, Professional Role
National Category
Pharmaceutical Sciences
Identifiers
urn:nbn:se:uu:diva-15524 (URN)10.1007/s11096-006-9072-0 (DOI)000250208100006 ()17701082 (PubMedID)
Available from: 2008-02-18 Created: 2008-02-18 Last updated: 2018-01-12Bibliographically approved
Tully, M., Latif, S., Cantrill, J. A. & Parker, D. (2007). Pharmacists' changing views of their supplementary prescribing authority.. Pharmacy World & Science, 29(6), 628-634
Open this publication in new window or tab >>Pharmacists' changing views of their supplementary prescribing authority.
2007 (English)In: Pharmacy World & Science, ISSN 0928-1231, E-ISSN 1573-739X, Vol. 29, no 6, p. 628-634Article in journal (Refereed) Published
Abstract [en]

Objective  To investigate the views and experiences of pharmacists in England before and after they registered as supplementary prescribers. Method  Eight pharmacists were recruited from training courses; seven from secondary care and one from primary care and interviewed during training and again after registration. In the first interviews, topics included previous experience, views on current roles, responsibilities and accountability for prescribing and how these might change. In the second interviews, the pharmacists discussed how these had actually changed after gaining supplementary prescribing authority, how their role worked in practice and how they saw it developing in the future. Main outcome measure  Descriptions of anticipated and actual changes in their roles, responsibilities and accountability before and after registration as supplementary prescribers Results  The pharmacists anticipated that training would legitimise their current ‘informal’ prescribing practices, with increased legal responsibility and accountability, but experienced many procedural delays in implementing their new role. Pharmacists who were already heavily involved with prescribing were more likely to work as prescribers, but not necessarily within the clinical management plan framework. The desire to maintain the efficiency of their existing clinical services impacted negatively on the pharmacists’ ability or willingness to prescribe in this legally approved manner. Conclusion  Clear and realistic expectations need to be set by the pharmacists as to what is achievable and greater attention needs to be paid to minimising delays between the end of training and the beginning of practice, to minimise reduction in motivation and redeployment of staff.

Keywords
England, Humans, Pharmacists, Prescriptions; Drug, Professional Autonomy, Professional Role
National Category
Pharmaceutical Sciences
Identifiers
urn:nbn:se:uu:diva-15522 (URN)10.1007/s11096-007-9114-2 (DOI)17380422 (PubMedID)
Available from: 2008-02-18 Created: 2008-02-18 Last updated: 2018-01-12Bibliographically approved
Södergård, B., Halvarsson, M., Tully, M., Mindouri, S., Nordström, M.-L., Lindbäck, S., . . . Kettis Lindblad, Å. (2006). Adherence to treatment in Swedish HIV infected patients. Journal of Clinical Pharmacy and Therapeutics, 31(6), 605-616
Open this publication in new window or tab >>Adherence to treatment in Swedish HIV infected patients
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2006 (English)In: Journal of Clinical Pharmacy and Therapeutics, ISSN 0269-4727, E-ISSN 1365-2710, Vol. 31, no 6, p. 605-616Article in journal (Refereed) Published
Abstract [en]

Objectives: The objectives were to assess the prevalence of adherence to antiretroviral treatment in Swedish human immunodeficiency virus (HIV)-infected patients and to evaluate factors associated with adherence.

Methods: All HIV-treated patients, who attended one of 30 (of a total of 32) Swedish infectious diseases clinics, during 7 months, were asked to complete an anonymous questionnaire containing the 9-item Morisky Medication Adherence Scale (MMAS) and questions about other factors potentially affecting adherence. The summary score of MMAS ranges from 1 to 13, where 13 indicates perfect adherence; patients scoring 11 or above (corresponding to 95% adherence level) were classified as 'adherent'.

Results and discussion: In total 946 patients participated (response rate 97.5%). The proportion of patients who reported not missing a dose during the day prior to the completion of the questionnaire was 97% and the proportion classified as 'adherent' was 63%. 'Adherent' patients were more likely to have a good relationship with their health care professionals (P < 0.05) and not have problems with drugs or alcohol (P < 0.01). Being older (P < 0.01) and having a shorter time on current treatment (P < 0.01) and on treatment in total (P < 0.05) were factors also associated with good adherence.

Conclusion: Factors modifiable for interventions by health care professionals are patient-provider relationship, drug or alcohol problems and patients with long treatment periods.

Keywords
acquired immunodeficiency syndrome, highly active antiretroviral therapy, human immunodeficiency virus, patient compliance, Sweden
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:uu:diva-95139 (URN)10.1111/j.1365-2710.2006.00782.x (DOI)000242232900010 ()17176366 (PubMedID)
Available from: 2006-11-14 Created: 2006-11-14 Last updated: 2017-12-14Bibliographically approved
Södergård, B., Halvarsson, M., Lindbäck, S., Sönnerborg, A., Tully, M. & Kettis, Å. (2006). Differences in adherence and motivation to HIV therapy: Two independent assessments in 1998 and 2002. Pharmacy World & Science, 28(4), 248-256
Open this publication in new window or tab >>Differences in adherence and motivation to HIV therapy: Two independent assessments in 1998 and 2002
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2006 (English)In: Pharmacy World & Science, ISSN 0928-1231, E-ISSN 1573-739X, Vol. 28, no 4, p. 248-256Article in journal (Refereed) Published
Abstract [en]

Objective: The aim of this study was to compare the level of adherence and motivation in two independent cross-sectional samples of HIV-infected patients conducted in 1998 and 2002, and to investigate the relationship between adherence and motivation. Method: Consecutive HIV-infected patients on treatment at a Swedish clinic were asked to complete an anonymous questionnaire. In 1998, 60 patients participated and in 2002, 53 participated. In 2002, the 9-item Morisky Medication Adherence Scale (MMAS) was added to the questionnaire set. Main outcome measure: Self-reported adherence and motivation. Results: In 1998, 28.1% of the respondents were considered adherent, while the corresponding proportion was 57.4% in 2002 (P = 0.002). The mean summary score for MMAS was 10.7 in 2002 (13 = perfect adherence). The proportion considered motivated were 22.4% in the 1998 survey and 41.3% in 2002 (P = 0.038). Of the respondents considered motivated in the 2002 survey, 46.7% scored the maximum summary score on the MMAS, while 8.7% of the non-motivated respondents did so (P = 0.016). Conclusion: The respondents in 2002 were more adherent and motivated than the respondents in 1998 and a relationship between motivation and adherence was found. The difference in adherence and motivation might be due to a new treatment model at the clinic.

Keywords
Acquired immunodeficiency syndrome, AIDS, Highly active antiretroviral therapy, HIV, MMAS, Patient adherence, Patient compliance, Patient motivation, Pharmacotherapy, Sweden
National Category
Pharmaceutical Sciences
Identifiers
urn:nbn:se:uu:diva-95138 (URN)10.1007/s11096-006-9036-4 (DOI)000241727000010 ()17066240 (PubMedID)
Available from: 2006-11-14 Created: 2006-11-14 Last updated: 2018-01-13Bibliographically approved
Renberg, T., Kettis Lindblad, Å. & Tully, M. P. (2006). Exploring subjective outcomes perceived by patients receiving a pharmaceutical care service. Research in Social and Administrative Pharmacy, 2(2), 212-231
Open this publication in new window or tab >>Exploring subjective outcomes perceived by patients receiving a pharmaceutical care service
2006 (English)In: Research in Social and Administrative Pharmacy, ISSN 1551-7411, E-ISSN 1934-8150, Vol. 2, no 2, p. 212-231Article in journal (Refereed) Published
Abstract [en]

BACKGROUND:

There is a need for evidence to support expanded pharmacist services, especially regarding subjective outcomes experienced by patients. However, it is unclear what aspects of life are actually affected by such services.

OBJECTIVES:

The aims of this study are to identify patients' perceptions of both an expanded pharmacist service and its impact on subjective outcomes such as health and quality of life, and to elicit variables that may be targeted in future evaluation of the impact of such services.

METHODS:

In-depth interviews were performed with 12 respondents receiving a patient medication record service. The interviews were analyzed using a qualitative constant comparative method.

RESULTS:

The service was perceived very differently by unique respondents in regards to its purpose and content, as well as its outcomes. It was difficult for respondents to describe the service as separate from other health care experiences. Gaining control of drug treatment and a perceived feeling of increased safety were central concepts in patients' description of the service. Talking spontaneously about health effects of the service carried no meaning for the respondents.

CONCLUSIONS:

The value of enhanced patient consultation, empowerment, the feeling of safety, and increased drug knowledge are important to patients receiving this kind of service and should be central in choosing outcome measures when studying such services.

Keywords
Sweden, qualitative research, pharmaceutical care, patient medication record, humanistic outcomes
National Category
Pharmaceutical Sciences
Research subject
Social Pharmacy
Identifiers
urn:nbn:se:uu:diva-108386 (URN)10.1016/j.sapharm.2006.01.003 (DOI)17138509 (PubMedID)
Available from: 2009-09-17 Created: 2009-09-17 Last updated: 2018-01-13Bibliographically approved
Morecroft, C., Cantrill, J. & Tully, M. (2006). Patients' evaluation of the appropriateness of their hypertension management--a qualitative study.. Res Social Adm Pharm, 2(2), 186-211
Open this publication in new window or tab >>Patients' evaluation of the appropriateness of their hypertension management--a qualitative study.
2006 (English)In: Res Social Adm Pharm, ISSN 1551-7411, Vol. 2, no 2, p. 186-211Article in journal (Refereed) Published
Keywords
Adult, Aged, Antihypertensive Agents/adverse effects/therapeutic use, Female, Humans, Hypertension/*drug therapy/psychology, Male, Middle Aged, Patient Education, Patient Satisfaction, Physician-Patient Relations, Physicians; Family, Qualitative Research
Identifiers
urn:nbn:se:uu:diva-10168 (URN)17138508 (PubMedID)
Available from: 2007-02-28 Created: 2007-02-28 Last updated: 2011-01-11
Thornton, J., Elliott, R. A., Tully, M., Dodd, M. & Webb, A. K. (2005). Clinical and economic choices in the treatment of respiratory infections in cystic fibrosis: comparing hospital and home care.. J Cyst Fibros, 4(4), 239-47
Open this publication in new window or tab >>Clinical and economic choices in the treatment of respiratory infections in cystic fibrosis: comparing hospital and home care.
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2005 (English)In: J Cyst Fibros, ISSN 1569-1993, Vol. 4, no 4, p. 239-47Article in journal (Refereed) Published
Identifiers
urn:nbn:se:uu:diva-79073 (URN)16242385 (PubMedID)
Available from: 2006-04-03 Created: 2006-04-03 Last updated: 2011-01-11
Tully, M., Javed, N. & Cantrill, J. A. (2005). Development and face validity of explicit indicators of appropriateness of long term prescribing.. Pharm World Sci, 27(5), 407-13
Open this publication in new window or tab >>Development and face validity of explicit indicators of appropriateness of long term prescribing.
2005 (English)In: Pharm World Sci, ISSN 0928-1231, Vol. 27, no 5, p. 407-13Article in journal (Refereed) Published
Identifiers
urn:nbn:se:uu:diva-79075 (URN)16341749 (PubMedID)
Available from: 2006-04-03 Created: 2006-04-03 Last updated: 2011-01-11
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