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Developing the role of the drug and therapeutics committees: Perceptions of chairs
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research. (Health Services Research)
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research. (Health Services Research)
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research. (Health Services Research)
2007 (English)In: International Journal of Health Care Quality Assurance, ISSN 0952-6862, Vol. 20, no 2, 161-178 p.Article in journal (Refereed) Published
Abstract [en]

Purpose – According to Swedish law, every county is required to have a local drug and therapeutics committee (DTC) to contribute to safe and cost-effective drug use. The law presents merely a framework and gives no detailed instructions addressing, for example, organisation and methods. The aim of this study is to explore the variation of conceptions of the role of the DTCs among committee Chairs and to compare the results with an earlier study. Design/methodology/approach – Data were collected by questionnaires and telephone interviews with committee chairs, which were analysed using a phenomenographic approach. Findings – Four conceptions were identified, namely: traditional, patient-aware, influential, holistic and cooperative, which all involved prescribers. In one conception the DTC acted as an expert to decision-makers. One conception included the notion that cooperation across the bureaucratic borders was important. Patients were involved in two conceptions. Comparison with the earlier study showed a trend toward higher patient awareness and a higher agreement on DTC goals with an increased focus on quality issues. Originality/value – This study demonstrates an alternative research method bringing in new perspectives when exploring activities within healthcare. Patient involvement in the work of the DTCs is increasing, but should be further explored and developed.

Place, publisher, year, edition, pages
2007. Vol. 20, no 2, 161-178 p.
Keyword [en]
Health services, Patients, Public interest, Sweden
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:uu:diva-95181DOI: 10.1108/09526860710731843PubMedID: 17585614OAI: oai:DiVA.org:uu-95181DiVA: diva2:169298
Available from: 2006-11-21 Created: 2006-11-21 Last updated: 2010-05-26Bibliographically approved
In thesis
1. Towards Improved Medication Use: Increasing Understanding of Professional Efforts
Open this publication in new window or tab >>Towards Improved Medication Use: Increasing Understanding of Professional Efforts
2006 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Professionals and researchers have developed a number of strategies aimed at improving the quality and safety of medication use. However, studies continue to demonstrate persistent problems. For instance, the first paper in this thesis reveals the prevalence of potentially harmful drug combinations among elderly people in Europe. The following four papers focus on two professional groups and how they have approached safety and quality issues related to medication use: 1) the Swedish drug and therapeutics committees (DTCs) and 2) pharmacist involved in pharmaceutical care, an international movement. Qualitative research approaches were applied.

Papers II and III focus on the DTCs: analyses indicate a development of the perception of the DTC role over time. The focus of the activities was broadened – from targeting prescribing physicians to incorporating decision-makers and patients. However, a clear patient-centered perspective was generally lacking. Moreover, the findings indicate a shift in focus from cost aspects of medication use to an increased focus on quality and safety aspects.

In the studies addressing pharmaceutical care (Papers IV and V), the findings propose that different classification systems for drug-related problems had different characteristics which reflected differences in goals in the pharmaceutical care process. It was also found that the concept of pharmaceutical care was understood in different ways and that the perceptions were based on at least two different understandings of health and illness. First, a patient-centered perspective characterized by a holistic understanding of health and illness, and, second, an “EBM perspective” primarily based on a biomedical understanding of health and illness.

This thesis has disclosed new aspects of how two groups of professionals perceive their work towards improved quality and safety of medication use. A patient-centered perspective among healthcare collectives is not obvious; therefore, efforts and comprehensive strategies supporting change are necessary. Strategies should focus on challenging the traditional thought patterns and care approaches among professionals and students.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2006. 85 p.
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 206
Keyword
Health services research, drug quality problems, drug and therapeutics committees, pharmaceutical care, perceptions, patient centeredness, Hälso- och sjukvårdsforskning
Identifiers
urn:nbn:se:uu:diva-7343 (URN)91-554-6731-8 (ISBN)
Public defence
2006-12-12, Robergsalen, Akademiska sjukhuset ing 40, 4 tr, Uppsala, 13:15
Opponent
Supervisors
Available from: 2006-11-21 Created: 2006-11-21Bibliographically approved

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Björkman, IngeborgHolmström, IngerBernsten, Cecilia

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