Research Methods in Pharmacy

Practice

Felicity Smith
BPharm, MA, PhD, MRPharmS

Reader in Pharmacy Practice

School of Pharmacy
University of London, UK

(RP)
London. Chicago Pharmaceutical Press
Contents

Preface x
Acknowledgements xii
About the author xiii
Introduction xiv

1 Survey research: design, samples and response 1

Research objectives 2
Study design 3
Populations and settings 5
Sampling procedures 6
Sampling pharmacists 8
Sampling other professional groups 1 1
Sampling for population-based surveys 12
Sampling patient and user groups 16
Ethical issues in identification of samples 19
Response rates and non-responders 20
Tactics used to maximise response rates 21
Response rates achieved 24
Investigation of non-responders 28
Conclusion 31
References 31

2 Survey research: instruments, validity and reliability 43

Survey instruments 43
Validity 45
Types of validity 4 6
Problems and processes of validation 5 1
Quantification in questionnaires 54-• ,
Adopting and adapting measures in the literature 56
Reliability 5 7
Variation between interviewers 5 9
Internal consistency 59
Measuring attitudes 59
Scales 63
Other scaling procedures 64
Characterising pharmacies, pharmacists and clientele 65
Generalisability 69
vi Contents

Sampling procedures and sampling frames 69

Sample sizes 70
Poor response rates 71
Geographical localisation of the study 71
Preliminary fieldwork and pilot studies 73
Analytical procedures in survey research 73
Statistical procedures 73
Missing values 75
Conclusion 76
References 76

Theoretical perspectives and models in survey research 85

Theoretical frameworks and measures 86
Sociological approaches 86
Incorporation of specific theories 87
Theory building 92
Professional orientation and activities 92
Application of established measures in explanatory models 94
Patients' perspectives regarding pharmacy services 95
Analytical procedures in the development of models 97
Multivariate statistical procedures 97
Conclusion 106
References 106

Qualitative interviews 1 1 1
What is qualitative research? 1 12
Research objectives 1 16
Populations, settings and samples 1 17
Sampling procedures 1 19
Response rates 1 22
Development of the interview guide 1 22
Data collection 125
Location of interview 1 26
Data processing and analysis 1 27
Approaches to data analysis 1 27
Analytical procedures 128
Computers in data processing and analysis 1 30
Reporting the results 131
Validity 132
Reliability 134
Generalisability 135
Conclusion 135
References 136
 Contents vii

Focus groups 143

Group or individual interviews? 143
Place in the research process 144
Research objectives and settings 145
Consensus methods: nominal group and Delphi techniques 146
Selecting groups and sampling procedures 147
Diversity in or between groups? 149
Established groups or groups convened for the purposes of
the study? 1 49
How many groups? 150
Group size 151
Conduct of the groups 152
Data analysis 153
Validity, reliability and generalisability 155
Ethical issues 1 56
References 157

Non-participant and participant observation 161

Participant or non-participant observation 161
Non-participant observation 162
Research objectives and settings 1 62
Sampling procedures 1 64
Response rates 1 66
Data collection 1 67
Validity 168
Reliability 171
Generalisability 171
Data analysis 1 71
Ethical issues 1 72
Participant observation 175
Conclusion 176
References 176

Triangulation 181

Comparing methods 1 84
Combining methods for validation 1 85
Content validity 1 86
Complementarity 188
Combining data or methods to serve an objective 1 88
Combining methodologies to serve related objectives 190
Clinical areas and techniques 191
Service evaluation 1 92
viii Contents

Logistical considerations 1 93
Study design 194
Data analysis 1 95
References 196

Evaluation of pharmaceutical services: objectives,

designs and frameworks 203

Research objectives 204

Study design 2 0 5
Randomised controlled trials (RCTs) 205
Quasi-experimental studies 210
Before-and-after studies 211
C o h o r t studies 21 3
Descriptive studies 21 3
Frameworks 215
Structure-process-outcome 21 5
Efficacy, effectiveness and efficiency 21 9
Appropriateness 223
Acceptability 224
Conclusion 225
References 2 2 6

Evaluation of pharmaceutical services: methods and

measures 237

Methods 237
Surveys 238
Interviews 238
Observation 239
Analysis of routinely collected data 240
Structured data on processes 241
Triangulation 242
Measures 2 4 2
Physiological measures 2 4 4
Measurement of health status 244
Measuring satisfaction and acceptability 2 4 7
Costs 2 4 9
Prescription interventions 253
Appropriateness of prescribing 2 5 6
Initiatives to influence prescribing 2 5 7
Ward pharmacy services and discharge from secondary care 258
Evaluation of advice-giving 2 5 9
Health promotion 2 6 0
Educational initiatives 261
 Contents ix

Patient knowledge 262

Measures of compliance/adherence 263
Conclusion 266
References 266

Index 278