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  1. Article ; Online: Integration of a clinical pharmacist workforce into newly forming primary care networks

    Jim McCambridge / Duncan Stewart / Thomas Mills / Mary Madden / Brendan Gough

    BMJ Open, Vol 12, Iss

    a qualitatively driven, complex systems analysis

    2022  Volume 11

    Abstract: Objective The introduction of a new clinical pharmacist workforce via Primary Care Networks (PCNs) is a recent national policy development in the National Health Service in England. This study elicits the perspectives of people with responsibility for ... ...

    Abstract Objective The introduction of a new clinical pharmacist workforce via Primary Care Networks (PCNs) is a recent national policy development in the National Health Service in England. This study elicits the perspectives of people with responsibility for local implementation of this national policy package. Attention to local delivery is necessary to understand the contextual factors shaping the integration of the new clinical pharmacy workforce, and thus can be expected to influence future role development.Design A qualitative, interview studySetting and participants PCN Clinical Directors and senior pharmacists across 17 PCNs in England (n=28)Analysis Interviews were transcribed, coded and organised using the framework method. Thematic analysis and complex systems modelling were then undertaken iteratively to develop the themes.Results Findings were organised into two overarching themes: (1) local organisational innovations of a national policy under conditions of uncertainty; and (2) local multiprofessional decision-making on clinical pharmacy workforce integration and initial task assignment. Although a phased implementation of the PCN package was planned, the findings suggest that processes of PCN formation and clinical pharmacist workforce integration were closely intertwined, with underpinning decisions taking place under conditions of considerable uncertainty and workforce pressures.Conclusions National policy decisions that required General Practitioners to form PCNs at the same time as they integrated a new workforce risked undermining the potential of both PCNs and the new workforce. PCNs require time and support to fully form and integrate clinical pharmacists if successful role development is to occur. Efforts to incentivise delivery of PCN pharmacy services in future must be responsive to local capacity.
    Keywords Medicine ; R
    Subject code 360
    Language English
    Publishing date 2022-11-01T00:00:00Z
    Publisher BMJ Publishing Group
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  2. Article ; Online: Experiencing Male Infertility

    Esmée Hanna / Brendan Gough

    SAGE Open, Vol

    2015  Volume 5

    Abstract: This article examines the qualitative research literature that exists in relation to men’s experiences of male infertility. Since men have often been marginalized in the realm of reproduction, including academic research on infertility, it is important ... ...

    Abstract This article examines the qualitative research literature that exists in relation to men’s experiences of male infertility. Since men have often been marginalized in the realm of reproduction, including academic research on infertility, it is important to focus on any qualitative research that gives voices to male perspectives and concerns. Given the distress documented by studies of infertile women, we focus in particular on the emotive responses and lived experiences of men in relation to infertility. In this article then, we present an analysis of the core themes across 19 qualitative articles, which include “infertility as crisis”; “emoting infertility- men as “being strong”’ “infertility as a source of stigma”; and the “desire for fatherhood.” In light of these insights, we identify key areas for future research and development including men’s emotional responses to infertility, how men seek support for infertility, the intersection between masculinity and infertility, the relationship between the desire to father and infertility, and the outcomes of infertility for men in terms of other aspects of their lives. We suggest that such research would facilitate making the experiences of men more central within our understandings of infertility within a field that has primarily been female focused.
    Keywords History of scholarship and learning. The humanities ; AZ20-999 ; Social Sciences ; H
    Subject code 360
    Language English
    Publishing date 2015-10-01T00:00:00Z
    Publisher SAGE Publishing
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  3. Article ; Online: Conceptualising alcohol consumption in relation to long-term health conditions

    Mary Madden / Stephanie Morris / Duncan Stewart / Karl Atkin / Brendan Gough / Jim McCambridge

    PLoS ONE, Vol 14, Iss 11, p e

    Exploring risk in interviewee accounts of drinking and taking medications.

    2019  Volume 0224706

    Abstract: Background Alcohol use is a major contributor to the burden of disease, including long-term non-communicable diseases. Alcohol can also interact with and counter the effects of medications. This study addresses how people with long term conditions, who ... ...

    Abstract Background Alcohol use is a major contributor to the burden of disease, including long-term non-communicable diseases. Alcohol can also interact with and counter the effects of medications. This study addresses how people with long term conditions, who take multiple medications, experience and understand their alcohol use. The study objective is to explore how people conceptualise the risks posed to their own health from their concurrent alcohol and medicines use. Methods and findings Semi-structured interviews were conducted with a sample of 24 people in the North of England taking medication for long term conditions who drank alcohol twice a week or more often. Transcripts were analysed using a modified framework method with a constructionist thematic analysis. Alcohol was consumed recreationally and to aid with symptoms of sleeplessness, stress and pain. Interviewees were concerned about the felt effects of concurrent alcohol and medicines use and sought ways to minimise the negative effects. Interviewees associated their own drinking with short-term reward, pleasure and relief. Risky drinking was located elsewhere, in the drinking of others. People made experiential, embodied sense of health harms and did not seem aware of, or convinced by, (or in some cases appeared resigned to) future harms to their own health from alcohol use. The study has limitations common to exploratory qualitative studies. Conclusions Health risk communication should be better informed about how people with long-term health conditions perceive health outcomes over time, and how they adopt experience-based safety strategies in contexts in which alcohol consumption is heavily promoted and weakly regulated, whilst medicines adherence is expected. Supporting people to make active and informed connections between medicines, alcohol and potential personal health harms requires more than a one-way style of risk communication if it is to be perceived as opening up rather than restricting choice.
    Keywords Medicine ; R ; Science ; Q
    Subject code 360
    Language English
    Publishing date 2019-01-01T00:00:00Z
    Publisher Public Library of Science (PLoS)
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  4. Article ; Online: Addressing complex pharmacy consultations

    Jim McCambridge / Karl Atkin / Ranjita Dhital / Brent Foster / Brendan Gough / Mary Madden / Stephanie Morris / Ronan O’Carroll / Margaret Ogden / Anne Van Dongen / Sue White / Cate Whittlesea / Duncan Stewart

    Addiction Science & Clinical Practice, Vol 16, Iss 1, Pp 1-

    methods used to develop a person-centred intervention to highlight alcohol within pharmacist reviews of medications

    2021  Volume 9

    Abstract: Abstract Background Alcohol is challenging to discuss, and patients may be reluctant to disclose drinking partly because of concern about being judged. This report presents an overview of the development of a medications review intervention co-produced ... ...

    Abstract Abstract Background Alcohol is challenging to discuss, and patients may be reluctant to disclose drinking partly because of concern about being judged. This report presents an overview of the development of a medications review intervention co-produced with the pharmacy profession and with patients, which breaks new ground by seeking to give appropriate attention to alcohol within these consultations. Methods This intervention was developed in a series of stages and refined through conceptual discussion, literature review, observational and interview studies, and consultations with advisory groups. In this study we reflect on this process, paying particular attention to the methods used, where lessons may inform innovations in other complex clinical consultations. Results Early work with patients and pharmacists infused the entire process with a heightened sense of the complexity of consultations in everyday practice, prompting careful deliberation on the implications for intervention development. This required the research team to be highly responsive to both co-production inputs and data gathered in formally conducted studies, and to be committed to working through the implications for intervention design. The intervention thus evolved significantly over time, with the greatest transformations resulting from patient and pharmacist co-design workshops in the second stage of the process, where pharmacists elaborated on the nature of the need for training in particular. The original research plans provided a helpful structure, and unanticipated issues for investigation emerged throughout the process. This underscored the need to engage dynamically with changing contexts and contents and to avoid rigid adherence to any early prescribed plan. Conclusions Alcohol interventions are complex and require careful developmental research. This can be a messy enterprise, which can nonetheless shed new insights into the challenges involved in optimising interventions, and how to meet them, if embraced with an attitude of ...
    Keywords Alcohol ; Complex interventions ; Pharmacist ; Brief intervention ; Person-centred ; Medications review ; Medicine (General) ; R5-920 ; Social pathology. Social and public welfare. Criminology ; HV1-9960
    Subject code 360
    Language English
    Publishing date 2021-10-01T00:00:00Z
    Publisher BMC
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  5. Article ; Online: It’s long-term, well it’s for life basically

    Georgina Jones / Eva Brown Hajdukova / Esmee Hanna / Rosie Duncan / Brendan Gough / Jane Hughes / Debbie Hughes / Fran Ashworth / Johan Prevot / Jose Drabwell / Leire Solis / Nizar Mahlaoui / Anna Shrimpton

    Qualitative Research in Medicine & Healthcare, Vol 4, Iss

    Understanding and exploring the burden of immunoglobulin treatment in patients with primary immunodeficiency disorders

    2021  Volume 3

    Abstract: This paper describes the burden of receiving immunoglobulin (Ig) treatment from the perspective of patients diagnosed with a Primary Immunodeficiency (PID). Thirty semi-structured interviews with patients receiving intravenous (n=21) and subcutaneous ... ...

    Abstract This paper describes the burden of receiving immunoglobulin (Ig) treatment from the perspective of patients diagnosed with a Primary Immunodeficiency (PID). Thirty semi-structured interviews with patients receiving intravenous (n=21) and subcutaneous immunoglobulin (n=9) therapy, either at home or in hospital were undertaken. Underpinned by a phenomenological theoretical framework, and using a qualitative, inductive thematic approach to prioritise patients’ concerns, we identified that Ig treatment requires considerable effort by the patient, particularly in relation to the amount of time, organization and planning that is needed. They also face numerous physical, social, relationship, emotional, role functioning, travelling, and financial challenges in their effort to undergo and maintain their infusions and care for their health. Some qualitative differences in treatment burden were noted between home and hospital settings which contributed to non-adherence to those regimes. Immunoglobulin treatment burden is complex and influenced by therapeutic mode and setting and the personal circumstances of the patient. As choice over treatment method appears to be mainly informed by lifestyle needs, PID patients may benefit from more information about these potential Ig lifestyle influences when selecting which form of treatment to take together with their health professional.
    Keywords Primary immunodeficiency ; immunoglobulin treatment ; qualitative research ; thematic analysis ; Medicine (General) ; R5-920
    Subject code 360
    Language English
    Publishing date 2021-02-01T00:00:00Z
    Publisher PAGEPress Publications
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  6. Article ; Online: A pilot cluster randomised trial of the Medicinesand Alcohol Consultation (MAC)

    Duncan Stewart / Anne van Dongen / Michelle Watson / Laura Mandefield / Karl Atkin / Ranjita Dhital / Brent Foster / Brendan Gough / Catherine Hewitt / Mary Madden / Stephanie Morris / Ronan O’Carroll / Margaret Ogden / Steve Parrott / Judith Watson / Sue White / Cate Whittlesea / Jim McCambridge

    BMC Health Services Research, Vol 20, Iss 1, Pp 1-

    an intervention to discuss alcohol use in community pharmacy medicine review services

    2020  Volume 10

    Abstract: Abstract Background Alcohol interventions are important to the developing public health role of community pharmacies. The Medicines and Alcohol Consultation (MAC) is a new intervention, co-produced with community pharmacists (CPs) and patients, which ... ...

    Abstract Abstract Background Alcohol interventions are important to the developing public health role of community pharmacies. The Medicines and Alcohol Consultation (MAC) is a new intervention, co-produced with community pharmacists (CPs) and patients, which involves a CP practice development programme designed to integrate discussion of alcohol within existing NHS medicine review services. We conducted a pilot trial of the MAC and its delivery to investigate all study procedures to inform progression to a definitive trial. Methods This cluster pilot RCT was conducted in 10 community pharmacies in Yorkshire, UK, with a CP from each who regularly conducted Medicine Use Review (MUR) and New Medicine Service (NMS) consultations. Randomisation was conducted using a secure remote randomisation service. Intervention CPs (n = 5) were trained to deliver the MAC in MUR/NMS consultations. Control CPs (n = 5) provided these services as usual. Consecutive MUR/NMS patients were asked by CPs to participate, screened for eligibility (consumption of alcohol at least twice per week), and baseline data collected for those eligible. A two-month follow-up telephone interview was conducted. Blinding of CPs was not possible, but patients were blinded to the alcohol focus of the trial. Primary outcomes were total weekly UK units (8 g of ethanol per unit) of alcohol consumption in the week prior to follow-up, and confidence in medications management. Trial procedures were assessed by recruitment, attrition, and follow-up rates. Results 260 patients were approached by CPs to take part in the trial, 68% (n = 178) were assessed for eligibility and 30% (n = 54) of these patients were eligible. Almost all eligible patients (n = 51; 94%) consented to participate, of whom 92% (n = 47) were followed-up at 2 months; alcohol consumption was lower in the intervention arm and confidence in medication management reduced slightly for both groups. Exploration of recall issues at follow-up showed a high level of agreement between a two-item quantity/frequency ...
    Keywords Alcohol ; Community pharmacy ; Medicine reviews ; Pilot trial ; Feasibility ; Public aspects of medicine ; RA1-1270
    Subject code 310
    Language English
    Publishing date 2020-10-01T00:00:00Z
    Publisher BMC
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  7. Article ; Online: Vztah tělesné aktivity a duševního zdraví – současný pohled kvalitativního výzkumu The physical activity and mental health relationship – a contemporary perspective from qualitative research

    Brendan Gough / Andy Smith / Diane Crone

    Acta Universitatis Palackianae Olomucensis. Gymnica, Vol 36, Iss 3, Pp 29-

    2006  Volume 35

    Abstract: Pozitivní vztah mezi tělesnou aktivitou a duševním zdravím a jeho využití při léčbě duševních chorob jsou známy. Přesto stále nebylo dosaženo shody ohledně mechanismu, který je za tento vztah zodpovědný. Článek zkoumá vztah tělesné aktivity a duševního ... ...

    Abstract Pozitivní vztah mezi tělesnou aktivitou a duševním zdravím a jeho využití při léčbě duševních chorob jsou známy. Přesto stále nebylo dosaženo shody ohledně mechanismu, který je za tento vztah zodpovědný. Článek zkoumá vztah tělesné aktivity a duševního zdraví kritickým posouzením biochemických, fyziologických a psychologických mechanismů, které mají tento jev vysvětlovat. Z takového posouzení vyplývá, že přes různá navrhovaná vysvětlení panuje v této oblasti jen málo shody, s výjimkou toho, že jde o vztah komplexní a že v zodpovědném mechanismu či zodpovědných mechanismech se pravděpodobně navzájem kombinují prvky psychologické, biochemické i fyziologické. Pokus o lepší pochopení komplexnosti tohoto vztahu doplňují zjištění z kvalitativního výzkumu zkoumajícího vztah z pohledu osob, které prospěšný vliv cvičení na duševní zdraví zažívají. Pomocí metodologie kvalitativního výzkumu zjišťovala studie zkušenosti účastníků cvičebních programů ve Velké Británii. Závěrem je konstatováno, že kvalitativní metodologie zkoumající zkušenosti lidí a prostředky, které je usnadňují, poskytuje další pohled na složitou povahu vztahu tělesné aktivity a duševního zdraví. There is a known positive relationship between physical activity and mental health, and in the treatment and maintenance of mental illness. Despite this relationship however, there still remains a lack of consensus on the mechanism responsible for the relationship. This paper explores the physical activity and mental health relationship by reviewing and critiquing the biochemical, physiological and psychological mechanisms proposed to explain this phenomenon. Through this review it becomes apparent that although there are varied explanations proposed, there is little agreement except that the relationship is complex and the responsible mechanism(s) are likely to be interrelated combining the disciplines of psychology, biochemistry and physiology. In an attempt to understand further the complexities of the relationship the paper presents findings from qualitative ...
    Keywords Physical activity ; mental health relationship ; qualitative research ; Sports medicine ; RC1200-1245
    Subject code 796
    Language English
    Publishing date 2006-02-01T00:00:00Z
    Publisher Palacky University
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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