The Medication Use Review Service (MUR): A Case Study For Identifying E-Learning Opportunities In Pharmacists’ On-Going Training
Thesis DisciplineHealth Sciences
Degree GrantorUniversity of Canterbury
Degree NameMaster of Health Science
Abstract The aim of this research is to examine the role e-learning could have in the training of community pharmacists. The premise of the project is to suggest that e-learning could provide timely and flexible options for training so a sufficient number of trained healthcare workers are in place in time for the roll-out of a healthcare service. The Medicine Use Review (MUR) service, a publically funded medication adherence intervention, was used as a case study. The MUR is a service run from some community pharmacies which aims to support patients’ adherence to a medication regime through advice and application of pharmaceutical expertise. This case study was of interest because there were problems in providing nationwide access to the MUR service in New Zealand and discontent with aspects of the training course. The study design used two research tools; a case-study and two on-line questionnaires to answer the research questions. The two questionnaires were used in a nationwide survey about the MUR service and the MUR training. The first had dispensary business questions (DSQ) and the second had MUR training questions (CQ). The two questionnaires used closed ended questions for quantitative data collection and open ended for qualitative data collection. Community pharmacies from thirteen of the twenty District Health Boards (DHB) were faxed an invitation to complete one of the on-line questionnaires. Community pharmacists who had completed training for the MUR were invited to complete the CQ by the representatives at DHBs responsible for the regional pharmacy contract. Seventy-five community pharmacists from across New Zealand responded to the survey. Results from both questionnaires included attitudinal responses to the usefulness of the MUR service, support offered for pharmacists to complete the training and their preferences for course delivery. Cross tabulation of survey questions provided analysis of quantitative data based on dispensaries which offered the MUR service and dispensaries which did not. Over two hundred and fifty text based comments provided qualitative data, which was analyzed by categorizing into subjects and frequency of concepts. Through triangulation with quantitative results, it was concluded that on the whole the pharmacists surveyed believed the MUR service was a useful service to offer their customers. The Dispensary Service Questionnaire (DSQ) provided quantitative data which linked dispensary activity to the business decisions to offer the service and identified commonalities in the problems experienced by New Zealand pharmacists with pharmacists offering similar adherence service overseas. These included communication skills, the pharmacists' role in the primary healthcare team and remuneration for the service. The number of responses received from the course questionnaire (CQ) was around the size of a group that might have participated in a course. Their preferences for training may have been influenced by the age ranges of this group; forty-seven percent were in the age group of 46 – 55 years old, although there was no statistically significant association found. It was confirmed by these respondents that networking skills and cultural competencies were considered to be important for future content of training. Peer networking both face-to-face and on-line was considered a useful method of delivering training. A model called the Environment of Planning Training (EPT) was formed from the relevant literature and survey results. This model formed the basis for a discussion aimed to guide how the model could be used by stakeholders to identify factors driving the need for on-line delivery of the professional training content. Conclusions from this research project are: e-learning for pharmacists has the potential to support value added services; further investigation is needed into the capacity of New Zealand pharmacists to participate in e-learning before it can be used effectively; evaluation of e-learning needs to be done in the context of the healthcare service evaluation and evaluation of pharmacist practice.