Full text of DOI:10.1592/phco.21.7.731.34570

P RA C TIC E I N S IG H TS
Practice-Based Research: Lessons from Community
Pharmacist Participants
Scot H. Simpson, Pharm.D., Jeffrey A. Johnson, Ph.D., Catherine Biggs, B.Sc.Pharm.,
Rosemarie S. Biggs, B.Pharm., Arlene Kuntz, B.S.P., William Semchuk, Pharm.D., M.Sc.,
Jeff G. Taylor, Ph.D., Karen B. Farris, Ph.D., and Ross T. Tsuyuki, Pharm.D., M.Sc.,
for the Study of Cardiovascular Risk Intervention by Pharmacists Investigators
We designed this project to determine community pharmacists’ opinions
regarding the challenges and motivations of their recent participation in a
pharmacy practice-based research study. At the conclusion of a randomized,
multicenter study, 87 community pharmacist-investigators were sent a
questionnaire that explored four areas: motivating factors to participate,
barriers to participation, communication tools used by study coordinators,
and design issues for future studies. Fifty-eight (67%) completed
questionnaires were returned. Key factors motivating participation in the
study were desire to improve the profession and opportunity to learn. Time
was the greatest barrier to participation. Pharmacy practice-based research
has two distinct advantages. First, it translates clinical knowledge into direct
application in the community. Second, it provides needed data to
demonstrate the value of enhanced pharmacy practice. Thorough
understanding of pharmacists’ opinions is necessary to optimize the design of
future studies.
(Pharmacotherapy 2001:21(6):731–739)
care1 and the potential benefits of an enhanced
level of practice by pharmacists. The past decade
presented many new opportunities for
pharmacists to increase the capacity of their
practice. This expanding role resulted from
considerable effort by pioneers in the profession.
Tremendous opportunity remains to explore
larger roles for pharmacists in contemporary
health care systems. A secondary, albeit still
important, hurdle to overcome is the reimburse-
ment of pharmacists for nondispensing activities.2, 3
In an era of evidence-based decision making,
the expansion of the professional role may be
facilitated by strong evidence that an enhanced
level of practice leads to improved health
outcomes for patients. If we liken this situation
to that of decisions regarding drug therapies,
such evidence should be in the form of
randomized controlled trials with rigorous
design.4, 5 Given the recognized importance of
More than a decade has passed since the
introduction of the concept of pharmaceutical
From the EPICORE Center, Division of Cardiology,
Faculty of Medicine and Dentistry (Drs. Simpson and
Tsuyuki), and the Faculty of Pharmacy and Pharmaceutical
Sciences (Dr. Johnson), University of Alberta; the Institute
of Health Economics (Drs. Johnson and Tsuyuki); and the
Alberta College of Pharmacists (Ms. C. Biggs), Edmonton,
Alberta; Broadmoor Pharmacy, Sherwood Park, Alberta (Ms.
C. and Ms. R. Biggs); Shoppers Drug Mart (Ms. Kuntz) and
Regina Health District (Dr. Semchuk), Regina,
Saskatchewan; the University of Saskatchewan, Saskatoon,
Saskatchewan (Dr. Taylor); and the University of Iowa, Iowa
City, Iowa (Dr. Farris).
Supported by the Alberta Heritage Foundation for
Medical Research (Drs. Simpson and Johnson) and the
University Hospital Foundation (Dr. Tsuyuki).
Address reprint requests to Ross T. Tsuyuki, Pharm.D.,
Epidemiology Coordinating and Research (EPICORE)
Centre, Division of Cardiology, Department of Medicine,
Faculty of Medicine and Dentistry, University of Alberta,
213 Heritage Medical Research Centre, Edmonton, Alberta,
Canada T6G 2S2; e-mail: ross.tsuyuki@ualberta.ca.

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PHARMACOTHERAPY Volume 21, Number 6, 2001
strong clinical and pharmacoeconomic evidence
for pharmaceutical products before approval for
formulary listing, it would be incongruous to
expect policy decisions regarding the pharmacist’s
role and reimbursement to be made in the
absence of equally robust evidence.
To that end, research focused on the expanding
practice of pharmacy has increased over the past
decade. A body of both theoretical and empirical
research has examined the benefits of
pharmaceutical care activities. Empirical data,
however, were largely limited to retrospective
reviews or uncontrolled, prospective studies of
short duration or with limited numbers of
patients on inpatient wards,6–9 or to hospital-
based ambulatory clinics.10–15 Because few
pharmacists practice in institutional settings and
most people who benefit from pharmacy services
are in the community, evidence of the impact of
pharmacists’ interventions in community
pharmacy settings must be generated.16
needed. Lack of understanding about important
methodologic components of study design by
pharmacy practitioners may reduce internal
validity of study results. Furthermore, when
academic researchers lack awareness of issues
and challenges facing practicing pharmacists, the
result can be frustrating for both parties. In both
cases, execution of the study may be jeopardized,
resulting in less than optimal outcomes.
Despite this and the rapid growth in pharmacy
practice-based research, surprisingly little
literature addressed the attitudes and opinions of
pharmacists regarding involvement in practice
research; a literature search identified only three
articles on the topic.31–33 Whereas certain
barriers to participation might be predictable,
such as confidence, motivation, and logistic
issues of workload,34, 35 little evidence indicates
the degree to which these factors affect
participation in practice-based research.
The Study of Cardiovascular Risk Intervention
by Pharmacists (SCRIP), a large-scale,
multicenter, randomized trial of community
pharmacist intervention in cholesterol risk
management, provided an opportunity to
evaluate pharmacy practice research from the
perspective of the community-based practitioner.
Study design and description of services provided
in SCRIP are published elsewhere.5 Briefly,
SCRIP was a randomized, multicenter trial
designed to evaluate the efficacy of a community
pharmacist program of cholesterol risk
intervention in patients who are at high risk for
cardiovascular disease. Eligible patients were
randomly assigned to receive either intervention
or usual pharmacy care. Intervention consisted
of a pharmacist-led interview to identify
modifiable and nonmodifiable cardiovascular
disease risk factors, a point-of-care cholesterol
assessment, education on heart disease and risk
factors, and instructions to visit their family
physician for further risk-factor assessment. A
single-page form containing the patient’s risk
factors, as well as total cholesterol and blood
pressure levels, was faxed to the patient’s family
physician. Usual pharmacy care was defined as
provision of a heart-disease brochure and usual
pharmacy services from each center.
Since 1993, several large-scale, multicenter
studies in ambulatory clinics or community
pharmacies have been conducted.5, 17–23 One
review examining the impact of pharmaceutical
services in community and ambulatory care
settings suggests that pharmacists can affect the
health care system by means of patient
counseling and physician education.24 Another
review suggests that pharmacists can improve
detection and significantly reduce the impact of
drug-related problems.25 Although it is unclear
whether patient health outcomes may be affected,
evidence supports the assertion that these
enhanced services likely can result in reduced
health care use and substantial cost savings.23,
26–30
Reviews of pharmacy practice evaluations
suggest that well-designed studies with many
subjects are necessary to clearly establish the
impact of pharmaceutical services on patient
outcome.16, 24, 25 The application of methods
developed for large multicenter clinical trials4
could be applied to the naturalistic practice
setting to generate stronger evidence for the
efficacy, effectiveness, and efficiency of enhanced
pharmacy practice interventions.5
Most pharmacists in community practice have
had limited exposure to clinical research
methodology. Academic researchers may go to
great lengths to design rigorous experimental
studies, but taking that research to the field
requires active participation of pharmacy
practitioners. For this interaction to benefit the
profession, a clear and mutual understanding of
the issues and expectations of both groups is
Fifty-four community pharmacies from Alberta
and Saskatchewan, Canada, participated in
SCRIP: 37 in large urban centers (Edmonton,
Calgary, and Regina), 8 in smaller urban centers,
and 9 in rural areas. Of the 54 pharmacies, 34
belonged to a chain and 20 were operated
independently. The planned enrollment for

COMMUNITY-BASED RESEARCH Simpson et al
733
SCRIP was 1000 patients, with 500 in each
treatment group.5 Participating pharmacies were
asked to recruit 25 patients each; suggested
recruitment rate was one patient/week. At this
rate, the recruitment goal was anticipated to be
achieved approximately 6 months after the
pharmacy entered the study. The first patient
was enrolled during spring 1998.
During winter 1999 an external data and safety
monitoring committee reviewed the data and
recommended early termination of SCRIP
because of striking benefit of the intervention
program. At the conclusion of recruitment, 675
patients had been enrolled, with 7 (13%)
pharmacies reaching the recruitment goal of 25
patients (Figure 1). Overall, an average of 12.5
patients were recruited by each of the 54 SCRIP
centers; however, this figure ranged from 1–40
patients/center. Although not all centers started
at the same time, the 2 years required to recruit
675 patients was longer than anticipated.
study protocol. To facilitate candid answers,
responses were anonymous, and consent to
participate was indicated by the returned
questionnaire. Monthly newsletters and a local
study representative reminded pharmacist-
investigators to complete and return the survey.
Items for the questionnaire were generated
through a literature search and from issues raised
by pharmacist-investigators during the study.
Previous surveys exploring pharmacists’ attitudes
toward practice-based research33 and pharmacy
practice36–38 were reviewed for relevant survey
questions. Review articles on pharmacy practice
research were also examined for applicable
information.39–41 The questions were grouped
into four key areas: motivating factors to
participate as an investigator, barriers to
participation, communication tools used by the
study coordinators, and design issues for future
studies. Pharmacist-investigators’ opinions in
these areas were explored by a combination of
closed and open-ended questions.
Discussions with other researchers leading
large, multicenter, pharmacy practice-based
research studies suggested that our experience in
SCRIP was not unusual. Therefore, our purpose
was to determine community pharmacists’
opinions regarding the challenges and
motivations regarding their recent participation
in a pharmacy practice-based research study.
A five-point Likert scale was used for response
options to the closed questions; responses were
evaluated with descriptive statistics, using SPSS
software (SPSS Inc., Chicago, IL). Responses to
the open questions were grouped thematically.42
Results
Fifty-eight (67%) completed questionnaires
were returned from the 87 pharmacist-
investigators. To maintain anonymity, respondents’
demographic data and site information were not
collected. Therefore, we could not compare data
from nonrespondents or between centers with
different levels of recruitment.
Methods
A survey of participating pharmacists was
conducted during the closeout phase of the main
study. During spring 2000, approximately 1
month after the final investigator meeting,
questionnaires were mailed to the 87 pharmacists
who participated in SCRIP by enrolling and
following at least one patient according to the
Initial Interest
Pharmacist-investigators in SCRIP were asked
to indicate the extent to which various
recruitment strategies influenced their decision
to participate in the study. Factors that were
anticipated to play a role are shown in Table 1,
with summarized responses. The most important
factors were desire to improve the profession,
opportunity to learn more about disease
management, and ability to provide enhanced
service to patients. Reputation of the academic
researchers who organized the study and
curiosity were less important than interest in
clinical research or recommendations of a
colleague.
16
14
12
10
8
6
4
2
0
1–5
6–9
10–16
Number of patients
17–25
26–35
> 35
Comments from the open-ended questions on
motivating factors mirrored responses to the
Figure 1. Recruitment rates.

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PHARMACOTHERAPY Volume 21, Number 6, 2001
Table 1. Factors That Motivated Participation
Responses (%)
Not at All A Little Bit Moderately Quite a Bit Extremely
Interest in clinical research
Researcher reputation
Colleague’s recommendation
Learn more about disease management
Provide another service to patients
Curiosity
2
19
19
0
0
9
10
9
12
2
3
9
24
38a
16
5
10
45a
7
52a
19
12
16
9
45
47
16
53a
43a
48a
40a
22
Desire to improve the profession
aMedian response.
0
0
40
Table 2. Barriers to Participation
Responses (%)
Strongly
Disagree Disagree Neutral
Strongly
Agree
Agree
Hard to find eligible patients
Promotional items not helpful
Study activities took too much time
Too many internal issues (e.g., staff holidays, pharmacy renovations)
Other responsibilities cut into time for study
Lack of reimbursement
Poor physician attitudes
Low level of confidence
Initial responses were discouraging
9
9
0
2
0
2
7
21
28
49
46
50
23
16
36
48
55
54
28
21
27
23
21
34
23
21
14
14
25
23
43
50
23
18
5
0
0
0
9
14
5
5
0
0
5
closed questions. Ten respondents indicated that
their desire to participate in practice-based
research came from a need to change the nature
of pharmacy practice. A recurring theme was the
desire to broaden the pharmacist’s role to involve
more clinical programs and move away from
dispensing. Fourteen respondents reported that
participation gave them a chance to enhance
their knowledge and improve patient-care skills.
Participation in SCRIP was viewed as an exciting
opportunity that added to daily practice.
and poor physician attitudes, were considered
less important.
Comments regarding barriers to participation
focused on support from other pharmacy staff
and time. Most SCRIP centers had one or two
pharmacists participating as investigators.
Several respondents reported that lack of support
from other pharmacy staff made it difficult to
identify patients and perform study-related
activities. This lack of support, combined with
few pharmacists working on each shift, made it
hard to complete other expected activities to
allow time for the study. Study activities were
imposed on an already busy day in the
dispensary. Despite these challenges, respondents
indicated that the study activities were well
organized and easy to follow.
Barriers to Participation
Time was identified as the greatest barrier to
participation and patient recruitment (Table 2).
Approximately two-thirds of respondents agreed
or strongly agreed that time devoted to other
duties at work diminished the time available to
participate in the study. However, only 23% felt
the study-related activities took too much time.
Responses also indicated that internal issues such
as staff holidays limited ability to participate in
SCRIP. On the other hand, low level of
confidence and poor initial responses were not
considered barriers to participation. Other
possible barriers, such as lack of reimbursement
Communication
Ongoing communication with the community
pharmacist-investigators was a priority for SCRIP
coordinators. Various methods were used to
monitor recruitment progress, solve problems as
they arose, and keep the pharmacist-investigators
motivated. Almost three-fourths of respondents
indicated that monthly newsletters, investigator

COMMUNITY-BASED RESEARCH Simpson et al
735
meetings, and site visits by area monitors were
quite helpful or extremely helpful for
maintaining interest in SCRIP. Many respondents
remarked that the investigator meetings were
invaluable tools for discussing issues with other
pharmacist-investigators and learning more
about the study. Two respondents suggested
holding regular conference calls because this
format was perceived to be more convenient,
especially in rural centers.
During the study, recruitment was the primary
message to the pharmacist-investigators; several
incentives were used to stimulate and encourage
recruitment. For example, four recruitment
challenges were held during SCRIP, with rewards
given to the group who recruited the most
patients. Individual recruitment milestones were
celebrated with recognition at investigator
meetings and lapel pins (silver for 10–16
patients, gold for 17–25 patients, platinum for
26–34 patients, and diamond for more than 35
patients recruited). Respondents indicated they
enjoyed having their achievements recognized
and felt this was a major factor in motivating
their continued participation.
issues for hypercholesterolemia and clinical
evidence to support administration of
cholesterol-lowering drugs; it began several
months before the start of the study. Also, the
study coordinator visited each site to review
study procedures in detail and provide tips on
patient identification and recruitment. Several
pharmacist-investigators who entered the study
after it had begun commented that they would
have liked more training. As new staff joined the
pharmacy and other pharmacists became
involved with SCRIP, it became apparent that
repeated training visits would have been helpful.
Case Report Forms
Eighteen (31%) respondents commented on
the case report forms: five thought there were
too many, and four objected to the transmission
of forms by fax machine to the study
coordinating office. Despite these comments,
respondents recognized the need for the forms
and found them logical and easy to follow.
Respondents suggested that future studies use a
computer-based system with online or e-mail
transmissions.
During the latter phases of recruitment, the
project office faxed weekly word puzzles as
reminders to encourage recruitment. These were
less enthusiastically received than other forms of
communication. Some respondents indicated
that the puzzles were irritating and recommended
that efforts be redirected toward in-person
meetings or center visits.
Study Procedures
A few respondents commented on study
procedures. Two thought the first two follow-up
visits (at weeks 2 and 4) were too close together;
another felt the device used for cholesterol
testing (Accutrend GC) was unreliable.
Advice for Future Studies
SCRIP Study Design Issues
Pharmacist-investigators were asked if they
would participate in a future study and for their
opinions regarding reimbursement and
recruitment expectations. Enthusiasm for
participation in future research projects was high;
48 (83%) respondents stated they would
absolutely or most likely participate in another
unpaid study with our research group. Only one
indicated refusal to participate in another
research study.
When respondents were asked what they
considered reasonable reimbursement for future
SCRIP-like studies, 21% suggested $25–40, 52%
suggested $50–75, and 21% suggested more than
$75 for each patient. Six respondents felt they
should be reimbursed for cognitive services
provided as part of the study. One respondent
commented that other pharmacists felt
reimbursement was a necessary part of any study:
“While I don’t need reimbursement…Several
To obtain feedback for future practice-based
research studies, pharmacist-investigators were
asked the open-ended question, “If you could
change any one part of SCRIP, what would you
do?” The responses fell into three themes:
investigator training, case report forms, and
study procedures.
Training
Eighteen (31%) respondents commented on
training provided for the study. Comments
centered mostly around training more than one
pharmacist at each site. For example, one
respondent stated, “All pharmacists must be
trained in each pharmacy—answers questions
and motivates! Difficult to do, but essential to
encourage full participation.”
Training included discussion of background
and study procedures, as well as management

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PHARMACOTHERAPY Volume 21, Number 6, 2001
other pharmacists who work for the same
organization had asked me often if I was getting
paid for this work. When I told them ‘no,’ they
told me that we were wrong to do it.”
regarding barriers to participation than any other
topic, perhaps reflecting the importance of
recruitment barriers in this study. In general,
most comments focused on a work environment
conducive to provision of advanced services. As
a profession, pharmacists (and pharmacy
managers) must move toward a clear commitment
to, and definition of, patient care. Participants of
future practice-based research projects should
consider coordinating staff and resources to
facilitate patient care and implemen-tation of
study procedures. Academic researchers should
be sensitive to time constraints and responsibilities
of community-based investigators when they
develop study procedures. When pharmacists are
not reimbursed for participation, 10–20 patients/
pharmacy may be a reasonable expectation.
Despite careful attention to design of a
practice-based research study, implementation in
community pharmacies may be limited without
adequate training. The SCRIP was the first major
project in which many of our pharmacist-
investigators had participated. Although
pharmacists routinely communicate with their
patients and are comfortable providing health
care advice, approaching patients for recruitment
into a study was a new experience for many. This
inexperience and initial hesitation with informed
consent and enrollment procedures may have
kept some pharmacists from recruiting patients.
Furthermore, pharmacist-investigator feedback
indicated that patients were sometimes surprised
when approached by their pharmacist for
participation in a “research study.” Working on
the notion that this terminology may have
conjured images of investigational drugs or
invasive procedures, we found patients
responded more favorably when words such as
“program” were used instead of “research study.”
The pharmacist-investigators in SCRIP frequently
commented on the need for continued training
and contact with study support staff to ensure
greater participation and recruitment.
When respondents were asked what they
considered a reasonable recruitment goal (SCRIP
goal was 25 patients), 63% indicated 10–20 and
37% indicated 25 patients. Fifty-two (90%)
respondents commented on recruitment,
covering several themes. Work environment
conducive to patient contact (time commitment,
staffing, and managerial support) was cited
frequently as a major factor in recruitment. Size
of patient base (i.e., prescription volume) and
proportion of eligible patients also were cited
often. Many respondents indicated that because
of the prevalence of cardiovascular disease and
diabetes, this was not a legitimate reason for poor
recruitment. Several respondents indicated that
20–25 patients would be optimal because it
would allow them to gain experience and “get
good at it.”
Discussion
To our knowledge, SCRIP is the largest,
randomized, multicenter study evaluating
efficacy of community pharmacist intervention in
cardiovascular disease management. This study
demonstrated the beneficial effect of community
pharmacists working in collaboration with
patients and their family physicians to improve
health care delivery.43
During the study, over 80 community
pharmacists from 54 pharmacies in urban and
rural centers joined the network and became
practice-based investigators. These pharmacist-
investigators provided valuable information for
the design and execution of future research in
community pharmacies.
Enlistment of interested pharmacist-
investigators is a major concern for researchers.
Our findings are similar to those of others33 in
that many pharmacists participated in practice-
based research because of interest in research.
More important, respondents to our survey
indicated that a strong desire to expand their
level of care (to provide more services) and to
help demonstrate the value of the profession
were motivating factors. Personal knowledge of
academic researchers would suggest confidence
in the design and purpose of the study; however,
respondents did not consider this an important
motivating factor.
Our training program for new investigators
consisted of a meeting, a detailed study
operations manual, and an on-site visit. Support
was provided to investigators through monthly
newsletters, investigator meetings (every 3–4
months), and a toll-free telephone help line.
Many investigators wanted several pharmacy staff
members to be trained at each site. Although we
suggested this at the beginning of the study, it
was often difficult to achieve because other
pharmacists at the site lacked interest, the site
was inaccessible, and/or many investigators were
Respondents provided more comments

COMMUNITY-BASED RESEARCH Simpson et al
737
unable to attend training sessions. In general,
study coordinating staff observed that sites with
several trained investigators seemed to have the
greatest and most consistent recruitment.
Therefore, we recommend that written
commitment for training and participation be
obtained from most of the pharmacy staff
(including manager and/or owner) before a site is
accepted for study participation.
Training issues may be alleviated by Internet
technology, which provides delivery of
interactive, problem-based, and accessible
training whereby pharmacists can learn at
their own speed. To this end, some members
of our group developed a training program
(modeled after SCRIP procedures) for manage-
ment of a patient with elevated cholesterol:
PHARMALearn-CHOLESTEROL (available from
www.pharmalearn.com). Proper training
provides investigators with the incentive to not
only learn, but also act.
Documentation of the study data should be
simple and a natural extension of the pharmacist’s
interaction with the patient. Case report forms
(and data clarification forms that often follow
from the study coordinating center) are a much-
maligned part of any clinical trial. The SCRIP
used concepts of a large, simple trial,4 whereby
only minimal information was collected from
each patient. In addition, the case report forms
were used as a means to implement clinical
guidelines for cholesterol management. This
resulted in having a single place for
documentation of patient information, study
procedures, and patient progress. A patient in
the intervention group required 10 pages of
forms during the study; a patient in the usual-
care group required only 6 pages. Case report
forms were faxed to the study coordinating
center, where they were entered into the database
manually. Nevertheless, several investigators
indicated some dissatisfaction with the case
report forms (volume of information required,
pickiness of data quality procedures). Perhaps
this is reflective of the fact that most investigators
in SCRIP had not previously participated in
research. In addition, as with any fax system of
data transfer, some faxes are lost, frustrating
investigators (and study coordinating center
staff). Researchers could improve communi-
cation of case report form expectations and
provide more timely feedback on data quality
issues so as to prevent mistakes. By trying to
ensure that documentation is considered as
important for study purposes as for patient care,
researchers may improve pharmacist-
investigators’ perceptions about required study
documentation.
Although the survey questions were worded to
elicit constructive criticism on study procedures,
overall feedback on study design and conduct
was very positive. One area involved communi-
cation from the study coordinating office. The
SCRIP coordinators used a system of local study
facilitators (similar to that used in the Digitalis
Investigation Group trial44 and Heart Outcomes
Prevention Evaluation study) in addition to study
newsletters and local meetings.45 The five local
study facilitators (two of whom were also
investigators) provided local support and were
crucial to the success of the project. These
individuals acted as agents of the study
coordinating center and visited the sites regularly
to address recruitment and data quality issues.
Although SCRIP did not provide reimbursement
for patient enrollment or follow-up, guidance
was sought from the investigators regarding this
issue for future trials. Average contact time
between investigator and patient in the
intervention group was 100 minutes, versus 60
minutes for patients in the usual-care group.46
Three-fourths of the investigators felt that
$25–$75/patient would represent fair reimburse-
ment. Survey comments indicate that some
respondents confuse issues of reimbursement for
activities relating to practice-based research to
prove the value of pharmacists’ services with that
of fees for cognitive services (i.e., income-
generating activities). This is not to say that
pharmacists should not be reimbursed for time
spent in research endeavors (especially if it helps
to gain pharmacy managers’ support) but that
they should appreciate that these are separate
issues. Benefit of pharmacy services, as
addressed by practice-based research, must be
proven before government, insurers, and the
public will be willing to reimburse for them.
Perhaps the best test of investigators’ attitudes
toward practice-based research is whether they
would “do it again.” It is encouraging that most
investigators indicated willingness to participate
in future research projects, although we do not
know to what degree these opinions were
influenced by the positive outcome of the study.
Limitations
Results of this survey of pharmacists’ opinions
toward participation in practice-based research
may not be generalized to all community

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PHARMACOTHERAPY Volume 21, Number 6, 2001
pharmacists. We recognize that the respondent
sample is inherently biased for two reasons.
First, these participants had already demonstrated
willingness to participate in such research.
Second, the survey was administered shortly after
investigators learned of the positive results of
their efforts in SCRIP. Furthermore, issues
related to pharmacy practice in general, such as
the shortage of pharmacists for available
positions, were not explored in detail in this
survey. Still, these issues could affect the
decision to participate in practice-based research.
Despite these limitations, we felt that obtaining
information from these motivated pharmacists
would be valuable in planning future pharmacy
practice-based research.
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Summary
Pharmacist-investigators who responded to this
survey indicated eagerness and willingness to
participate in practice-based research in order to
improve the pharmacy profession and take the
opportunity to expand services to patients. For
successful participation, pharmacists should
secure support of other pharmacy staff, including
managers and owners, and work as a team to
support study-related activities. Academic
researchers must ensure that practice-based
research protocols can be integrated into existing
time commitments and responsibilities of the
community pharmacist. Comprehensive and
ongoing training on the disease state under study
is essential to give investigators confidence to
perform study procedures. Finally, during
execution of practice-based research, an ongoing
support network should be in place for contact
and support of the pharmacist-investigators.
Pharmacy practice-based research, particularly
in community pharmacies, has two significant
advantages. First, it uses an existing infra-
structure to provide primary care services to
patients at the community level and therefore
serves as an excellent public health approach.
Second, these projects have the potential to
provide much needed data to demonstrate the
value of pharmacists’ clinical activities. These are
compelling reasons to continue efforts to
understand how best to conduct such research.
We hope this article stimulates further discussion
among pharmacy practitioners and researchers,
so that research methods improve and the
strength of evidence of the value of enhanced
pharmacy services in the community increases.
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