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Pharmacy Practice – University of Reading

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  • Start a research career in pharmacy practice

    With one of our PhD projects

Pharmacy Practice

Grow your potential in pharmacy practice research, by joining one of the PhD projects we have available at the University of Reading. If you're looking for a career in pharmacy practice, this is the perfect place to start.

This is a taster of some of the PhD projects you can be involved in at the University of Reading. To discuss the different projects available, please contact Professor Vitaliy Khutoryanskiy by emailing v.khutoryanskiy@reading.ac.uk.

Improving prescribing in mental health: investigating parity of esteem in general practice and a role for clinical pharmacists in primary care

Supervised by Dr Parastou Donyai, advised by Orla MacDonald (Oxford Health NHS Foundation Trust) and Kate Masters (Berkshire Healthcare NHS Foundation Trust)

The prescribing and monitoring of medications for mental health conditions (MHCs) in primary care is a key national challenge. Parity of esteem is about valuing mental and physical health equally. This project will use qualitative research methods to investigate the issues around shared care prescribing with an emphasis on mental health drugs and parity of esteem in general practice nationally and a role for pharmacists in this setting to result in i) a meta-synthesis of existing research evidence about barriers to prescribing in MHCs in general practice, ii) a grounded theory to encapsulate the current prescribing and monitoring of medications in MHCs in general practice, iii) a proposed model of service for pharmacists contributing to general practice to improve parity of esteem in primary care.

The project will draw upon experiences from two completed PhDs that examined the prescribing of antipsychotics and stimulants, respectively, in general practice using qualitative research methods and will exploit strong links with Academic Pharmacy Units, East and West Berkshire Clinical Commissioning Group pharmacists as well as the College of Mental Health Pharmacist members nationally.

Moral Hazard and Medicines Use

With Dr Parastou Donyai

The concept of moral hazard is taken from the insurance and financial sectors and relates to the potential for someone to undertake riskier behaviour specifically as a result of being offered protective action. For example, in insurance this relates to the idea that someone who is insured will be more careless or take greater risks because they know they are protected by insurance - inadvertently increasing the potential for claims. Some individuals of course could also take out large insurance policies specifically to make a claim.

In the insurance and banking sectors firms identify moral hazards and use techniques to recognise and monitor customers and behaviours. Thus a moral hazard can arise when an arrangement of good intentions creates an incentive for someone to behave against the interest of themselves or others. Although the idea has been recognised and explored in other fields, there is room for better recognition and definition of moral hazards with everyday medicines.

The idea of moral hazards is easily extended to drugs such as statins and even insulin, which can create incentives and opportunities for patients to pursue hazardous health behaviours (with the false assumption that sufficient protection is being afforded by their medicine). For example, insulin is associated with weight-lowering behaviour as well as unhealthy behaviours and increased body mass index in patients with diabetes. Statins too can be considered to neutralise the cardiovascular risk of unhealthy food choices. This project will use qualitative methodology to explore the notion of moral hazard with the prescribing and use of medicines.

The prescribing of sodium valproate to women of childbearing age: investigating the continued prescribing of the drug despite guidelines

Supervised by Dr Parastou Donyai, advised by Kate Masters (Berkshire Healthcare NHS Foundation Trust)

The prescribing of sodium valproate for women of child-bearing age has been highlighted as a patient safety concern because of a risk to an unborn child should there be a pregnancy. One current initiative is to ask hospital nurses to complete a valproate card for each patient on discharge so that patients in turn take responsibility for avoiding pregnancy.

This project will use qualitative research methods to investigate the issues around continued prescribing of the drug in this patient group with an emphasis on finding solutions to change prescribing habits and to result in i) a meta-synthesis of existing research evidence about the prescribing of valproate in women of child-bearing age, ii) a grounded theory to encapsulate the current prescribing of valproate in practice, iii) a proposed model for changing practitioner prescribing behaviours.

The project will draw upon experiences from two completed PhDs that examined the prescribing of antipsychotics and stimulants, respectively, in general practice using qualitative research methods and will exploit strong links with Academic Pharmacy Units, East and West Berkshire Clinical Commissioning Group pharmacists as well as the College of Mental Health Pharmacist members nationally.

Development of an interprofessional intervention for prescriber management of respiratory tract infections

With Dr Rosemary Lim

Resistance to antibiotics is a major global health problem. Antibiotic stewardship is a key way to conserve antibiotic sensitivity. Non-medical prescribers often prescribe for antibiotics in primary care and patients who have received care from them have reported very high satisfaction rates. The project will develop and pilot test an interprofessional intervention to manage antimicrobial prescribing for respiratory tract infections.

Resilience in the use of IV insulin infusions in hospital in-patients with diabetes

With Dr Rosemary Lim

The use of intravenous insulin infusions in hospital is a complex and risky process. Traditional safety approaches focuses on why things have gone wrong to improve safety. This study will use a Safety-II  and resilient healthcare perspective to understand and develop resilient strategies for managing the use of IV insulin infusions in adult hospital in-patients, diagnosed with diabetes.

Supporting people with dementia and their informal carers with their medicines

With Dr Rosemary Lim

Medication management in people with dementia is a complex process that often requires support from informal carers. Previous work has demonstrated that people with dementia and family carers develop resilient strategies to manage the entire medicines management process. The study will build on this previous work and apply ‘organisational resilience’ to develop an intervention to support people with dementia and family carers with managing medicines.

Clinical pharmaceutics

With Dr Nilesh Patel

This is the application of the unique knowledge base of pharmaceutics to patients and to clinical situations. An example of a project in this area includes the investigations into the pharmaceutical issues associated with the co-administration of IV medicines via Y-site. This project uses physical analysis techniques to determine the physico-chemical stability of intravenous medicines commonly co-administered via Y-site. The aim is to make recommendations to NHS contacts based on the findings.

Medicines use and health services evaluation

With Dr Nilesh Patel

Various projects can be devised from these themes with potential methodologies including questionnaire design, focus groups and interviews. Current work includes examining the input of pharmacists in GP practices, independent prescribing and medicines reuse. Both qualitative and quantitative research methodologies are likely to be employed.

Infant feeding

With Professor Kath Ryan

Breastfeeding statistics in the UK are among the lowest in the world and we know that women do not receive the right support at the right time to enable them to breastfeed for as long as they would have liked. 

The UK currently does not have a National Breastfeeding Strategy, the Royal Pharmaceutical Society does not have a Policy on Infant Feeding and we know nothing about what is taught about infant feeding in Schools of Pharmacy in the UK, including the use of medicines in breastfeeding women. Projects in this area will address these issues and more.

Medication narratives

With Professor Kath Ryan

How do people talk about their medicines?  What meaning do they have in their lives? I'm thinking quite broadly about people's experiences with medicines, not so much adverse reactions but more about how they incorporate them into their daily lives, decide what to take and when (especially in terms of over-the-counter medicines), where they store them in their houses, and how they talk to their friends and family about them. 

This work would follow on from earlier work that colleagues and I have done about medication narratives and how people relate to medicines, the use of multiple medicines in Australia, and theoretical work on the stories that people with chronic illness construct around their use of medicines. It might address the question of how people become pharmaceuticalised.

Pharmacists in general practice

With Professor Kath Ryan

In 2015, NHS England announced a three-year pilot to test the role of pharmacists working in GP surgeries. Having a pharmacist in a general practice team, however, is not new but because of recent changes in the role and rapid development there is limited UK research that could inform the pilot.

Work is needed on pre-existing collaborations and early pilot sites to provide preliminary insights into the practicalities, benefits and barriers of employing pharmacists in general practice, multidisciplinary team development and stakeholder experiences of service provision, among other things such as impact metrics.

This work is being conducted in collaboration with Dr Nilesh Patel, University of Reading and Dr Graham Stretch, pharmacist in Ealing GP Federation and involves a number of projects:

  • Work with the Ealing Patient Practice Group (PPG) to devise a) informational materials for members of the public and b) a patient satisfaction survey specific to pharmacy services in general practice
  • Understanding the delivery and impact of pharmacy services in aged care and nursing homes
  • Exploring the range of models of employing pharmacists in general practice

Public and patient involvement, engagement and participation in pharmacy practice research and education

With Professor Kath Ryan

People bring their own unique perspectives and experiences to decisions about their health needs so there is a call for their greater involvement in designing and delivering appropriate services and programmes, not just in healthcare but also in teaching and research, including the lay voice can lead to attitudinal shifts that change the delivery of care and the training of health professionals. 

Public and patient involvement, engagement and participation (PPIEP) is a concept defined by INVOLVE, the body set up by the National Institute for Health Research (NIHR) to support active public involvement in the UK National Health Service. There is strong evidence that PPIEP provides better outcomes for all in the short-term.

More research is needed on how to engage with members of the public and the longer term impact on health professional behaviour, attitudes, skills and knowledge in relation to PPIEP in Pharmacy Practice research and education.

 

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