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Purpose – The purpose of this paper is to examine the Irish community pharmacy sector in the context of power relationship theory. Specifically, the paper analyses the relationship between dispensary software vendors and the independent community pharmacist; and explore dominant industry partners' influence on individual pharmacies in terms of technology adoption. The core objective is to ascertain whether the potential for a cooperative construct can be realised in this milieu. Design/methodology/approach – A comprehensive literature review precedes a full investigation and analysis of the Irish community pharmacy sector's competitive environment, in the context of the pre‐mentioned power relationship theory. Findings – This research uncovered a potential alternative to the industry's existing power imbalance in the form of a cooperative construct between a team of independent community pharmacists and an employed software vendor. The purpose of this partnership was to ensure the installed software focused on the pharmacist's strategic needs rather than those of the dominant partners. The paper goes on to discuss the failure of this partnership in the context of independent pharmacist's future competitive survival. Research limitations/implications – Data collection was limited to the community pharmacy sector in the Republic of Ireland. Therefore, care should be taken in making generalisations from this study. Practical implications – In the absence of cooperative constructs, power relationship imbalances will continue to exist in this competitive environment, to the detriment of the small firm. Originality/value – Little research has been completed in the area of small business cooperative constructs as a means of competing successfully in a power relationship scenario. This paper goes some way to redressing this.

Organisational culture (OC) shapes individuals’ perceptions and experiences of work. However, no instrument capable of measuring specific aspects of OC in community pharmacy exists. The purpose of this paper is to report the development and validation of an instrument to measure OC in community pharmacy in Great Britain (GB), and conduct a preliminary analysis of data collected using it.

Instrument development comprised three stages: Stage I: 12 qualitative interviews and relevant literature informed instrument design; Stage II: 30 cognitive interviews assessed content validity; and Stage III: a cross-sectional survey mailed to 1,000 community pharmacists in GB, with factor analysis for instrument validation. Statistical analysis investigated how community pharmacists perceived OC in their place of work.

Factor analysis produced an instrument containing 60 items across five OC dimensions – business and work configuration, social relationships, personal and professional development, skills utilisation, and environment and structures. Internal reliability for the dimensions was high (0.84 to 0.95); item-total correlations were adequate (r=0.46 to r=0.76). Based on 209 responses, analysis suggests different OCs in community pharmacy, with some community pharmacists viewing the environment in which they worked as having a higher frequency of aspects related to patient contact and safety than others. Since these aspects are important for providing high healthcare standards, it is likely that differences in OC may be linked to different healthcare outcomes.

This newly developed and validated instrument to measure OC in community pharmacy can be used to benchmark existing OC across different pharmacies and design interventions for triggering change to improve outcomes for community pharmacists and patients.

The purpose of this paper is to examine the effect of ownership of community pharmacies on the perception of organizational identity and its relationships with organizational performance.

A survey was carried out on a sample of pharmacists working in community pharmacies in Portugal. The sample comprised 1,369 pharmacists, of whom 51 percent were owner-managers. Measures of pharmacies’ normative (community health oriented) and utilitarian (business oriented) identities, identity strength (clear and unifying), substantive (stockholder focused) and symbolic (society focused) performance were included.

Both owners and employed pharmacists rated the normative identity of pharmacies higher than the utilitarian identity. Compared with employed pharmacists, owners perceive a lower level of utilitarian identity, the same level of normative identity, and higher levels of identity strength. Normative identity and identity strength predicted symbolic performance. Normative and utilitarian identities and identity strength predicted substantive performance. The relationship between utilitarian identity and substantive performance was significant among owner pharmacists but not among employed pharmacists.

The limitations include the use of perceptive measures and the focus on the individual level of analysis.

In order to improve pharmacies’ performance, pharmacists who manage community pharmacies are challenged to reconcile tensions arising from the co-existence of business and community health identities and from their own agency (self-serving) and stewardship (altruistic) motives.

This study draws on institutional, identity and stewardship theories to understand how pharmacists, owners and employees, view the identity of community pharmacies and how identity relates to organizational performance.

The success ofIn recent years, there has been significant interest in the application of continuous quality improvement (CQI) and total quality management (TQM), and patient‐focused care (PFC) in health care organisations around the globe. The hospital industry has substantially embraced the concepts of CQI and TQM with the belief that these concepts and programmes will lead to an improvement in both the quality and efficiency with which health services are delivered. The objective of this article is to achieve better outcomes in health care services with fewer resources by studying the implementation of patient‐focused care in the health care provision context and particularly in the area of pharmaceutical care management as an integrated process in the delivery of health care in a hospital setting. The changes in health care provision have in many instances meant that the provision of pharmaceutical services needed re‐assessing.

Using the example of medication safety, this paper aims to explore the impact of three managerial interventions (adverse incident reporting, ward‐level support by pharmacists, and a medication safety subcommittee) on different professional communities situated in the English National Health Service (NHS).

Semi‐structured interviews were conducted with clinical and managerial staff from two English NHS acute trusts, supplemented with meeting observations and documentary analysis.

Attitudes toward managerial intervention differ by professional community (between doctors, nurses and pharmacists) according to their existing norms of safety and perceptions of formal governance processes.

The heterogeneity of social norms across different professional communities and medical specialties has implications for the design of organisational learning mechanisms in the field of patient safety.

The paper shows that theorisation of professional “resistance” to managerialism privileges the study of doctors' reactions to management with the consequent neglect of the perceptions of other professional communities.

The aim of this paper is to study pharmacy service impact on patient satisfaction and to determine what factors saliently link with pharmaceutical service performance at Hamad General Hospital.

A patient satisfaction questionnaire was designed using the literature and consultation with Hamad General Hospital medical experts. The questionnaire contained 22 items that focused on five influencing factors: promptness; attitude; supply; location; medication education; and respondent demographic aspects. A total of 220 respondents completed the questionnaire. An exploratory factor analysis was used to group items and a structural equation model was developed to test causality between five factors along with their influence on patient satisfaction.

The study establishes statistical evidence that patient satisfaction is positively influenced by service promptness, pharmacist attitude, medication counseling, pharmacy location and waiting area. Several socio‐demographic characteristics have statistically different effect on satisfaction, notably: gender; marital status; health status; age; educational level; and ethnicity. However, medication supply did not influence patient satisfaction.

Pharmaceutical services are recognized as an essential healthcare‐system component. Their impact on customer satisfaction has been investigated in many countries; however, there is no such study in Qatar.

The findings identify pharmaceutical service performance indicators and provide guidelines to improve Qatari pharmaceutical services.

This study aims to assess whether patients [who receive community pharmacy services at locations where routine medication therapy management (MTM) care is reimbursed] who were adherent to their medications generated lower inpatient hospitalization expenses.

This is a retrospective, descriptive and cross-sectional study using administrative claims data drawn from 84 community pharmacies in North Dakota. The included patients were enrolled in a Blue Cross Blue Shield of North Dakota insurance plan and were taking one or more of eight groups of medications (metformin, antidepressants, anti-asthmatics, ACEs/ARBs, beta-blockers, calcium channel blockers, diuretics and statins) commonly prescribed to treat chronic conditions filled between July 1, 2014 and June 30, 2015. Community pharmacists used software that allowed the pharmacists to provide and bill for MTM services. Data from these sources were used to calculate medication adherence and inpatient costs.

Patients prescribed a beta blocker, a calcium channel blocker, and a diuretic or an anti-diabetic medication, and those who are fully adherent to their medications were associated with significantly lower inpatient hospitalization costs (as measured by insurance payments to hospitals) as compared to non-adherent patients. Patients who were fully adherent to their medications had no statistically significant differences in patient-specific costs compared to non-adherent patients.

Patients receiving services at a community pharmacy that offers MTM services and those who were adherent to their medication regimens generate lower health care expenses. Most of the savings come from lower hospitalization expenses, rather than patient-paid expenses.

The purpose of this study is to identify patient experience unique to online pharmacy services (OPS) based on the characteristics of OPS (i.e. interactivity and virtuality) and to reveal how patient experience is derived from OPS and thereby enhances patient adherence from both online social support and patient experience perspectives.

The Stimulus-Organism-Response framework was used to conceptualize this study; both primary and secondary data for 296 validated participants were collected on a real OPS platform. A structural equation modeling approach combined with partial least squares was employed for the quantitative analysis.

Social presence and user engagement can be identified as patient experience in the OPS context; online emotional support has a stronger association with patients' social presence than it does with patients' user engagement; patients' social presence has a stronger association with their medication adherence than it does with diet adherence, while patients' user engagement has a stronger association with their diet adherence than it does with medication adherence; patients' medication knowledge negatively moderates the relationship between user engagement and diet adherence.

This study identifies patient experience in accordance with unique characteristics of OPS, and it reveals the nuanced underlying mechanisms by which online social support is associated with patient experience and by which patients' experience is associated with their adherence. This study enriches the literature on patient adherence, patient experience and OPS, providing insights for healthcare providers, OPS designers and policymakers.

Community pharmacists need good retrieval skills and competencies for effective use of online information resources for professional practice. This study aims to ascertain the internet literacy skills of community pharmacists in Lagos State, Nigeria.

A survey research design was adopted for the study. Convenience sampling technique was used in selecting community pharmacists. Questionnaire was the instrument used for data collection, whereas descriptive and inferential statistics were used for data analysis.

The study revealed that community pharmacists possess requisite internet literacy skills for effective use of online health information resources. There is a positive relationship between informational and operational internet literacy skills [r = 0.820, p(0.000) < 0.05], informational and strategic internet literacy skills [r = 0.838, p(0.000) < 0.05] and operational and strategic internet literacy skills [r = 0.810, p(0.000) < 0.05]. There is a statistically significant gender difference in the level of skillfulness in internet use based on self-reported skills. There is a significant relative contribution of demographic variables (gender, age, educational qualification and number of years in professional practice) to the level of skillfulness in internet use among community pharmacists.

To improve the use of online internet resources, the Association of Community Pharmacists of Nigeria, Lagos Chapter, should conduct training needs assessment regularly to offer the right levels of internet use skills. They must be proactive and incorporate training on computer and internet skills into their annual conferences and zonal meetings. They should also prepare and give internet use manuals to their members to read and understand how to use the internet more effectively. Community pharmacists, especially the female pharmacists, should also take advantage of free online training sessions called webinars to improve their internet literacy skills to cope with rapid changes in the e-environment, as well as to boost the quality of health-care services delivery. Pharmacists’ Council of Nigeria, the agency responsible for regulating and controlling the education, training and practice of pharmacy, should include an internet literacy skills module in the Mandatory Professional Continuing Education Programme.

The study investigated the internet literacy skills of community pharmacists in Lagos State and identified the gender gap in level of skillfulness. This study also explored the relationship between level of skillfulness and internet use, as well as the relationship between community pharmacists’ informational, operational and strategic internet literacy skills.

The developing generic market has huge advantages of availability and affordability of therapy. The question of whether a therapeutic equivalent substitute under an unfamiliar name may cause confusion that leads to medical errors has not been sufficiently studied. This paper seeks to answer this question.

The study was triggered following sporadic reports according to which patients mistakenly consider therapeutic equivalents as unrelated medications rather than substitutes. Family physicians and pharmacists in one of eight districts of Clalit, Israel's largest healthcare provider were surveyed. The survey's questions recall episodes of medication uncertainty, confusion, misidentification, and medication mistakes associated with switching from one therapeutic equivalent to another. A total of 66 physicians and 63 pharmacists responded to the surveys (61 percent and 45 percent, respectively).

The results recall uncertainty, confusion, misidentification, and mainly cases of medication mistakes in which patients consumed both therapeutic equivalents simultaneously as was reported by 81 percent of physicians and 70 percent of pharmacists.

There are two limitations in this work, the first is the study type, which is recall survey; the second is the response rate which is not unusual among health care professionals. However, the high face‐validity and the consistency of the findings in both physicians and pharmacists surveyed indicates high validity of the study conclusions.

A practical implication is unique medication error of consuming both therapeutic equivalents simultaneously. The authors wish to raise awareness of the potential of such error, which may be difficult to disclose as each of the therapeutic equivalents is apparently the intended medication but consuming them simultaneously results practically in doubling the intended dose. Given the forecast for generic market growth, awareness is not enough and worldwide regulatory cooperation should be made otherwise these types of medication errors will inevitably emerge.

The study is original as a literature search revealed no studies evaluating potential medication mistakes attributed to a switch between therapeutic equivalents.