e29Abstracts / Research in Social and Administrative Pharmacy 10 (2014) e1–e64

Methods: A multiple-case study design was employed.

Purposeful sampling was used to identify primary care

clinics providing pharmacist services beyond dispensing.

Maximum variation in organizational context was

sought, including differences in health-system affiliation,

university-based, location, and physician specialty. The

principal investigator spent 1 to 3 days at each clinic for

data collection, which involved shadowing clinic nurses,

clerks, and pharmacists, interviewing 1 to 2 individuals

in each of the different roles (including administrators,

physicians, pharmacists, nurses, medical assistants, and

clerks), and reviewing collaborative drug therapy man-

agement agreements. The immersion/crystallization

method was used throughout data collection and anal-

ysis processes, involving cycles of engaging in the subject

and data, followed by crystallizing patterns. Triangula-

tion between different data sources and peer debriefing

were used to strengthen the validity of the inquiry.

Results: Seven clinics enrolled in the study and 56

individuals were interviewed. Levels of pharmacist

integration were categorized as limited integration –

where pharmacists saw most of their patients apart from

physician visits, moderate integration – where pharma-

cists were incorporated into provider care teams to

discuss patient progress regularly in addition to seeing

patients independently, and extensive integration –

where pharmacists reviewed the list of all patients

coming to see their physicians each day. Also, 4

challenges were identified: limited billing mechanisms

for pharmacist visits, difficulty for patients to under-

stand pharmacist roles in clinic, pharmacists not being

utilized to maximum potential and limited pharmacist

staffing.

Conclusions: A diversity of pharmacist practices in

primary care clinics and challenges encountered were

identified. These findings can inform pharmacists and

practice managers in optimizing clinic workflow design

when incorporating pharmacists in primary care clinics

to fulfill the needs of patients with chronic diseases.

Interprofessional Collaboration - Can MalaysianPharmacists Expand their Non-dispensing Role inOsteoporosis Screening and Prevention?L.S. Toh1, P.S.M. Lai2, K.T. Wong1, B.Y. Low1, C.

Anderson3, 1School of Pharmacy, Faculty of Science,

University of Nottingham, Malaysian Campus, Selangor,

Malaysia, 2Department of Primary Care Medicine,

University of Malaya Primary Care Research Group

(UMPCRG), Faculty of Medicine, University of Malaya,

Kuala Lumpur, Malaysia, 3Division of Social Research in

Medicines and Health, School of Pharmacy, University

ofNottingham, Nottingham, UK

This study describes the perspective of nurses, pharma-

cists, doctors and policy makers regarding the integra-

tion of the non-dispensing role of pharmacists in

osteoporosis screening and prevention at the primary

care level.

Methods: Nurses (n¼10), pharmacists (n¼11), doctors

(n¼10) and policy makers (n¼5) from a primary care

clinic in Kuala Lumpur, Malaysia, were individually

interviewed using a semi-structured topic guide. Purpo-

sive sampling was used. Interviews were transcribed

verbatim and analysed using thematic analysis informed

by constant comparison.

Results: Pharmacists were principally perceived by all

participants to be suppliers of medication, although

there was some recognition of the pharmacist’s role in

providing medication advice. Nonetheless, doctors,

nurses and policy makers were eager for pharmacists

to be more proactive via interprofessional collaboration

in osteoporosis screening, prevention advice and disease

management. Interviewed pharmacists referred to their

current role as ‘robotic dispensers’ and unanimously

agreed that the role of the pharmacist in osteoporosis

management could be expanded. Barriers to overcome

include inadequate staffing and infrastructure, and the

lack of pharmacist dispensing rights (meaning that

doctors can also dispense medications directly to their

patients). These findings were further examined using the

D’Armour’s structural model of collaboration which

encompasses four main themes: shared goals and vi-

sions, internalisation, formalisation and governance.

This model supports our data which highlights a lack

of governance and formalisation, that fosters consensus,

leadership, protocol and information exchange. Based

on the D’Armour’s model, this primary care clinic is

described as developing towards an interprofessional

collaboration in managing osteoporosis but is still in its

early stages.

Conclusions: The pharmacy profession in Malaysia is

gradually moving in the direction of its overseas

counterparts where interprofessional collaboration in

osteoporosis management is currently being practised.

Efforts extending to awareness and acceptance towards

the pharmacists role will be crucial for a successful

change.

Introducing writing circles to undergraduate final yearpharmacy studentsM.J. Spark, K. Moses

Writing circles can be used to improve students’ knowl-

edge and understanding of writing. This paper reports

on final year pharmacy students’ perceptions of writing

circles (WC).

Methods: Students supplied a piece of writing for their

WC members to read and provide critical feedback. WC

groups of six met three times. In the first session,

students reviewed examples of good and bad student

writing from the previous year. In each of the remaining

two sessions, half the group provided a paragraph from

an assessment essay to be critiqued. Following each WC

session there was a whole of class question-and-answer

time where lecturers answered questions about writing

or the assessment essay. After the essays had been

e30 Abstracts / Research in Social and Administrative Pharmacy 10 (2014) e1–e64

submitted, students were asked to provide anonymous

written feedback about WC, their usefulness and how

they could be improved.

Results: Responses were obtained from 85% (53) of

enrolled students. More than two thirds of respondents

reported an adequate, high or very high contribution to

WC 81%(43), usefulness of WC 75%(40), quality of help

given to them by other students 74%(39) and the quality

of their learning from WC 68%(36). From the student

perspective, their experience could be improved by:

having writing circles earlier in the course; distributing

student work before sessions; ensuring that all partici-

pants come prepared to discuss the writing; allocating

marks to WC to improve participation; and lecturers

organising groups. The most useful aspects of WC were:

the question-and-answer sessions; feedback from peers;

starting the essay earlier in the semester; the opportunity

to critique other students writing and learn about

different writing styles as well as thinking more deeply

about their own writing.

Conclusions: Students perceived writing circles as

improving their writing and suggested that writing

circles be introduced earlier in the course.

Joint Surveys By Pharmacist and Physician BasedResearch Networks on Collaborative RolesB. Chewning1, D. Kreling1, D. Hahn2, D. Wilson1, L.

Sater1, R. Carrier3, 1School of Pharmacy, University of

Wisconsin , Madison Wisconsin, 2School of Family

Medicine and Practice, University of Wisconsin, Madison

Wisconsin, 3Mallott’s Pharmacy, Madison Wisconsin

To report the results of parallel surveys of members of

the physician Wisconsin Research Education Network

(WREN) and the Pharmacy Practice Enhancement Ac-

tion Research Link RX (PEARL Rx) to explore how

pharmacist-physician collaboration could be expanded

regarding patient medication management.

Methods: A 5-minute electronic Qualtrics survey was

designed for physicians and pharmacists to identify

patient care services, interests for joint activity and

preferred means of interprofessional communication.

This research surveyed respondents about specific roles

including medication reconciliation in care transitions,

medical device education, monitoring patient therapy

status, medication affordability assistance, daily dose

orchestration, optimizing therapy decisions, medication

regimen adherence assistance, adherence assistance

packaging, patient medication “check up”. The physi-

cian survey asked respondents to indicate for each

service if they already have the pharmacist do it, would

like the pharmacist to do it, or are not interested in

having the pharmacist do the service. Similarly, the

pharmacist survey asked respondents if they already

provide it, would like to provide it or are not interested

in providing the service. The survey also identified

current and preferred modes of communication between

physicians and pharmacists.

Results: Response rates were 69.5% (41) of pharmacists

and 21% (63) of physicians sampled. More than 60% of

physicians indicated they would like pharmacists to pro-

vide medication reconciliation, device education, medica-

tion affordability assistance, daily dose orchestration,

optimize treatment decisions, and offer patient medication

check ups. Many pharmacists provided these services.

Pharmacists preferred communicating with physicians via

fax (74%) while 64% of physicians preferred communi-

cating with pharmacists by phone. Over half of physicians

and three quarters of pharmacists are interested in a joint

project, with another 38% of MD’s saying they were

possibly interested in a joint project.

Conclusions: Collaborative projects will be planned and

studied based on these results.

Knowledge and Perception of Pharmacy Students aboutComplementary and Alternative Medicine: Findingsfrom a Malaysian Public UniversityS.Q. Jamshed1, R. Elkalmi1, S.H. Hadijah1, N.M.

Haniki1, A.K. Alshami1, A.I. Jawad1, M.A. Hassali2,1Department of Pharmacy Practice, School of Pharmacy,

International Islamic University Malaysia, Kuantan,

Pahang, Malaysia, 2School of Pharmaceutical Sciences,

Universiti Sains Malaysia, Penang, Malaysia

This study aimed to explore the knowledge, perception

and attitude of pharmacy students towards complemen-

tary and alternative medicine (CAM).

Methods: This is a cross-sectional study design which

was conducted as a classroom survey in 2013. All the

pharmacy students (n¼400) studying in International

Islamic University Malaysia (IIUM) were recruited. The

study instrument was designed on the basis of previously

published studies and was subjected to face validity and

content validity. Cronbach alpha was found to be 0.85.

Data was entered into PASW version 20 and descriptive

and inferential statistics were applied.

Results: A response rate of 71.2% was achieved. Out of

285 respondents, 79(26.3%) were male, while 206

(68.7%) respondents were female. Overall, the highest

correct response for knowledge item was on the drug

interaction of herbal medicines and digoxin which was

answered correctly by less than half of the students

(n¼110: 38.6%). In terms of perception, almost half of

the respondents disagree that CAM use is unsafe

(n¼122; 42.8%). This was found to be statistically

significant with respect to gender (p¼0.007). In evalu-

ating attitudes towards CAM, slightly less than half of

the respondents agreed to use CAM therapies for minor

ailments (n¼142; 47.3%). Many of them agreed to use

CAM therapies for their health and well-being (n¼179;

59.7%). Respondents were not sure whether they use

CAM with or without conventional medicines for their

minor ailments (n¼121; 40.3%).

Conclusion: Thefindings identified that pharmacy students

do not have adequate knowledge on CAM . On the

contrary, they perceived CAM positively. Their attitudes