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While studies have reported pharmacists' perspectives of research involvement, almost all are limited by sector, have little focus on research translation and have not incorporated behavior change theory. The objective of this research was to determine pharmacists' views and experiences of research conduct, dissemination and translation. This was an electronic cross-sectional survey of pharmacists across six Scottish health board areas. Survey items were: demographics; research activities (e.g. conduct, dissemination) in the last two years; research interests, experience and confidence in research tasks (e.g. proposal writing, data collection); and Likert statements on research conduct, dissemination and the translation of research findings into practice. Conduct/dissemination and translation items were based on the Theoretical Domains Framework (TDF). Data were analysed using descriptive and inferential statistics, and principal component analysis (PCA) of TDF items. Following determination of internal consistency, scores for each component were calculated. The response rate was 19.4% (136/701), with 17 (12.5%) currently involved in research. Responses were more positive for interest in research than experience or confidence. PCA of research conduct/dissemination items identified three internally-reliable components of support/opportunities, motivation/outcomes, and roles/characteristics. Component scores for support/opportunities to participate in research were most negative. PCA of translation items identified three internally-reliable components of current practices/abilities, consequences and support. Scores for all three components were positive, being most positive for consequences of research translation. Those in secondary care, with a postgraduate qualification and prescription responsibilities scored higher for interest, experience, confidence and for most components (p < 0.05). In conclusion, a minority of pharmacists are involved in research conduct/dissemination and these are more likely to be highly-qualified individuals, based in secondary care. Given the need to develop and evaluate new models of pharmaceutical care, involvement should be extended to all practice settings. Study findings could be used to develop behavior change interventions targeting individuals and organizations.

Background Multi-compartment compliance aids (MCAs) are promoted as a potential solution to medicines non-adherence despite the absence of high quality evidence of effectiveness of MCA use impacting medicines adherence or any clinical outcomes. Furthermore, there is a lack of qualitative research which focuses on the perspectives of older people receiving MCAs. Objectives To describe experiences and beliefs surrounding very sheltered housing (VSH) residents’ use of MCAs with emphasis on issues of personalisation, reablement, shared decision-making, independence and support. Setting VSH in north east Scotland. Methods Qualitative, face-to-face interviews with 20 residents (≥ 65 years, using MCA > 6 months) in three VSH complexes. Interviews focused on: when and why the MCA was first introduced; who was involved in making that decision; how the MCA was used; perceptions of benefit; and any difficulties encountered. Interviews were audiorecorded, transcribed and analysed using a framework approach. Main outcome measure Experiences and beliefs surrounding use of MCAs. Results Nine themes were identified: shared decision-making; independence; knowledge and awareness of why MCA had been commenced; support in medicines taking; knowledge and awareness of medicines; competent and capable to manage medicines; social aspects of carers supporting MCA use; benefits of MCAs; and drawbacks. Conclusion Experiences and beliefs are diverse and highly individual, with themes identified aligning to key strategies and policies of the Scottish Government, and other developed countries around the world, specifically personalisation shared decision making, independence, reablement and support.

Background Limited data exist on the facilitators and barriers to implementing electronic systems for medicines management in hospitals. Whilst numerous studies advocate system use in improved patient safety and efficiency within the health service, their rate of adoption in practice has been slow. Objective To explore the perceptions of key stakeholders towards the facilitators and barriers to implementing electronic prescribing systems, robotic pharmacy systems, and automated medication storage and retrieval systems in public hospital settings using Normalization Process Theory as a theoretical framework. Methods Individual face-to-face semi-structured interviews were conducted in three public hospitals in Ireland with 23 consenting participants: nine nurses; four pharmacists; two pharmacy technicians; six doctors; and two Information Technology managers. Results Enhanced patient safety and efficiency in healthcare delivery emerged as key facilitators to system implementation, as well as the need to have clinical champions and a multi-disciplinary implementation team to promote engagement and cognitive participation. Key barriers included inadequate training and organisational support, and the need for ease and confidence in system use to achieve collective action. Conclusions Many themes that are potentially transferable to other national settings have been identified and extend the evidence base. This will assist organisations around the world to better plan for implementation of medication-related eHealth systems.

Background The expansion in terms of available treatment options and models of care has led to a growing global momentum for outpatient antimicrobial therapy (OPAT) services. A systematic review was undertaken to explore Human Factors aspects relating to OPAT service delivery and to evaluate whether OPAT is amenable to description using the Systems Engineering Initiative for Patient Safety (SEIPS 2.0) model. Method Following a preliminary search, a search string was applied to four databases, including Medline, Cumulative Index of Nursing and Allied Health Literature, International Pharmaceutical Abstracts and PsychINFO. Inclusion criteria ensured only articles published after the year 2000 and written in English were accepted. The methodological quality of studies was assessed by three reviewers. Narrative synthesis was performed to uncover the key interactions between work system entities which underpin OPAT processes and outcomes as described using the SEIPS 2.0 model. Results A total of twenty-seven studies were deemed eligible for the final review. Of these, most described sample populations representative of the population under study, while duration of the studies varied from a few months to years. Some studies evaluated a single model of care whilst others evaluated all three currently available models. The breadth and scope of the studies included enabled extraction of rich Human Factors data describing barriers and enablers to service provision. Conclusion OPAT is a service which offers significant benefits to both patients and care providers. These benefits include patient satisfaction and wellbeing, as well as financial performance. OPAT is a complex sociotechnical system, and a systems approach may offer the opportunity to enhance system design, maximising system performance. This review demonstrates that the service can be better understood using the SEIPS 2.0 model to identify key work system interactions that support performance.

The aims of this study were to quantify the behavioural determinants of health professional reporting of medication errors in the United Arab Emirates (UAE) and to explore any differences between respondents. A cross-sectional survey of patient-facing doctors, nurses and pharmacists within three major hospitals of Abu Dhabi, the UAE. An online questionnaire was developed based on the Theoretical Domains Framework (TDF, a framework of behaviour change theories). Principal component analysis (PCA) was used to identify components and internal reliability determined. Ethical approval was obtained from a UK university and all hospital ethics committees. Two hundred and ninety-four responses were received. Questionnaire items clustered into six components of knowledge and skills, feedback and support, action and impact, motivation, effort and emotions. Respondents generally gave positive responses for knowledge and skills, feedback and support and action and impact components. Responses were more neutral for the motivation and effort components. In terms of emotions, the component with the most negative scores, there were significant differences in terms of years registered as health professional (those registered longest most positive, p = 0.002) and age (older most positive, p

Multi-compartment compliance aids (MCAs) are repackaging systems for solid dosage form medicines, heralded by some as a solution to non-adherence but with little evidence of benefit.The aim was to use a theoretical approach to describe the behavioural determinants impacting the use of MCAs in older people from the perspectives of the individual and health and social care providers.A case study investigation was conducted.The study took place in three very sheltered housing sites in North East Scotland.Twenty residents (≥65 years) using an MCA for at least 6 months and 34 members of their care team [17 formal carers, eight general practitioners (GPs), eight pharmacists, one family member].Semi-structured, face-to-face interviews with items based on the Theoretical Domains Framework were conducted. Interviews were audio-recorded, transcribed and analysed thematically.Several behavioural determinants impacted the use of MCAs from the perspectives of the stakeholders involved. Goals of use related to promoting adherence and safety, with less emphasis on independence. Beliefs of consequences related to these goals and were considered of value, with additional consequences of concern around reduced awareness of medicines and complexities of changing medicines. There was a lack of clearly defined roles of professionals for all processes of MCA use, with evidence of blurring and gaps in roles. There were additional issues relating to capabilities of older people in using MCAs and capacity issues for pharmacy-supplied MCAs.Several behavioural determinants impacted the use of MCAs, and while MCAs were valued, there is a need to more clearly define, develop, implement and evaluate a model of care encompassing resident and medicines assessment, supply and ongoing review of MCAs.

Rationale and aim The structures and processes around the management of medicines for elderly, hospitalized patients are ill defined. This study aimed to determine consensus related to strategic and operational approaches in the United Arab Emirates. Methods A modified Delphi technique, consensus study with first round statements developed from systematic reviews related to medicines management. Normalization process theory and the theoretical domains framework were applied in the construction of statements, organized into key elements of medicines management: guidelines for medicines management, medicines reconciliation, medicines selection, prescribing and review, medicines adherence, medicines counselling, health professional training and evaluation research. Seventy per cent (summative agree and strongly agree) was set as the target for consensus. Thirty panellists were recruited, representing senior physicians working within geriatrics, hospital pharmacy and nursing directors, chief health professionals (including social workers) and policy makers within the Health Authority of Abu Dhabi and academics. Results A high level of consensus was obtained for most statements relating to the structures and processes of medicines management. While consensus was not achieved for targeting only those patients with medicines related issues, it was achieved for focusing on all elderly admissions. Similarly, consensus was not achieved for which professions were most suited to roles but was achieved for trained and competent staff. Conclusions High levels of consensus were obtained for structures and processes of medicines management relating to elderly hospitalized patients. Trained and competent health professionals were preferred to specific professions for any tasks and that all elderly patients and not targeted patients should be the focus for medicines management.

Objective To identify, critically appraise, synthesise and present the available evidence on healthcare professionals’ perceptions of the facilitators and barriers to implementing electronic prescribing, dispensing and/or administration of medicines in the hospital setting. Methods A systematic search of studies focusing on healthcare professionals’ perceptions of technologies for prescribing, dispensing and administering medicines in the hospital setting was performed using MEDLINE, Cumulative Index to Nursing and Allied Health, International Pharmaceutical Abstracts, PsycARTICLES, PsycINFO, Cochrane Database of Systematic Reviews and Centre for Reviews and Dissemination. Grey literature inclusive of manual searching of core journals, relevant conference abstracts and online theses were also searched. Independent duplicate screening of titles, abstracts and full texts was performed by the authors. Data extraction and quality assessment were undertaken using standardised tools, followed by narrative synthesis. Key findings Five papers were included in the systematic review after screening 2566 titles. Reasons for exclusion were duplicate publication; non-hospital setting; a lack of investigation of healthcare professionals’ perceptions and a lack of focus on implementation processes or systems specific to electronic prescribing, dispensing or administration of medicines. Studies were conducted in the USA, Sweden and Australia. All studies used qualitative interview methods. Healthcare professionals perceived systems improved patient safety and provided better access to patients’ drug histories and that team leadership and equipment availability and reliability were essential for successful implementation. Key barriers included hardware and network problems; altered work practices such as time pressure on using the system and remote ordering as a potential risk for errors; and weakened interpersonal communication between healthcare professionals and with patients. Conclusions Few studies were identified on healthcare professionals’ perceptions of the facilitators and barriers to system implementation in hospitals. Key facilitators included a perception of increased patient safety and better access to patients’ drug history while key barriers involved technical problems, changes to routine work practices and weakened interpersonal communication. Investigating this area further will assist in improving patient safety and reducing medication costs by informing and strengthening implementation strategies.

Our aim was to test the feasibility of interprofessional, workplace-based learning about improvement through a 4-week placement for one medical and two pharmacy final year students in an Acute Surgical Receiving Unit (ASRU). The target was insulin because this is a common, high-risk medicine in this ASRU and the intervention was medicines reconciliation. Baseline data were collected from 10 patients and used to construct a cause and effect diagram and a process map through feedback and discussions with staff. Hypoglycaemia occurred in four patients but hyperglycaemia occurred in eight patients, of whom six were placed on intravenous insulin infusion (IVII). We estimated that £2454 could be saved by preventing one patient from going on IVII. The students designed and tested a sticker to improve medicines reconciliation for insulin patients. An online form was created to capture clinician feedback on the layout and usability of the sticker. The intervention was associated with improvements in the reliability of medicines reconciliation. The students’ work contributed to a larger project to reduce the risk of hypoglycaemia in the ASRU. This proved beneficial in enabling the students to engage with the clinical team. Nonetheless, it was challenging for students from two Universities to get a shared understanding of improvement methods and work effectively with the clinical team. The students said that they learnt more about quality improvement in a working healthcare environment than they would ever learn in a classroom and they valued the opportunity to work with students from other healthcare backgrounds in practice. Despite the additional staff time required to support students from two Universities, both have supported continuation of this work.

Introduction Technology enables medical services to be provided to rural communities. This proof of concept study assessed the feasibility and acceptability of delivering community pharmacy services (CPS; including advice, sale of over-the-counter products and dispensing of prescriptions) by tele-technology (the Telepharmacy Robotic Supply Service (TPRSS)) to a rural population in Scotland. Methods Data collection included the following: postal surveys to local residents; focus groups/ interviews with pharmacists, other healthcare professionals (HCPs) and service users, at baseline and follow-up; TPRSS logs. Interviews/focus groups were audio-recorded, transcribed and thematically analysed. Descriptive statistics were reported for survey data. Results Qualitative results: Pre-installation: residents expressed satisfaction with current pharmacy access. HCPs believed the TPRSS would improve pharmacy access and reduce pressure on GPs. Concerns included costs, confidentiality, patient safety and ‘fear’ of technology. Post-installation: residents and pharmacy staff were positive, finding the service easy to use. Quantitative results: Pre-installation: almost half the respondents received regular prescription medicines and a third used an over-the-counter (OTC) medicine at least monthly. More than 80% (124/156) reported they would use the TPRSS. There was low awareness of the minor ailment service (MAS; 38%; 59/156). Post-installation: prescription ordering and OTC medicine purchase were used most frequently; the video link was used infrequently. Reasons for non-use were lack of need (36%; 40/112) and linkage to only one pharmacy (31%; 35/112). Discussion Community pharmacy services delivered remotely using tele-technology are feasible and acceptable. A larger study should be undertaken to confirm the potential of the TPRSS to reduce health inequalities in rural areas.

Introduction : Interprofessional education (IPE) continues to be a key component in prequalifying health professional education, with calls for regulators to publish a joint statement regarding IPE outcomes. To date, the regulatory documents for healthcare education in the United Kingdom have not been examined for common learning outcomes; information that could be used to inform such a statement and to identify opportunities for interprofessional learning. Methods : A mapping of the outcomes/standards required by five, UK, health profession regulatory bodies was undertaken. This involved the identification of common outcomes, a keyword search and classification of common outcomes/standards; presented as themes and subthemes. Results : Seven themes were identified: knowledge for practice, skills for practice, ethical approach, professionalism, continuing professional development (CPD), patient-centered approach and teamworking skills, representing 22 subthemes. Each subtheme links back to the outcomes/standards in the regulatory documents. Conclusions : This study identifies the key areas of overlap in outcomes/standards expected of selected healthcare graduates in the United Kingdom. The mapping provides a framework for informing prequalifying IPE curricula, for example, identifying possible foci for interprofessional education outcomes and associated learning opportunities. It allows reference back to the standards set by regulatory bodies, a requirement for all institutions involved in health profession education. Publisher PDF

REVIEW OBJECTIVE The objective of this review is to critically appraise, synthesize and present the available evidence on health professionals’ beliefs, attitudes and experiences of medication error reporting. Review questions More specifically, this review seeks to answer the following questions. In relation to health professionals (i.e. doctors, nurses and pharmacists): 1.What are their beliefs and attitudes towards medication error reporting? 2. What are their experiences of medication error reporting? (E.g. nature of feedback obtained, any subsequent changes in their practice, ease of use of the reporting system, any improvements required to optimize medication error reporting.) 3. What are the reasons given or factors which are associated with under-reporting of medication errors? (E.g. lack of awareness or understanding of the reporting system, fear of possible consequences of reporting, and forgetting to report.) INCLUSION CRITERIA Types of participants This review will only consider studies that include doctors, nurses and pharmacists, as these are the health professionals involved in the patient medication journey and specifically in the processes of prescribing of medicines (doctors, nurses and pharmacists all have prescribing rights in certain countries, e.g. the United Kingdom), administering (all are involved) and dispensing (all may be involved to some extent in different countries). Phenomena of interest While there is no intervention (as would be the case in reviews of effectiveness or cost-effectiveness), the qualitative component of this review will consider studies that investigate the phenomenon of medication error reporting from a number of different perspectives (e.g. doctors, nurses, pharmacists). TRUNCATED AT 250 WORDS

Compared to the nursing and medical professions, simulation-based pharmacy education is a relatively new mode of supporting learning, although one that is growing rapidly to meet the training needs of a new generation of healthcare professionals. Within the UK (and particularly Scotland), access to the clinical environment through the more traditional route of placement is limited, and simulation offers a partial solution to this problem. As is well-established, simulation—if used appropriately—also offers excellent opportunities for enhancing patient safety, including allowing the exploration of the science of human factors. Given the high incidence of medication errors, pharmacists need to be included in any intervention for improvement of patient safety. It is true, however, that the “clinical environment” experienced by the practising pharmacist (especially in community pharmacy) is different from the typical nursing or medical situation. This, combined with a lack of understanding of the role of the pharmacist as a member of the wider healthcare team, means that there are additional considerations required when designing simulation-based learning activities. This commentary undertakes a narrative review of the current situation for pharmacy simulation, and considers how this may be developed to support the Scottish healthcare vision, whilst recognising that the issues raised are likely to be relevant across the sector.

Background. Whilst placement supervision and clinical education programmes are of significant value in shaping the behaviours of undergraduate healthcare students, appropriate provisions which are efficacious to the learner are somewhat lacking, particularly for students studying on UK MPharm programmes.Objectives. To explore and explain the value of placement supervision to the personal development and employability of undergraduate pharmacy students.Methods. Students participated in a week long community pharmacy pilot programme, a result of a collaborative effort between the School of Pharmacy and Life Sciences and a small consortium of community pharmacies. Students and stakeholders were asked to evaluate their experiences via separate questionnaires which had been developed to elicit views and attitudes.Key Findings. Feedback from students and stakeholders towards the experience was overwhelmingly positive with multiple benefits being reported. Of particular prominence was the emphasis in student feedback on the value of placement supervision to their professional and personal development. Findings were indicative of a development in clinical practice proficiencies, core skills, and improvement in decision-making practice.Conclusions. The benefits of clinical supervision to the professional and personal development of MPharm students are well documented, although attracting professional pharmacy supervisors is proving a problematic task for educational providers in the UK.

Purpose To explore medical and non-medical practitioners’ views of the impact of ehealth on shared care. Method A systematic review was conducted using a meta-narrative approach with publication search dates limited from 1 January 2005 to 28 February 2011 and English language only. Search results from the databases (ASLIB, EBSCO Host, Cochrane Library, Informa Healthcare, PsycNet, Sciverse Scopus, Zetoc) were independently reviewed and data extracted by two of the authors. The review included peer reviewed papers about medical and non-medical practitioners who provide ehealth supported shared care. Articles which focused solely on searching the internet or exchange of emails were excluded. Results Screening reduced the initial 327 papers identified to 12 which included three reviews, four qualitative, two mixed methods and three quantitative studies. Included studies collected data using combinations of questionnaires, case study, group/individual interviews, observation and extraction of data from records. Data were analysed using thematic, interpretive, analytic induction/constant comparative and statistical analysis methods. Practice settings were primary care, secondary care or both. The focus was on electronic records (7), telemedicine (2) or general ehealth implementation (3) predominantly from the perspective of doctors, nurses, IT developers, policy makers and managers plus one hospital pharmacist. The studies showed acceptance of ehealth technologies to support increasing levels of shared care but with cost effectiveness, level of resourcing and training questioned by respondents. Emerging themes across all study types were organisational, social and technical: resource and time implications, culture of the workplace and change management requirements; impact on patient consultation, extra workload, need for training suited to varying levels of IT literacy, usability, patient privacy and the practitioner9s role; systems incompatibility, technological inadequacies, need for shared definition and terminology. Conclusions Findings indicate acceptance of ehealth to support shared care but question anticipated efficiencies. Organisational, social and technical issues identified were similar to non-healthcare IT implementations and adoption of innovation theory. Evidence of medical and non-medical practitioners’ views of the impact of ehealth on shared care remains limited with further areas for pharmacy ehealth research identified.

The structures and processes around the management of medicines for elderly, hospitalized patients are ill defined. This study aimed to determine consensus related to strategic and operational approaches in the United Arab Emirates.A modified Delphi technique, consensus study with first round statements developed from systematic reviews related to medicines management. Normalization process theory and the theoretical domains framework were applied in the construction of statements, organized into key elements of medicines management: guidelines for medicines management, medicines reconciliation, medicines selection, prescribing and review, medicines adherence, medicines counselling, health professional training and evaluation research. Seventy per cent (summative agree and strongly agree) was set as the target for consensus. Thirty panellists were recruited, representing senior physicians working within geriatrics, hospital pharmacy and nursing directors, chief health professionals (including social workers) and policy makers within the Health Authority of Abu Dhabi and academics.A high level of consensus was obtained for most statements relating to the structures and processes of medicines management. While consensus was not achieved for targeting only those patients with medicines related issues, it was achieved for focusing on all elderly admissions. Similarly, consensus was not achieved for which professions were most suited to roles but was achieved for trained and competent staff.High levels of consensus were obtained for structures and processes of medicines management relating to elderly hospitalized patients. Trained and competent health professionals were preferred to specific professions for any tasks and that all elderly patients and not targeted patients should be the focus for medicines management.

Background Given the multiplicity of issues relating to medicines in the elderly, the structures and processes of medicines management should be clearly defined and described to optimise patient outcomes. There is a paucity of research which provides an in-depth exploration of these elements of medicines management for elderly patients. Objectives This study explored health professionals’ experiences of medicines management for elderly, hospitalised patients in Abu Dhabi. Setting The research was conducted in five major hospitals in Abu Dhabi, the United Arab Emirates. Method Responses to an online sampling questionnaire were used to purposively select nurses, pharmacists and physicians for interview. A semi-structured interview schedule was developed with reference to normalization process theory (NPT) and the theoretical domains framework (TDF) to explore issues of medicines management structures, processes and outcomes. Face-to-face interviews of 20–30 min were audio-recorded, transcribed verbatim and analysed using the Framework Approach. Main outcome measures Health professionals’ in-depth experiences of structures, processes and outcomes relating to medicines management. Results Saturation of themes was deemed to occur at interview 27 (7 nurses, 13 pharmacists, 7 physicians). Six key themes and several subthemes emerged from the qualitative analysis, which pertained to the need for: appropriate polypharmacy; a systematic approach to medicines history taking; improved communication and documentation; improved patients’ adherence to medicines; guidelines and policies to support medicines selection, and an educated and trained multidisciplinary team. The most dominant TDF behavioural determinants were issues around: professional role and identity; beliefs about capabilities; beliefs about consequences; environmental context and resources; knowledge, and goals. NPT construct identified little evidence of coherence, cognitive participation, collective action and reflexive monitoring. Conclusion The key themes identified in this research indicate the need to develop a more structured approach to medicines management in elderly hospitalised patients in Abu Dhabi. The NPT constructs and the TDF behavioural determinants can be utilised as part of service development and implementing change.

Robert Gordon University’s key strength is employability (reflecting close liaison with the professions) and courses must therefore offer opportunities for work-based learning, which can be challenging in the current financial climate. This is a particular problem for Pharmacy: opportunities for placement are extremely limited and tend to be focused on the later years of the course. This ‘late and limited’ exposure to practice is thought to be responsible for significant failures in the ability of students and newly-qualified pharmacists to take their knowledge of science and medicines and apply it in the context of solving clinical problems. Furthermore, a lack of engagement with practice makes it difficult for the theoretical learning (especially the underpinning science) to be effectively contextualised, leading to an artificial segregation of the science and practice sections of the course. While pharmacists must be technically capable, success depends on a broader range of non-technical skills, including communication and empathy as well the ability to deal with the unexpected. Simulation is used as a partial alternative to the practice environment, but there are often vast differences between these highly-managed scenarios and the real situations encountered in practice. Since there is no ‘ideal’ setting for a pharmacist, students should be educated and trained with an understanding, at the forefront of their minds, of human factors - something which challenges existing course design. Teaching and learning activities must allow students to explore the differences between the ‘ideal’ and ‘real’ clinical environments and to recognise when deviations from the ideal are likely to affect patient safety. This paper discusses a piece of action research by MPharm undergraduate students, exploring ways in which such activities may be developed. These new activities are based upon an existing cardiovascular risk assessment, currently used to deliver scientific theory and develop technical skills, and involving the identification of modifiable and non-modifiable risk factors and the use of these to calculate the ten-year risk of cardiovascular disease.The approach involved the building of two simulated scenarios, one representing an ‘ideal’ risk assessment and the other reflecting adverse outcomes arising as a result of practice-based problems. Developing the simulations required an in-depth analysis of factors contributing to outcomes, and a combination of interviews with healthcare professionals and peer-peer focus groups were used to explore this. This paper discusses the challenges and learning points arising from this work, as well as an evaluation of the ways in which the work was used to enhance teaching in the academic session 2013-14.

of a presentation given at the Research council for complementary medicine 2015 conference (RCCM): demonstrating the value of integrative medicine, 10 September, London, UK.

The use of complementary and alternative medicine (CAM) in paediatric subjects is increasing globally. However, most of the data available in the UK is based on hospital-based studies; and studies of such use in the general population are scarce. Also, available British studies were mostly conducted in England; with much fewer Scottish studies. The only such study in Aberdeen, North-east Scotland, was conducted 10 years ago. Current data on the subject is therefore needed, particularly for paediatric CAM use in the general population.

Background The World Health Organization (WHO) defines eHealth as ‘the combined use of information and communications technologies for health’ [1]. eHealth strategies worldwide aim to promote quality, safety and efficiency by underpinning shared healthcare provision with technology. The Scottish eHealth Strategy incorporates an ePharmacy programme to support pharmacists’ increasing role in shared care [2]. It acknowledges organisational development and training for core and optional eHealth services as key. Purpose To explore and report methodologies, findings and gaps in research related to healthcare professionals’ perceptions of the adoption of eHealth technologies for shared care. Materials and Methods A systematic review was conducted using a meta-narrative approach [3]. Articles published post-2004 in English were included; articles on Internet searches for health information or email were excluded. Data were extracted, synthesised and summarised. Ethical approval was not required. Results Screening reduced the initial 327 papers identified to 12 which included three reviews, four qualitative, two mixed-methods and three quantitative studies. Data were collected using questionnaires (3), case study (1), group (2) and individual (6) interviews, observation (3) and extraction of data from records (1). Practice settings were remote rural or urban featuring primary care, secondary care or both. The focus was on electronic records (7), telemedicine (2) or general eHealth implementation (3) from the perspective of doctors, nurses, IT developers, policy makers and managers. One study included the views of a hospital pharmacist. Acceptance of eHealth technologies is reported but with cost effectiveness, resourcing and training questioned. Emerging themes are organisational, social and technical. Conclusions Strategists worldwide believe technology has the potential to promote quality, safety and efficiency in shared care where organisational, social and technical issues are addressed. However, evidence of hospital pharmacists’ views, their perceptions of eHealth and shared care, organisational development and training needs remain under-researched. References World Health Organization (2010). Atlas eHealth country profiles: based on the findings of the second global survey on eHealth. WHO: Geneva. Scottish Government (2008). eHealth Strategy 2008–2011. Available online at: http://www.scotland.gov.uk/Publications/2008/08 /27103130/13 Greenhalgh, T. et al , (2005). Storylines of research in diffusion of innovation: a meta-narrative approach to systematic review. Social science & medicine , 61(2), pp. 417–430. No conflict of interest.