Specialists or Specialising Generalists A Grounded Theory of the Role of the Clinical Pharmacist in Neuroscience

Abstract

Neuroscience is a relatively small and emerging clinical pharmacy specialism focusing on drug therapy for neurological disease. Against a professional momentum for specialist practice within pharmacy, there is paucity both of relevant research, and a clearly defined role for specialist pharmacy practice in neuroscience. A qualitative research study was undertaken, using constructivist grounded theory method, to explore how hospital based pharmacists practicing in neuroscience define and develop their role and specialism. Data were concurrently generated and analysed, through verbatim transcription of telephone interviews with fourteen pharmacists. Data analysis resulted in the identification of three processes: (1) Acquiring and utilising knowledge in practice; (2) Gatekeeping access to drug therapies; (3) Integrating into the neuroscience service. The key findings within each process are: (1) Pharmacists utilise different forms of knowledge and there can be barriers to gaining knowledge. Pharmacists identify strengths in their breadth of clinical knowledge and holistic consideration of patients’ drug therapy. (2) Pharmacists act as barriers to drug therapy but also act to expedite and secure access to drug therapy. (3) Pharmacists act as an organisational nexus between pharmacy and neuroscience services and identify the importance in practice of forming working relationships within neuroscience services, underpinned by trust. The study identified a basic social process: Maintaining an overview of drug therapy for patients with neurological disease. This process conceptualises the tensions experienced by the pharmacists between their role as near-patient facing clinical specialists, but also as pharmacist generalists. The study findings have implications for supporting pharmacy practice in neuroscience.