CORA
Cork Open Research Archive (CORA) is UCC’s Open Access institutional repository which enables UCC researchers to make their research outputs freely available and accessible.
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Recent Submissions
Community development: a critical analysis of its “keywords” and values
(Blackhall Publishing, 2009) Meade, Rosie R.
Government and community development in ireland: the contested subjects of professionalism and expertise
(Wiley, 2012) Meade, Rosie R.
This paper historicises the recent and ongoing professionalisation of community development in the Republic of Ireland. The term professionalisation refers both to the designation and accreditation of a distinctive community work occupation and a wider set of processes that effect more strategic approaches to the planning, delivery and evaluation of community organisations. The paper reviews some tensions associated with professionalisation; tensions that closely relate to community work's reputation as a “bottom-up” or “participatory” strategy. It also interrogates community development's place as a strategy of government in contemporary Ireland. In so doing it reconsiders the assumed separateness and distinctiveness of the state and community sectors, arguing that the state has been centrally implicated in calling the community sector into being. In their turn community development organisations have shaped and mediated policy delivery on the ground. It is these processes of hybridisation, co-operation, antagonism and struggle that have given professionalisation its momentum.
Exploring career choices of pharmacy graduates over 15 years: A cross-sectional evaluation
(Elsevier Inc., 2024) Fitzpatrick, Katie L.; Allen, Evin A.; Griffin, Brendan T.; O'Shea, Joseph P.; Dalton, Kieran; Bennett-Lenane, Harriet
Introduction: Career opportunities for pharmacists beyond those commonly associated with the degree continue to emerge. A paucity of literature regarding evaluation of pharmacy graduate career paths over extended periods is apparent. Considering international pharmacy workforce capacity pressures, the primary study aim was to evaluate trends in career paths of pharmacy graduates. Methods: This study utilised a multimethod approach to access graduate career data using publicly accessible information from LinkedIn® profiles and an online survey. The survey was distributed to all pharmacy graduates of a university (2007–2022). Data from both methods was combined, cross-checked, coded and analysed quantitatively using descriptive and inferential statistics. Results: Data from 69.7% of the university's pharmacy graduates was collected. Community pharmacy was the most prevalent employment sector (47.7%), followed by industry (21.5%) and hospital (17.7%). A higher proportion of more recent graduates (≤5 years post-graduation) work in a community or hospital pharmacy role versus those who graduated greater than five years ago (χ2 = 8.44, df = 2, p < 0.05). Post-graduate education was undertaken by 41.3% of graduates. Career satisfaction was high (88.2%) but was lower (χ2 = 11.31, df = 1, p < 0.05) for those in community and hospital (82%) versus other sectors (97.5%). Conclusion: This study provides the first analysis of graduate career paths over an extended period, highlighting a novel approach to track pharmacist workforce. While almost two thirds of pharmacy graduates occupy community or hospital roles, a trend of leaving these settings five years post-graduation was evident. Accordingly, this work represents a springboard for additional research to inform future pharmacist workforce planning worldwide. © 2024 The Authors
Economic cost-benefit analysis of person-centred medicines reviews by general practice pharmacists
(Springer Science and Business Media Deutschland GmbH, 2024) O’Mahony, Cian; Dalton, Kieran; O’Hagan, Leon; Murphy, Kevin D.; Kinahan, Clare; Coyle, Emma; Sahm, Laura J.; Byrne, Stephen; Kirke, Ciara
Background: Medicines reviews by general practice pharmacists improve patient outcomes, but little is known about the associated economic outcomes, particularly in patients at higher risk of medicines-related harm. Aim: To conduct an economic cost-benefit analysis of pharmacists providing person-centred medicines reviews to patients with hyperpolypharmacy (prescribed ≥ 10 regular medicines) and/or at high risk of medicines-related harm across multiple general practice settings. Method: Service delivery costs were calculated based on the pharmacist’s salary, recorded timings, and a general practitioner fee. Direct cost savings were calculated from the cost change of patients’ medicines post review, projected over 1 year. Indirect savings were calculated using two models, a population-based model for avoidance of hospital admissions due to adverse drug reactions and an intervention-based model applying a probability of adverse drug reaction avoidance. Sensitivity analyses were performed using varying workday scenarios. Results: Based on 1471 patients (88.4% with hyperpolypharmacy), the cost of service delivery was €153 per review. Using the population-based model, net cost savings ranging from €198 to €288 per patient review and from €73,317 to €177,696 per annum per pharmacist were calculated. Using the intervention-based model, net cost savings of €651–€741 per review, with corresponding annual savings of €240,870–€457,197 per annum per pharmacist, were calculated. Savings ratios ranged from 181 to 584% across all models and inputs. Conclusion: Person-centred medicines reviews by general practice pharmacists for patients at high risk of medicines-related harm result in substantial cost savings. Wider investment in general practice pharmacists will be beneficial to minimise both patient harm and healthcare system expenditure. © The Author(s) 2024.
Development and evaluation of pharmacist-provided teach-back medication counselling at hospital discharge
(Springer Science and Business Media Deutschland GmbH, 2023) O’Mahony, E.; Kenny, J.; Hayde, J.; Dalton, Kieran
Background: Pharmacists can use teach-back to improve patients’ understanding of medication; however, the evidence of its impact on patient outcomes is inconsistent. From the literature, there is no standardised way to provide pharmacist-delivered medication counselling at hospital discharge, with limited reporting on training. Aim: To develop a standardised medication counselling procedure using teach-back at hospital discharge, and to evaluate feedback from patients and pharmacists on this initiative. Method: A standardised intervention procedure was developed. Participating pharmacists (n = 9) were trained on teach-back via an online education module and watching a demonstration video created by the researchers. Pharmacists provided patients with discharge medication counselling utilising teach-back and a patient-friendly list of medication changes to take home. To obtain feedback, patients were surveyed within seven days of discharge via telephone and pharmacists answered an anonymous survey online. Results: Thirty-two patients (mean age: 57 years; range: 19–91) were counselled on a mean 2.94 medications/patient with the mean counselling time as 23.6 min/patient. All patients responded to the survey, whereby 93.7% had increased confidence regarding medication knowledge and were satisfied with the counselling and the information provided. All pharmacist survey respondents (n = 8) agreed they were given adequate training and that teach-back was feasible to apply in practice. Conclusion: This is the first study to evaluate patients’ views on pharmacist-provided teach-back medication counselling. With positive patient outcomes, a standardised procedure, and a comprehensive description of the training, this study can inform the development of discharge medication counselling utilising teach-back going forward. © 2023, The Author(s).