How participating in research made me a better pharmacist

Even though they are not always well signposted, research opportunities are well worth investment of time and effort.
Man looking into microscope, suggesting clinical research

As pharmacists, we work hard to ensure our patients receive safe and cost-effective care to optimise resources and reduce drug-related morbidity/mortality. But what if we challenged the comfort of our processes? The question is not ‘what if?’, it is ‘how?’.

My research interests stemmed from my Saturday job as a healthcare assistant in community pharmacy. Here, I observed a high frequency of patient-reported side effects from moisturisers. I also found it challenging to advise patients on selecting a moisturiser owing to a lack of evidence-based guidance.

For my university dissertation, I captured these issues through a patient/healthcare professional survey that I co-designed with the Centre for Evidence Based Dermatology. In 2016, with support and networking, I published our findings, which contributed to a Cochrane systematic review​[1,2]​. I was proud of my accomplishment but yearned to investigate these issues further, once qualified.

I discovered that selecting moisturisers or topical corticosteroids with certain physiochemical and therapeutic properties was a bit like baking — my brownie-making skills have improved exponentially as a result

I explored the literature and initiated conversations with experts, which helped me to identify that the composition of a moisturiser was an important piece in solving the puzzle; however, this concept appeared poorly understood in the clinical setting. Upon identifying this gap, I sought mentorship from a distinguished expert from Switzerland who happened to be a clinical academic pharmacist. Together, with input from patients and clinicians, we constructed a narrative review to educate healthcare professionals on the clinical significance of moisturiser composition​[3]​. This had an interesting connection with topical corticosteroid potency classification — an ambiguous issue — so we angled our publication accordingly. I discovered that selecting moisturisers or topical corticosteroids with certain physiochemical and therapeutic properties was a bit like baking — my brownie-making skills have improved exponentially as a result. 

By introducing our work to my hospital seniors, I created local opportunities to provide advice to clinicians and formulary teams as part of my residency. Publishing in a Medline/Embase-indexed journal also created remote opportunities for me to contribute to further reviews​[4]​. However, I was aware that I required further clinical and academic training but I was stumped on how to fund or incorporate my research and development alongside my full-time role. I needed protected time, as well as a local clinical-academic role model, to help guide me and facilitate translation of my work.

Undertaking a trust-funded clinical diploma during my transition to a senior pharmacist provided an opportunity to enhance my medicines optimisation skillset through a variety of activities. These included constructing a systematic review to support an independent funding request for an unlicensed treatment, auditing compliance with, and effectiveness of, a vancomycin continuous infusion protocol, plus changing associated guidance through a quality improvement project (QIP). I also networked through events within my trust and my diploma-hosting university throughout this period. This introduced me to locally and nationally-funded research training opportunities, exciting developments in digital technologies and influential clinical-academics with similar interests. 

I developed my research skills, ideas, connections and reflective practice though a funded postgraduate certificate

By choosing and creating diploma projects with my collaborators that complimented their interests — my own and my trust’s — I started to overcome barriers. I successfully applied to the trust’s ‘Chief Nurse Research Fellowship’ (CNRF), basing my application around my diploma vancomycin QIP to improve therapeutic drug monitoring.

During my weekly protected CNRF day, I developed my research skills, ideas, connections and reflective practice though a funded postgraduate certificate. In conjunction with my collaborators and pharmacy mentors, I also published my clinical diploma audit and developed leadership skills through research engagement activities​[5]​. These involved raising awareness, providing advice, representing pharmacy at clinical-academic groups and surveying nursing, midwifery and allied health professions’ views to inform trust research strategy/funding.

Collectively, the CNRF gave me with the time and training to construct a research proposal exploring novel digital therapeutic drug monitoring strategies to enhance patient care based on my own findings. It also assisted me in trialling a sustainable clinical academic post within my department and developing a subsequent plan for my clinical and academic progression towards a specialist pharmacist post and PhD proposal.

Combined, I feel the CNRF put me in a competitive position to secure a Health Education England/National Institute for Health Research (HEE/NIHR) Integrated Clinical and Practitioner Academic Pre-Doctoral Clinical and Practitioner Academic Fellowship (PCAF)​[6]​. This is a centrally-funded opportunity enabling me to pursue my ambitions through a part-funded MSc and salaried research role. I would have struggled to fund the rest of the MSc, as well as attend conferences and workshops that I identified to develop my PhD proposal, so I also reached out to Pharmacy Research UK (PRUK); a fantastic charity supporting aspiring pharmacy researchers to change clinical practice for the benefit of patients and the profession​[7]​. With a vision, commitment and support, I’ve created a life-changing and rewarding trajectory to improve patient care and pursue a consultant pharmacist post through the NIHR PCAF.

In my experience, the research journey is not well signposted and I am sure that I will encounter further obstacles; however, to get your foot in the door and to overcome challenges, I would recommend a few things:

  • First, if you have an idea, fully understand the problem behind that idea, ascertain if there is a genuine need from stakeholders and if you have the resources and capability to explore it before committing further energy;
  • Second, networking and working with the right people is a balancing act, but integral to success, so do some investigating to find the leaders in your field of interest;
  • Finally, ensure that your research benefits all stakeholders. By demonstrating that your interests are associated with cost-savings and/or improving patient care quality, you increase your chances of integrating research into your role.

With the challenges facing healthcare and pharmacy’s status in the UK, there has never been a better time for pharmacists to optimise opportunities and embrace research. 

Robert Oakley is a senior pharmacist at St George’s University Hospitals NHS Foundation Trust. His role is split working clinically and academically through a HEE/NIHR ICA Pre-doctoral Clinical Academic and Practitioner Fellowship. 

  1. 1
    Oakley R, Lawton S. Views on unwanted effects of leave-on emollients and experiences surrounding their incidence. Dermatol Nurs 2016;15.
  2. 2
    van Zuuren EJ, Fedorowicz Z, Christensen R, et al. Emollients and moisturisers for eczema. Cochrane Database of Systematic Reviews. 2017;2020. doi:10.1002/14651858.cd012119.pub2
  3. 3
    Oakley R, Arents BWM, Lawton S, et al. Topical corticosteroid vehicle composition and implications for clinical practice. Clin Exp Dermatol. 2020;46:259–69. doi:10.1111/ced.14473
  4. 4
    Lax SJ, Harvey J, Axon E, et al. Strategies for using topical corticosteroids in children and adults with eczema. Cochrane Database of Systematic Reviews. 2022;2022. doi:10.1002/14651858.cd013356.pub2
  5. 5
    Oakley R, Bakrania P, Yau T, et al. P37 Variable adherence to and effectiveness of a vancomycin continuous infusion protocol within ICUs at a London tertiary-care hospital: a single-centre retrospective service evaluation. JAC-Antimicrobial Resistance. 2022;4. doi:10.1093/jacamr/dlac004.036
  6. 6
    HEE-NIHR Integrated Clinical and Practitioner Academic Programme. National Institute for Health and Care Research. (accessed Oct 2022).
  7. 7
    Mofidi D. NIHR Pre-Doctoral Clinical and Practitioner Academic Fellowship Partnership Update. Pharmacy Research UK. 2022. (accessed Oct 2022).
Last updated
The Pharmaceutical Journal, PJ, November 2022, Vol 309, No 7967;309(7967)::DOI:10.1211/PJ.2022.1.160942

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