Challenges in qualitative social pharmacy research: Reflections based on a conference workshop.

A methodological debate within social pharmacy is ongoing regarding how to apply a qualitative approach. This paper emanates from a workshop at the Nordic Social Pharmacy Conference in 2019, named 'How do we know it's good? A workshop on quality criteria in qualitative social and clinical pharmacy research', that addressed this debate. The aim of this paper is twofold (1) to present the main key points raised during the workshop and (2) based on these inputs to contribute to the ongoing discussion on qualitative methodology within social pharmacy research. This paper starts with what was discussed at the workshop and further elaborated are some of the challenges with conducting qualitative research within social pharmacy. These include methodological and disciplinary competence and insecurity, reflections on the consequences of that many social pharmacy researchers come from a natural science background and how this (possibly) shapes the practice of qualitative research within the field. For example, how concepts like transparency and saturation, together with checklists and quality criteria are understood and used. Finally, we make suggestions for the next step for qualitative research in social pharmacy.

Use of dietary supplements and medication among postmenopausal women with vasomotor symptoms.

OBJECTIVES: To assess how postmenopausal women with severe vasomotor symptoms who volunteer for an acupuncture trial (ACUFLASH) differ from the general population (the Norwegian Women and Cancer study, NOWAC); and to describe the use of dietary supplements and medication during trial intervention and follow-up. METHODS: Questionnaire data on postmenopausal women regarding demography and use of dietary supplements and medication were compared between the ACUFLASH trial (baseline, 2006-2007, n = 267) and the NOWAC study (2004-2005, n = 331). Additionally, the trial intervention groups, acupuncture and self-care (n = 134) or self-care alone (n = 133), were compared regarding supplements and medication use. RESULTS: The prevalence of dietary supplement use was higher among women with severe vasomotor symptoms (83.9%) than in the population-based sample (74.3%), with particularly extensive use of cod liver oil. The prevalence of medication use was 46.4% in ACUFLASH and 55.0% in NOWAC. Trial participants reported poorer self-reported health, higher education level and tended to be former oral contraceptive users and smokers. At trial baseline, 48.5% of the acupuncture group and 60.3% of the self-care group used dietary supplements (p > 0.05), while 48.5% in the acupuncture group and 45.0% in the self-care group used medication (p > 0.05). Use of supplements for vasomotor symptoms increased significantly in the self-care group at 12 weeks, while it remained unchanged in the acupuncture group. Hormone therapy use increased significantly in both groups after intervention. CONCLUSION: Postmenopausal women suffering severe vasomotor symptoms used more dietary supplements than the general population. They also had poorer self-reported health, but their medication use was similar to that of the general population. Acupuncture did not influence use of dietary supplements in the randomized intervention.

Dietary intake of the water-soluble vitamins B1, B2, B6, B12 and C in 10 countries in the European Prospective Investigation into Cancer and Nutrition.

OBJECTIVES: To describe the intake of vitamins thiamine (B1), riboflavin (B2), B6 (pyridoxine), B12 (cobalamine) and C (ascorbic acid) and their food sources among 27 centres in 10 countries participating in the European Prospective Investigation into Cancer and Nutrition (EPIC) study. METHODS: Between 1995 and 2000, 36 034 persons aged between 35 and 74 years were administered a standardized 24-h dietary recall using a computerized interview software programme (EPIC-SOFT). Intakes of the four B vitamins and vitamin C were estimated using the standardized EPIC Nutrient Database (ENDB). Mean intakes were adjusted for age and weighted by season and day of recall. RESULTS: Intake of B vitamins did not vary considerably between centres, except in the UK health-conscious cohort, in which substantially higher intakes of thiamine and lower intakes of vitamin B12 were reported compared with other centres. Overall, meat was the most important contributor to the B vitamins in all centres except in the UK health-conscious group. Vitamin C showed a clear geographical gradient, with higher intakes in the southern centres as compared with the northern ones; this was more pronounced in men than in women. Vegetables and fruits were major contributors to vitamin C in all centres, but juices and potatoes were also important sources in the northern centres. CONCLUSIONS: This study showed no major differences across centres in the mean intakes of B vitamins (thiamine, riboflavin, B6, B12), whereas a tendency towards a north-south gradient was observed for vitamin C.

Dietary intakes of retinol, beta-carotene, vitamin D and vitamin E in the European Prospective Investigation into Cancer and Nutrition cohort.

OBJECTIVES: To describe the intake of the fat-soluble nutrients retinol, beta-carotene, vitamin E and vitamin D and their food sources among 27 redefined centres in 10 countries participating in the European Prospective Investigation into Cancer and Nutrition (EPIC) study. METHODS: Between 1995 and 2000, 36,034 subjects (age range: 35-74 years) completed a single standardized 24-h dietary recall using a computerized interview software program (EPIC-SOFT). Intakes of the fat-soluble nutrients were estimated using the standardized EPIC Nutrient Database. RESULTS: For all the nutrients, in most centres, men had a higher level of intake than did women, even after adjustments for total energy intake and anthropometric confounders. Distinct regional gradients from northern to southern European countries were observed for all nutrients. The level intake of beta-carotene and vitamin E also showed some differences by level of education, smoking status and physical activity. No meaningful differences in the nutrient intake were observed by age range. CONCLUSIONS: These results show differences by study centre, gender, age and various lifestyle variables in the intake of retinol, beta-carotene, vitamin E and vitamin D between 10 European countries.