There is little data assessing scientific publication productivity by hospital pharmacists. This is the first study to our knowledge to compare the publication record of hospital pharmacists in France vs. Quebec. Our ordinal logisitic regression allowed us to identify 7 determining and significant factors influencing scientific publication: working in France, being male, having academic duties or a PhD, having participated in a clinical trial, having personally obtained funding for a research project, and being able to allocate a greater number of hours to research per week. Most of these factors also were noted by other authors. Kaplan et al and Barnett et al showed that males publish more than females.17,18
Having tenure, having completed a doctorate, and having completed a fellowship program are predictive of scientific publishing.19-22
An adequate period of time dedicated to publishing activities is an important predictive factor in scientific publishing.17,20,22
Our study found that a higher number of respondents from France had at least 1 publication in their name, whatever the type of publication evaluated. Nevertheless, there were several differences between respondents from France and Quebec. The percentage of male respondents was higher in France than in Quebec (44% vs. 33%, p = 0.039) as was the percentage of respondents working more than 40 hours per week (70% vs. 42%, p = 0.001). The ordinal logistic regression, however, showed that respondents from France authored more articles in indexed journals than those from Quebec, even when considering factors such as time worked and gender. Furthermore, the percentage of respondents working in a UHC was lower in France than in Quebec (46 vs. 70%, p = 0.001), as was the percentage of respondents who had indicated a mastery of English (43 vs. 88%, p = 0.001). We expected that UHC practice would be a contributing factor in scientific publishing. However, as scientific publishing seems to be more related to the country of practice than the practice setting, the higher percentage of respondents from Quebec who worked in a UHC did not allow us to verify this hypothesis.
By evaluating the perceptions and motivations of hospital respondents from France and Quebec, we noted several differences that might help to explain this culture of publishing among respondents from France. For example, a higher percentage of respondents from France claimed that publication was governed by competition between teams (54% vs. 31%, p
= 0.001), having tenure (69 vs. 40%, p
= 0.001), or even competition within a department (81% vs. 53%, p
= 0.001). In addition, most of the respondents from France accepted that pharmacy department heads should be listed among the authors even if they did not contribute in a significant way to the work carried out (63 vs. 6%, p
= 0.001). They also believed that members of the department who needed to quickly establish a list of publications should be added to the authors of the paper, even if they did not directly or significantly participate in the project (28% vs. 8%, p
= 0.001). Also, we know that the duration of hospital internship is longer in France than in Quebec (4 years vs. 16 months). Although we could not compare the pharmacy curricula and publication objectives of these graduate programs, it is reasonable to think that a longer internship could contribute to scientific publishing, both through the student's labor within the program and through increased exposure to academic activities before beginning autonomous hospital practice. We learned that the reform of the healthcare system, the ISA point system, and the grouping in axes in France are potential positive factors for scientific publishing. In addition, the Système d'Interrogation, de Gestion et d'Analyse des Publications Scientifiques (SIGAPS) project in France is aimed at trying to help healthcare facilities compile their employees' Medline publications.23
All new employees bring to their new facility the benefit of their past publications. The SIGAPS project is involved in making funding decisions for the facility's education, research, referencing, and innovation missions.
Paradoxically, we noted an equal or lower percentage of respondents from France for all the statements surrounding motivations for publishing. With the exception of teamwork (81% vs. 67%, p = 0.005), the respondents from France did not feel that publishing allowed them to be creative, to exercise leadership, to have a certain social status or prestige, etc, to the same extent as respondents from Quebec. Thus, it appears to us that scientific publishing is a key activity that may affect the promotion of hospital pharmacists in France more than it affects those in Quebec, and that scientific publishing is more influenced by competition and promotion than by other professional motivations. This can be explained in particular by the differences in entrylevel permanent positions in France vs. Quebec and by the number of hospital pharmacists. Quebec is faced with a long-term shortage of pharmacists, and graduates may often obtain a pharmacist position as soon as they graduate from their residency program. In contrast, pharmacists in France must still take a competitive examination after their internship. Passing the competitive examination is conditional upon, among other things, the publication of scientific articles and work activities. Therefore, the difference in the employment process (eg, completing a competitive examination post internship in France) can explain why French pharmacists have higher publication rates than their counterparts in Quebec. Obtaining a stable position is only possible after passing the examination and spending several years working on fixed-term contracts.
Pharmacy practice has experienced unprecedented growth over the last few years. Hospital pharmacists are called on to contribute more than ever to scientific publishing in both clinical research on medications and evaluative research on modes of healthcare intervention including pharmaceutical practice. For example, the American College of Clinical Pharmacy published a white paper on the training required for research pharmacists.24
It also published several statements about the importance of hospital pharmacists taking part in research, both in clinical practice25
and at the level of pharmaceutical practice.26
Not surprisingly, exposure to structured research work is predictive of scientific publishing.
This study has certain limitations. First, we studied a convenience sample that was not representative of the population of hospital pharmacists and we therefore cannot generalize our findings to the 2 populations as a whole. We also had a selection bias given that the ratio of males to females was not representative of hospital pharmacists in France and Quebec. In fact, the ratio of females who practice hospital pharmacy is higher. In France, the way to enter a permanent position is a tenure-track system with emphasis, among other things, on publications. In Quebec, this is not the case and junior pharmacists can easily find permanent position after their residency. This fact alone may explain the higher rate of publication among respondents from France than from Quebec. Finally, the chi-square test does not allow us to highlight a causality link between certain factors and scientific publishing. To do this, further studies on a larger scale are required. The fact that pharmacists in Quebec took part in the survey at the request of their pharmacy department heads may indicate a better mode of recruitment than an invitation delivered solely through mailing lists, as was done in France.