This study was approved by the Human Research Ethics Committee of Curtin University.
The data were collected using focus groups. This qualitative method was chosen as it enabled exploratory work to be carried out in order to assess the views of study participants. Group discussion generated through interaction of study participants contribute to a more detailed, cost-effective and timely exploration of different perspectives [10
]. Participants in focus groups were currently working with at least one RACF. Focus groups consisted of GPs, pharmacists and RNs/carers. Each focus group was homogenous in terms of professions. Homogenous groups were organized since they capitalize on common experiences [11
]. Two focus groups were organized with GPs and two with pharmacists. To ensure a wide representation of ideas and saturation of themes, three focus group discussions with RNs and carers were organized since these groups, unlike pharmacists and GPs, contained both RNs and carers.
Focus groups with GPs were conducted in two metropolitan locations in Perth, namely Fremantle (main port south of Perth) and Osborne Park (northern suburb of Perth), Western Australia. These different areas in the metropolitan area were chosen to ensure a wide representation of GPs. Pharmacist participants came from different metropolitan areas and their focus groups were conducted in facilities of the Curtin University, School of Pharmacy. To avoid bias and ensure a wider representation of pharmacists each focus group had pharmacists who were not working in the same pharmacy. Focus groups with RNs/carers were conducted in respective RACF facilities located in different Perth metropolitan areas i.e. Bicton, Myaree and Belmont. RNs/carers were experienced in working at different RACFs. To further ensure a wider representation of participants, RACFs that were managed by different companies were chosen.
GP and pharmacist participants were contacted via telephone to seek agreement to participate and received an information letter and invitation to attend the focus group. GP participants were recruited through contacting their respective Divisions of General Practice aged care panels. Contacting pharmacists that worked with RACFs was a difficult task because there was no available official list of pharmacies that worked with RACFs. These pharmacies were identified by contacting pharmacies initially known to researchers to provide services to RACFs which then provided further information about other pharmacies that serviced RACFs. This was done until a sufficient number of pharmacists agreed to participate in the focus groups. A total of 20 GPs and 14 pharmacies working with RACFs were contacted. Participants for the RNs/carers focus groups were recruited by the RACF manager. The manager who invited RNs and carers to participate was informed about the approximate preferred number of participants in focus group meetings. All focus group participants received an information letter and invitation to attend the focus group and signed a consent form to participate.
A literature review aided the design of focus group questions and protocol [1
]. A consultation meeting of researchers and the facilitator of the focus group also assisted in the review and finalization of this process. The final focus groups questionnaire consisted of an opening question (icebreaker), six transition questions and three key questions. The opening question was related to participants’ opinion on current medication supply systems in RACFs. Transition questions pertained to difficulties with current medication supply systems, potential improvements and potential new models of medication supply. Key questions related to model preference and additional training needed.
In order to ensure a degree of neutrality and avoid bias, the focus groups were conducted by a facilitator who was a staff member of School of Pharmacy but not part of the research team. One of the researchers was present at each focus group meeting managing the audio-recording and taking notes about contributions made by each participant. Focus group participants were reimbursed for their time. All focus groups were conducted during February 2009.
Audio-recorded data from the focus group meetings were transcribed into Microsoft Word. In order to perform a secondary content analysis, audio-recorded data were re-listened to and also compared with field notes taken. Transcribed data was imported into NVivo® v8 where it was thematically analyzed by a single independent consultant who discussed and confirmed extracted themes with one of the researchers for consistency. A grounded theory approach was utilized during the process of qualitative analyses. To aid in interpreting the relevance of the comments illustrating a particular theme a ranking system using the symbol † was used. A comment that described a similar issue more than once and in another focus group meeting consisting of same health professionals was marked with a †.