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Alienation and/or anomie in pharmacists: a systematic review and narrative synthesis of the international literature.

Forsyth, Paul; Maguire, Barry; Carey, James; O’Brien, Robert; Maguire, Janice; Giblin, Lesley; O’Hare, Roisin; Rushworth, Gordon F.; Cunningham, Scott; Radley, Andrew

Authors

Paul Forsyth

Barry Maguire

James Carey

Robert O’Brien

Janice Maguire

Lesley Giblin

Roisin O’Hare

Gordon F. Rushworth

Andrew Radley



Abstract

Flourishing and belonging are key concepts for the wellbeing of staff and the success of a profession. Alienation and anomie are distinct types of psycho-social ills which inhibit flourishing and belonging. A better understanding of these may offer hope in preventing many negative work endpoints, including burnout and intention to leave. To systematically review and narratively synthesise alienation and/or anomie in pharmacists across the globe, reviewing all types of methodological designs, published in peer-reviewed journals. We identified published peer-reviewed research through searching eight electronic databases (MEDLINE, Embase, PsycINFO, CINAHL, Cochrane Library, Web of Science – Core Collection, Scopus, and Google Scholar) and extensive hand/citation searching. Two independent reviewers identified and critiqued eligible studies, extracted data, and synthesised the findings. The synthesis evaluated the focuses, causes, associated factors, and/or consequences of alienation and/or anomie and aligned these to six deductive themes from alienation theory: care; values; meaning; recognition; autonomy; and shared responsibility. Searches identified 886 papers, with 47 included in the final results. From the synthesis, ten key causes of alienation and/or anomie were identified; 1) Changing Professional Identity, 2) Reimbursement Models and Corporatisation, 3) Focus on Medicines Rather than People, 4) Misunderstanding and Deprofessionalisation, 5) Environments and Culture, 6) Suboptimal Societal Mandate, 7) Roles Misaligned with Aspirations, 8) Systematic Underutilisation, 9) Lack of Professional Agency, and 10) Value Conflict. From the evidence, there was high confidence that inhibitions of care, values, recognition, and/or autonomy (four of the six deductive themes) were associated with alienation and/or anomie. Alienation and/or anomie are present across many countries and regions. This paper helps us understand the aetiology of this complex psycho-social syndrome, a necessary first step in creating an inclusive profession where all pharmacists can flourish. Future research needs to trial new interventions targeted at correcting this professional malady.

Citation

FORSYTH, P., MAGUIRE, B., CAREY, J., O'BRIEN, R., MAGUIRE, J., GIBLIN, L., O'HARE, R., RUSHWORTH, G.F., CUNNINGHAM, S. and RADLEY, A. 2025. Alienation and/or anomie in pharmacists: a systematic review and narrative synthesis of the international literature. Research in social and administrative pharmacy [online], In Press. Available from: https://doi.org/10.1016/j.sapharm.2025.01.017

Journal Article Type Article
Acceptance Date Jan 24, 2025
Online Publication Date Jan 29, 2025
Deposit Date Jan 31, 2025
Publicly Available Date Jan 30, 2026
Journal Research in social and administrative pharmacy
Print ISSN 1551-7411
Electronic ISSN 1934-8150
Publisher Elsevier
Peer Reviewed Peer Reviewed
DOI https://doi.org/10.1016/j.sapharm.2025.01.017
Keywords Pharmacists; Alienation; Anomie; Workforce; Systematic review
Public URL https://rgu-repository.worktribe.com/output/2675563
Additional Information This article has been published with separate supporting information. This supporting information has been incorporated into a single file on this repository and can be found at the end of the file associated with this output.