Abstract
Introduction Mixed-methods methodology, as the name suggests refers to mixing of elements of both qualitative and quantitative methodologies in a single study. In the past decade, mixed-methods methodology has gained popularity among healthcare researchers as it promises to bring together the strengths of both qualitative and quantitative approaches. Methodology A number of mixed-methods designs are available in the literature and the four most commonly used designs in healthcare research are: the convergent parallel design, the embedded design, the exploratory design, and the explanatory design. Each has its own unique advantages, challenges and procedures and selection of a particular design should be guided by the research question. Guidance on designing, conducting and reporting mixed-methods research is available in the literature, so it is advisable to adhere to this to ensure methodological rigour. When to use it is best suited when the research questions require: triangulating findings from different methodologies to explain a single phenomenon; clarifying the results of one method using another method; informing the design of one method based on the findings of another method, development of a scale/questionnaire and answering different research questions within a single study. Two case studies have been presented to illustrate possible applications of mixed-methods methodology. Limitations Possessing the necessary knowledge and skills to undertake qualitative and quantitative data collection, analysis, interpretation and integration remains the biggest challenge for researchers conducting mixed-methods studies. Sequential study designs are often time consuming, being in two (or more) phases whereas concurrent study designs may require more than one data collector to collect both qualitative and quantitative data at the same time.
References
Pope C, Mays N. Reaching the parts other methods cannot: an introduction to qualitative methods in health and health services research. BMJ. 1995;311:42–5.
O’Cathain A, Murphy E, Nicholl J. Integration and publications as indicators of ‘yield’ from mixed methods studies. J Mix Methods Res. 2007;1:147–63.
Creswell WJ, Plano Clark VL. Designing and conduction mixed methods research. 2nd ed. Thousand Oaks: Sage Publications; 2011.
Johnson RB, Onwuebuzie AJ. Mixed-methods research: a research paradigm whose time has come. Educ Res. 2004;33:14–26.
Tashakkori A, Creswell JW. Editorial: the new era of mixed methods. J Mix Methods Res. 2007;1:3–7.
Johnson RB, Onwuegbuzie AJ, Turner LA. Toward a definition of mixed methods research. J Mix Methods Res. 2007;1:112–33.
Poses RM, Isen AM. Quantitative research in medicine and healthcare: questions and controversy. J Gen Intern Med. 1998;13:32–8.
Hadi MA, Alldred DP, Briggs M, Closs SJ. Mixed methods research in pharmacy practice: basics and beyond (Part 1). Int J of Pharm Pract. 2013;21:341–5.
Hadi MA, Alldred DP, Briggs M, Closs SJ. Mixed-methods research in pharmacy practice: recommendations for quality reporting (Part 2). Int J Pharm Pract. 2014;22:96–100.
Teddlie C, Tashakkaori A. A general typology of research designs featuring mixed methods. Res Sch. 2006;13:12–8.
Morse JM, Niehaus L. Mixed methods design: principles and procedures. Walnut Creek: Left Coast Press; 2009.
Greene JC, Caracelli VJ, Graham WF. Toward a conceptual framework for mixed method evaluation designs. Educ Eval Policy Anal. 1989;11:255–74.
Leech NL, Onwuegbuzie AJ. A typology of mixed methods research designs. Qual Quant. 2007;43:265–75.
Tiddlie C, Tashakkaori A. Foundations of mixed methods research. Thousand OAKS: Sage Publications; 2009.
Morse JM. Approaches to qualitative quantitative methodological triangulation. Nurs Res. 1991;40:120–3.
Tashakkori A, Teddlie C. Mixed methodology: combining qualitative and quantitative approaches. Thousand Oaks: Sage Publications; 1998.
O’Cathain A, Murphy E, Nicholl J. The quality of mixed methods studies in health services research. J Health Serv Res Policy. 2008;13:92–8.
Schifferdecker KD, Reed VA. Using mixed methods research in medical education: basic guidelines for researchers. Med Educ. 2009;43:637–44.
Leech NL, Onwuebuzie AJ. Guidelines for conducting and reporting mixed research in the field of counseling and beyond. J Couns Dev. 2010;88:61–9.
Curry LA, Krumholz HM, O’Cathain A, Plano-Clark VL, Cherlin E, Bradley EH. Mixed methods in biomedical and health services research. Circ Cardiovasc Qual Outcomes. 2013;6:119–23.
O’Cathain A, Murphy E, Nicholl J. Three techniques for integrating data in mixed methods studies. BMJ. 2010;341:c4587.
Irwin A, Weidmann AE. A mixed methods investigation into the use of non-technical skills by community and hospital pharmacists. Res Soc Adm Pharm. 2014;. doi:10.1016/j.sapharm.2014.11.006.
Witry MJ, Wesely PM, Goedken AM, Ernst EJ, Sorofman BA, Doucette WR. Development of a medication attitude monitoring measure using a mixed methods item development process. Int J Pharm Pract. 2015;. doi:10.1111/ijpp.12185.
Hadi MA, Alldred DP, Briggs M, Closs SJ, Marczewski K. Mixed methods evaluation of nurse-pharmacist managed pain clinic: design, rationale and limitations. Can Pharm J. 2013;46:1–5.
Hadi MA, Alldred DP, Briggs M, Marczewski K, Closs SJ. Effectiveness of a community based nurse-pharmacist managed pain clinic: a mixed-methods study. Int J Nurs Stud. 2015;. doi:10.1016/j.ijnurstu.2015.09.003.
Kaufmann CP, Stämpfli D, Hersberger KE, Lampert ML. Determination of risk factors for drug-related problems: a multidisciplinary triangulation process. BMJ Open. 2015;5:e006376. doi:10.1136/bmjopen-2014-006376.
Pollini RA, Lozada R, Gallardo M, et al. Barriers to pharmacy-based syringe purchase among injection drug users in Tijuana, Mexico: a mixed methods study. AIDS Behav. 2010;14(3):679–87.
Craig P, Dieppe P, Macintyre S et al. Developing and evaluating complex interventions: new guidance. 2008. www.mrc.ac.uk/complexinterventionsguidance. Accessed May 6, 2015).
Parker CP, Cunningham CL, Carter BL, Vander Weg MW, Richardson KK, Rosenthal GE. A mixed method approach to evaluate a pharmacist intervention for veterans with hypertension. J Clin Hypertens. 2014;16:133–40.
Harris AD, Bradham DD, Baumgarten M, Zuckerman IH, Fink JC, Perencevich EN. The use and interpretation of Quasi-experimental studies in infectious diseases. Clinic Infect Dis. 2004;38:1586–91.
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Hadi, M.A., Closs, S.J. Applications of mixed-methods methodology in clinical pharmacy research. Int J Clin Pharm 38, 635–640 (2016). https://doi.org/10.1007/s11096-015-0231-z
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DOI: https://doi.org/10.1007/s11096-015-0231-z