This study identified intentional and non-intentional compliance issues that could hinder the optimal use of medicines by older people who are at greater risk of medicine-related adverse effects. Large quantities of medicines, confusion, and lack of knowledge as to why a medicine had been prescribed contributed to non-compliance. Appropriate communication between the pharmacist and patient, patient education and aids such as medication cards and referral for medication review could improve compliance in this age group.

ObjectiveThe objective of this study was to evaluate general practitioners' (GPs) perceptions regarding access to medicines in New Zealand.DesignQualitative.SettingPrimary care.ParticipantsGPs.Main outcome measuresGPs' views and perceptions.ResultsGPs were of the view that the current range of medicines available in New Zealand was reasonable; however, it was acknowledged that there were some drugs that patients were missing out on. When considering the range of subsidised medicines available in New Zealand, some GPs felt that there had been an improvement over recent years. It was highlighted that unexpected funding changes could create financial barriers for some patients and that administrative procedures and other complexities created barriers in receiving a subsidy for restricted medicines. GPs also reported problems with the availability and sole supply of certain medicines and claimed that switching from a branded medicine to its generic counterpart could be disruptive for patients.ConclusionsThe research concluded that although there were some issues with the availability of certain drugs, most GPs were satisfied with the broader access to medicines situation in New Zealand. This view is to contrary to the situation presented by the pharmaceutical industry. The issues around sole supply, the use of generic medicines and the administrative barriers regarding funding of medicines could be improved with better systems. The current work provides a solid account of what GPs see as the advantages and disadvantages of the current system and how they balance these demands in practice.

The majority of pharmacists believed in the philosophy of the CPSA, but expressed concerns over funding, workload and benefits for patients. Future research is required to determine generalisability of these findings, investigate patient perspectives and assess the effect of the CPSA on patient outcomes.

Objective To introduce and evaluate a short clinical examination skills course in a BPharm programme. The study objectives were to assess needs, explore attitudes, record perceived competence requirements and assess the value of physical examination skills learning. Setting BPharm programme in Auckland, New Zealand. Participants were students enrolled in years 3 and 4 of the programme (2003). Method The design was a longitudinal, dual cohort, educational intervention evaluation using a self-completed questionnaire. An examination skills component was added to the fourth year of the pharmacy programme. Year 3 and 4 students were recruited, and completed the questionnaire at two points. Year 3 students were sampled one year before and soon after the skills sessions. Year 4 students were sampled after the sessions and 18 months later (once registered). The questionnaire sought their attitudes towards clinical skills training and practical relevance for future practice, and evaluated their learning experience. Key findings Response rates at the four points were 42-67%. Year 3 students identified a similar set of appropriate skills to those actually taught in year 4. Overall, attitudes to introducing examination skills learning were positive at all points. At follow-up, both cohorts agreed more strongly that examination skills training should be core (significantly for registered pharmacists versus year 3, P < 0.006). Measuring manual blood pressure was deemed the most difficult skill. All taught skills were used in practice except for respiratory rate; most used were body mass index (BMI), temperature and peak flow measurement. Conclusions There was a close correlation between what was offered in the course, what students felt they needed to learn and what was relevant in practice. Once registered, pharmacists were aware of their limitations and level of competence in relation to clinical skills. The small changes in attitudinal scores appear to reflect maturity and experience. The study design allowed us to adapt the educational component to student need. Health professional educators need to be aware of and respond to changes in professional scopes of practice.

Background: Access to health /disease screening (HDS) and medication monitoring /management (MM) services in New Zealand has traditionally been through general practitioners. While government and professional organisations are supportive of greater community pharmacy involvement, there has been little research on the extent of current provision or of the views of community pharmacists in this area. Aim: To describe the characteristics and extent of HDS and MM services provided in New Zealand community pharmacies, and to document pharmacists' opinions and perceived barriers in regard to the provision of these services. Methods: A four-part questionnaire was developed to record: the types of HDS /MM services offered by community pharmacies; the opinions of respondent pharmacists regarding these services; the characteristics of community pharmacies offering the services; and the profiles of the respondent pharmacists. The questionnaire was distributed to 879 community pharmacies in New Zealand. Results: There were 458 valid questionnaires returned, with a response rate of 52%. Over half (59%) of the responding pharmacies reported provision of HDS and /or MM services, although there were relatively few 'high level' services such as cardiovascular risk assessment and disease management. Most services were paid for by pharmacy customers, although some District Health Boards paid for services such as Medicines Use Review. Pharmacists cited lack of remuneration, lack of time and limited access to patient information as the main barriers to greater involvement. Conclusion: At the time of this study (2007), community pharmacists in New Zealand were in the 'early adoption' phase concerning the provision of HDS and MM services.