Exploring the prevalence of and factors associated with advice on prescription medicines: A survey of community pharmacies in an English city

Abstract

Service users rely upon pharmacy staff to provide advice on prescription medicines. The purpose of this study was to compare the prevalence of advice-giving in pharmacies located across different areas within an inner-city population. A questionnaire was administered with service users outside 29 community pharmacies in an English Midlands city between February and July 2014. The primary outcome measure was the percentage who had received information or advice when collecting a prescription medicine. A total of 1206 service users took part, of whom 49.1% were female and 50.9% were of minority ethnicity (48.8% white British). The age ranges were: 17-30 years (21.0%), 31-60 years (55.0%) and 61-80+ years (24.1%). Sixty-nine per cent of participants had collected a prescription for themselves, and the proportions of new and repeat prescriptions were 22.1% and 77.6% respectively. A subset of 141 participants had requested advice, of whom 94% confirmed that they had received it. Overall, 28.6% of 1065 participants received unsolicited information or advice. The overall prevalence of unsolicited advice-giving varied per pharmacy from 14% to 63% and for new and repeat prescriptions was 41.9% and 25.5% respectively (p < .001, new vs repeat). In areas of greater deprivation, a higher proportion of service users of minority ethnicity received unsolicited repeat prescription advice, compared to that of white British (33.0% vs 17.3% respectively; p < .001). Thus, the low incidence and contrasting patterns of prescription advice-giving suggests that the training and expertise of pharmacy staff may not always be used effectively within the UK NHS. Therefore, the current challenge is how community pharmacies can work in partnership with colleagues across the wider healthcare system when optimising the use of medicines and reducing health inequalities. The research performed here provides new insights reflecting the low prevalence of advice-giving and potential inequity associated with delivery of this pharmacy service.

Extending the scope of community pharmacists’ practice to patients requiring urgent care – An evaluation of a training programme using the Theoretical Domains Framework

“…This is in spite of some respondents’ comments suggesting potential barriers influencing successful implementation related to perceived difficultly in providing urgent care for patients in the context of an existing fee‐for‐service reimbursement model that incentivises quantity rather than quality service provision and prioritises dispensing and commercial interests over additional time‐consuming tasks where pharmacists’ scope of practice is extended (Hann et al., ). Thus, although pharmacists may have good intentions about extending their role, and see this as part of their professional role, it is possible that, as others have found, when they are under pressure medicines‐related activities will take precedence over, for example time‐consuming patient‐centred consultations involved in urgent care practice (Law, Okamoto, & Brock, ; Mansoor, Aslani, & Krass, ; Rivers, Waterfield, Grootveld, & Raynor, ). This may go some way towards explaining why only around one‐third of participants reported implementing the target behaviours of the training.…”

What influences prescribing decisions in a multimorbidity and polypharmacy context on the acute medical unit? An interprofessional, qualitative study

“…Medicines reconciliation is the formal process, described in a toolkit published by the Royal Pharmaceutical Society, 22 that ensures accurate and complete medication information is obtained at interfaces of care such as when a patient is admitted to and discharged from hospital. However, the full potential of pharmacists with therapeutic knowledge was not evident within the doctors' focus group transcripts, a finding that has also been reported by Anderson et al 25 The skills of pharmacists appeared to be under-utilized with regard to new product prescribing, as has been reported by Tan et al 26 and in community pharmacy practice, 27 as well as a lack of formal partnership between the two groups resulting in the actions of pharmacists' being curtailed.…”

What influences prescribing decisions in a multimorbidity and polypharmacy context on the acute medical unit? An interprofessional, qualitative study

“…The full potential of pharmacists with therapeutic knowledge was not evident within the doctors' focus group transcripts, a finding that has also been reported by Anderson et al 20 The skills of pharmacists appeared to be under-utilised with regard to new product prescribing, as has been reported by Tan et al 21 and in community pharmacy practice 22 , as well as a lack of formal partnership between the two groups resulting in the actions of pharmacists' being curtailed. Recent research in the UK demonstrates, however, that community pharmacists can conduct medication reviews and work effectively within a multidisciplinary team to tackle polypharmacy resulting in reduced re-admission rates after discharge from hospital.…”