Cross‐sectional survey of community pharmacists' views of the electronic Minor Ailment Service in Scotland

Objectives The aim was to investigate community pharmacists' views on the implementation of the electronic Minor Ailment Service (e‐MAS) in Scottish community pharmacies and to quantify the barriers and facilitators to service provision. Methods A postal cross‐sectional survey of all community pharmacies in Scotland (n = 1138) was conducted. A combination of open, closed and Likert‐type questions were used. Key findings A response rate of 49.5% was achieved. A majority of respondents (over 84%) ranked their level of implementation of e‐MAS as 4 or 5 on the five‐point scale where point 1 represented ‘not at all’ and 5 represented ‘very high’. A majority also identified opportunities to extend professional roles (83.3%), opportunities for more effective patient treatment (78.5%), opportunities to better meet patient expectations (74.4%) and financial advantage to their pharmacy (52.6%) as benefits of e‐MAS. Suspected misuse/overuse of the service by some customers (75.1%) and time required for recording each consultation or supply (61.3%) were two barriers agreed upon by the majority of the respondents. Conclusions A majority of respondents had positive views towards e‐MAS. The benefits agreed upon by the majority of the respondents relate to known facilitators of community pharmacy practice change. Major barriers, namely suspected misuse of the service by some customers and timely process for recording consultation or supply, could affect pharmacists' efficiency in service delivery and need to be addressed. These results could inform similar schemes that may be introduced locally in the UK or elsewhere.     

Drug test feasibility in a general population household survey

Drug testing was used as an adjunct to a general population household drug use survey administered via audio computer assisted self-interview. Participants, ages 18-40 years residing in Chicago, were recruited to participate in three different biological tests (hair, oral fluid, and urine) presented in random order subsequent to completing an interview. Subjects had the option of participating in zero to three different tests. We examined participation/refusal in tests, reaction to testing requests, as well as variables associated with participation and reaction. Subjects were randomly assigned to a low (US$ 10 per test) or high (US$ 20 per test) incentive condition. Over 90% of the sample participated in at least one test, usually the oral fluid test. Associations between refusal status and two variables, socioeconomic status (SES) and presence of children in the household, provided partial support for the notion that drug test participation parallels the survey response process in general. Incentive level did not directly increase drug test participation. Reporting of recent illicit drug use was associated with participation in only one procedure, hair testing. Type of test offered and individual differences in willingness to be drug tested were important predictors of drug test refusal and subject reaction to testing requests. Compared with urine and hair testing, oral fluid testing had lower refusal rates and was generally more acceptable to respondents in a general population survey. The findings support the feasibility of incorporating multiple drug tests with modest incentives into general population household surveys on drug abuse.     

Reliability of self-reported alcohol consumption in a general population survey

Reliability estimates for the measures of alcohol consumption used in a household survey were examined. Respondents who had not consumed any alcohol within the previous year and those under age 18 were excluded from the survey, yielding a sample of 1395 (48% men). With one survey that involved a 2-week recall period and another that involved a 4-week period, three methods for estimating reliability were employed: alternate forms, test-retest and a combined method. Validity was also examined using a 30-day drinking diary as a criterion. The findings indicate high levels of reliability, averaging .91 for the consumption measures of beer, wine and distilled spirits. Validity estimates were also fairly substantial but not uniformly so across the different beverage types. In general, the results suggest that these consumption measures can be used with considerable confidence.     

Attitudes towards drugs — a survey in the general population

Background: Studies have shown that many drugs have a lower effectiveness in clinical practice than would be expected from results reported in randomised controlled clinical trials. Many factors influence the use of drugs. Personal factors such as knowledge, attitudes, motivation, expectations are considered to be of particular consequence. The aim of the study was to analyse attitudes towards drugs from an epidemiological perspective.Design: Cross-sectional surveySetting:The county of Uppsala, Sweden, 1995.Results: 5,404 completed the questionnaire (response rate=68%). A majority either considered drugs as something positive, a help (60%), or as something necessary but evil (38%). A small proportion — around 2% — considered drugs as a danger. There were differences in attitudes according to education and income, self-care orientation, medication knowledge, and state of health. We also found differences in attitudes between users and non-users of certain types of drugs. Users of hypertensive drugs more often considered drugs as necessary but evil than did non-users of these drugs, while users of psychotropic drugs more often viewed drugs as something positive than did patients who did not use psychotropic drugs.Conclusion: A better understanding of the general attitudes towards drugs is important when giving both written and oral information to patients and to the public at large. It is also important to be aware of differences in attitudes between various patient groups and that certain patients, e.g., patients prescribed hypertensive drugs, could require more attention from health care professionals.     

Aggregate comparisons of self-reported versus nonself-reported drinking in a general population survey

Insight is gained into the validity of self-reported drinking in the general population by comparing self-reports and nonself-reports on the aggregate level. Married and cohabiting respondents of a general population survey (N = 2,169) were asked about both their own and their spouses' drinking behavior. It was found that on the aggregate level, distribution of "moderate" drinking and usual frequency of drinking is similar between self- and nonself-reports. Self-reported "heavy" drinking, however, is lower than nonself-reported "heavy" drinking among women in general, older women, and women with a lower education. Among men in general and older men in particular, however, self-reported occasional "heavy" drinking was found to be higher. The similar distribution of "moderate" drinking and usual frequency of drinking between self- versus nonself-reports gives reassurance about the validity of self-reported drinking behavior. The discordance in self-reported versus nonself-reported "heavy" drinking, however, raises questions about the validity. Interpretation of the discordance is not conclusive: more research (experimental and qualitative) has to be done to disentangle this issue.     

The prevalence of faecal incontinence and constipation in a general New Zealand population; a postal survey.

AIMS: To determine the prevalence of constipation and faecal incontinence in the community. METHODS: A 20-question multi-field postal questionnaire was sent to 1500 adults (over 18 years) randomly selected from the electoral roll in the Canterbury region. Questions detailed frequency of bowel function, time spent at the toilet, incidence and severity of faecal incontinence, constipation, and the effect of disordered bowel function. RESULTS: Of 1500 questionnaires, 717 (48%) were returned (male: female 388:329). The median age was 46 years (range 18-70). 24 (4%) had self-reported gastrointestinal disease. There was a median frequency of seven bowel motions per week (BM/wk) (range 1 to 70) with 89% having between two motions a day and one every two days. Faecal incontinence affected lifestyle in 58 (8.1%). Incontinence of solid stool at least once a month occurred in 70 (9.8%), of liquid stool in 91 (12.7%), of gas in 459 (64%), while 12 (2%) regularly wore a pad. Those with self-reported gastrointestinal disease had a significantly higher (p<0.05) bowel motion frequency (17 vs 7 BM/wk) and median faecal incontinence score (2.5 vs 0). Laxatives were used by 4.9% of the population, while 26.2% increased fibre to avoid constipation. CONCLUSIONS: The normal frequency of bowel motions (+/- 2SD) was 2-17 per week. Faecal incontinence affecting life style affected 8.1%, while constipation requiring regular laxative use affected 4.9% of people. There is acceptance in the community that a moderate degree of bowel dysfunction is normal. Stool frequency and faecal incontinence scores can be used to predict those most likely to have organic gastrointestinal disease.     

A cross-sectional survey of the Maltese general public on medication wastage

Background Medication wastage is a global issue, with key public health implications in terms of safety, the environment and the economy. A recently conducted systematic review of the published literature identified a lack of focus on the views of healthcare professionals and the general public. Objective To explore awareness, attitudes and behaviours relating to medication wastage amongst the general public in Malta. Setting Malta. Method Survey methodology employing a pre-piloted questionnaire was developed from theoretical frameworks of behaviour. Questionnaire items comprised open, closed and 5-point Likert scales. Medication adherence as a possible factor associated with wastage was measured using the 8-item Morisky Medication Adherence Scale. Random sample of 1920 was obtained from the Maltese electoral register 2013. Ethical approval was obtained. Main outcome measures Awareness, attitudes and behaviours relating to medication wastage amongst the general public in Malta. Results Response rate was 20.4 %. The majority (70.6 %) agreed that they were fully aware of the issue of wastage and 71.9 % disagreed that they had no interest in wastage. The following were significantly related to increased awareness of wastage: older age (p = 0.003), pensioners (p = 0.011), on regular medication (p = 0.021) and obtaining free medication (p = 0.026). Lack of interest in wastage was significantly related to obtaining free medication by government (p = 0.022), with those purchasing medication being significantly more interested (p = 0.028). While 75.1 % of respondents on regular medication self-reported not being fully adherent, there were no associations with awareness (p = 0.100) and interest in wastage (p = 0.385). Unemployed were more likely to report contribution towards wastage (p = 0.010) and the presence of a healthcare professional as family member was significantly related to confidence in ability to reduce wastage (p = 0.009). 46.2 % claimed to have unused medication at home and improvement in patient’s medical condition was the main reason for this. Conclusion More effort is warranted to raise awareness of the public as an initial step in promoting behavioural change in relation to medication wastage.