Satisfaction with information and its relationship with adherence in patients with chronic pain

□ Due to the nature of chronic pain it would be expected that patients are highly adherent to their pain medication. However, results from this study have shown that 23 per cent of patients often or always avoid using their pain medication, 13.4 per cent often or always alter dosages, and 10.3 per cent often or always stop taking their medication for a while. This suggests intentional non‐adherence to pain medication □ Less than 50 per cent of respondents were satisfied with information provided on side effects, what to do if side effects occur, and possible interactions with other medication □ Patients' satisfaction with information about their medication was related to self‐reported adherence; greater satisfaction was associated with higher self‐reported adherence     

Use of health information touchscreens by community pharmacy users in six local community pharmacies

□ Considerable update of touchscreen availability □ Wide variety of information accessed □ Number of accesses broadly comparable with NHS Direct call figures □ Sixty‐four per cent of touchscreen users are under the age of 35 years □ Supermarket pharmacy had most accesses     

Preliminary investigation of the problems associated with supply of palliative care medicines in primary care

□ Fax‐back was a cost effective method for administration of a self‐completion questionnaire which produced a high (76 per cent) response rate □ Problems with supply of palliative care medicines were reported by 58.5 per cent of health authorities responding to the survey □ Supply of medicines out of hours was the most common problem reported (93 per cent), with stock levels held in pharmacies and problems with specialist medicines also causing problems in over 50 per cent of respondents □ Some health authorities reported that protocols for supply of palliative medicines, or the existence of designated community pharmacies for their provision, reduced the problems reported □ Further research into effectiveness of protocols and designated palliative care pharmacies is indicated, and our study has identified those health authorities where such research could be targeted     

Supplying emergency hormonal contraception through patient group direction: a qualitative study of the views of pharmacists

□ Pharmacists have been supplying emergency hormonal contraception via patient group direction in two health action zone areas since late 1999 and early 2000 □ This paper presents qualitative interview data on participating pharmacists' views of the service □ Pharmacists were in general extremely positive about supplying EHC via patient group direction in the pharmacy, citing the chief benefits to users as including greatly improved access at no financial cost □ Participants also noted that the scheme also enhanced the professional standing of community pharmacy and demonstrated its worth as a sexual health resource □ There were concerns about use of EHC as a “regular” form of contraception and that widened availability might increase the number of episodes of unprotected sexual intercourse and consequently, sexually transmitted infections     

Developing an R&D agenda for pharmacy workforce research

□ A consultation exercise was conducted to identify and prioritise the research agenda on the pharmacy workforce □ A two‐ound Delphi technique was employed for the main study □ People from all sectors of the profession were invited to contribute their views on what research should be carried out □ Ninety per cent of respondents agreed that the top priority for research was to “identify the levels, causes and implications of turnover among different cohorts of pharmacists” □ The need to take forward aspects of the proposed programme is now a matter of some urgency for the profession and the National Health Service     

SIGN guidelines and the management of sore throat in community pharmacy

□ Scottish Intercollegiate Guidelines Network guidance on the management of sore throat recommends analgesia and refer to the role of the community pharmacist in advising symptomatic relief □ Advice given to 749 patients from 65 community pharmacies; 49 patients (6.5 per cent) were referred to their general practitioner □ Paracetamol, drug of choice from SIGN guideline, was recommended to 219 patients (29 per cent); a preparation for symptomatic relief either alone or in combination with an analgesic was advised for 590 patients (79 per cent) and of these, 315 patients (42 per cent) were recommended lozenges with anaesthetic and antibacterial action □ Compliance with SIGN guidelines was observed regarding choice of analgesic □ Evidence is required for choice of symptomatic relief.     

Effect of pharmaceutical pre‐assessment on post‐operative interventions

□ The study determined the extent of post‐operative interventions required for patients admitted for elective hip or knee arthroplasty □ In Phase 1, patients were pre‐assessed by nurses at admission, according to existing practice; in Phase 2, patients received pharmacist‐led pre‐assessment □ There were 131 interventions (2.05 per patient) in Phase 1 compared with 40 (0.68 per patient) in Phase 2, a reduction of approximately 70 per cent □ This study demonstrates that pharmaceutical pre‐assessment substantially reduces the number of interventions made during patients' post‐operative stay.     

Headache experiences and medication use in primary care

□ A survey was used to examine headache experiences and medication use in an adult population sample □ Seventy per cent had experienced headaches in the previous three months □ Sixty per cent had taken medication for headache in the past three months □ Most headache sufferers self‐treated their headaches □ Only a few respondents had taken medication before headache pain started or had found their medication ineffective, but combination therapy was common.     

Poor correlation between predicted ideal and prescribed digoxin dose: a community‐based pharmacokinetic study in the elderly

□ This study assessed if population‐based pharmacokinetics predicted measured plasma digoxin concentrations in elderly community‐managed patients □ Twenty‐seven per cent of the sample showed plasma concentrations consistent with a therapeutic level over an entire 24‐hour dosing schedule; 36 per cent showed therapeutic levels for at least some of the dosing schedule; the remainder showed digoxin concentrations not consistent with achieving a therapeutic plasma concentration for any part of the dosing schedule □ The mean daily prescribed dose of digoxin was significantly lower than that predicted from population kinetics.     

Concordance in Muslim patients in primary care

□ The study examined the perceptions of Muslim patients and general practitioners (GPs) about ways in which the Muslim faith may influence medicine concordance □ Fifty Muslim patients (100 per cent response) and 18 general practitioners (53 per cent response) were surveyed using self‐completion questionnaires in order to determine attitudes towards dietary requirements and medicines □ A large proportion of the Muslim patients sampled stated that they would stop taking a medicine if they found out that it was not halaal □ Pharmaceutical manufacturers also need to be sensitive towards the requirements of Muslim patients □ In specific cases, doctors should seek guidance from Islamic leaders as to the correct interpretation of Islamic law with regard to the use of medicines considered haraam     

The use of sublingual glyceryl trinitrate and aspirin in angina patients and enhancement of coronary heart disease databases

□ Audit involving 95 per cent of community pharmacists in one LHCC □ Data were gathered using a semi‐structured questionnaire □ A list of all participating patients was sent to each GP surgery in the locality to enhance their CHD database □ Not all appropriate angina patients are receiving aspirin □ Patients' knowledge of GTN management was poor and should be improved upon by input from healthcare professionals     

An audit of the supply of emergency hormonal contraception through patient group direction

This abstract reports on an innovative semi‐covert audit of community pharmacists' supply of emergency hormonal contraception (EHC) via patient group directions Two women researchers were trained to request EHC in 10 community pharmacies; they were told to tell the pharmacist that this was a result of unprotected sexual intercourse and they recorded their experiences of the consultation on a structured form following supply of EHC In 100 per cent of cases, pharmacists asked about the date of the last menstrual cycle, whether the last menstrual cycle was normal, whether they were taking any other medication, whether experiencing any other conditions and whether they had taken EHC before, and explained how EHC worked In 70 per cent of cases, pharmacists provided information about STIs, and long term contraception; in 80 per cent of cases, they provided condoms and in 100 per cent of cases supplied EHC; neither women experienced judgmental of negative attitudes Although we should be cautious about generalising from this small sample, on the evidence of this evaluation it appears that the service is being provided appropriately     

The impact of hospital antimicrobial policy on the incidence of Clostridium difficile infection

□ An antibiotic policy specifically targeting high risk drugs for Clostridium difficile‐associated diarrhoea (CDAD) development was introduced in the study site hospital □ Despite an increased usage of antibiotics (calculated in defined daily doses) within the hospital, the policy led to a 19.7 per cent decreased incidence of CDAD □ Further improvements are predicted with improved adherence of hospital staff to the hospital antibiotic policy     

Identification of psychosocial factors which influence patient adherence with antihypertensive medication

□ It is estimated that only 50 per cent of hypertensive patients adhere to medication regimens □ In this study evaluation of self‐efficacy and the theory of planned behaviour was used to identify psychosocial factors which impact on patient adherence to antihypertensives □ High self‐efficacy, intentions to comply with the medication regimen, possessing a positive attitude towards taking medication, perceiving pressure from significant others to take medication as prescribed, and perceiving control over taking medication were determinants of good adherence □ The successful identification of factors which influence adherence will allow health‐care providers to implement interventions, aimed at enhancing adherence with antihypertensive medication.     

A patient‐held medication record and a patient medication profile to support the continuity of acute cancer care

□ The sharing of care of patients receiving medical oncology care is vulnerable to errors in their documented drug history □ A patient‐held medication record identified over 90 per cent of patients' medications but was ‘forgotten’ by the patient in a third of contacts with a pharmacist □ Discrepancies between the medication records of GPs, community pharmacists and the medical oncology clinic were highly prevalent □ A posted patient medication profile issued by the hospital pharmacist to both the patient's GP and their community pharmacist was associated with a significant convergence in their records (discrepancies reduced from 17 to 6 % P<0.001) □ The patient‐held record had little impact on the accuracy of practitioners' records and its value lies more in facilitating patient education than rectifying errors in documentation     

Obtaining accurate patient‐specific perioperative anaesthetic costs in orthopaedic anaesthesia

□ The aim of the study was to obtain perioperative patient‐specific costs associated with orthopaedic anaesthesia □ A prospective observational study design was used to determine fixed, semi‐fixed, and variable costs □ The preliminary results of the first 60 patients reports a mean total perioperative anaesthetic cost of £291 (SD: £103.9, median: £278.09, IQR: £219.3–£369.5) □ Fixed and semi‐fixed costs are a major cost component of anaesthesia; variable costs account for only 12 per cent of total cost □ The results of this study will be used in an economic evaluation examining the use of different anaesthetic techniques in orthopaedics     

The views of pharmacists supplying emergency hormonal contraception through a patient group direction

Patient group directions (PGD) to supply emergency hormonal contraception (EHC) in community pharmacies have been operating for several years, predating the deregulation of the product to a pharmacy medicine This study explored attitudes of community pharmacists involved in PGD supply towards the scheme; a short self‐completion questionnaire was distributed to 98 community pharmacies, in Manchester, Salford and Trafford and a response rate of 63 per cent was achieved Most respondents thought a private room or area was necessary to provide an EHC service; 78 per cent of pharmacies had regular locums working in pharmacy, but only a third of all the locums were trained to supply EHC Sixty per cent of respondents admitted that there were days when their pharmacy could not supply the EHC service One cause of dissatisfaction among the pharmacists offering the scheme was the lack of personal remuneration     

Gender and age influences on prescription and consultation frequency for multiple sclerosis patients

□ The study aimed to examine whether gender and age affects the burden of disease in secondary care in terms of number of prescribed drugs and number of consultations with the general practitioner (GP) for multiple sclerosis and control patients □ Anonymised data for 1996 was obtained for all patients (patient years at risk = 220,538) from 24 GP practices in the GP Morbidity Database who had a Read code of MS at some point from 1993 to 1996 and a randomly selected age, gender and surgery matched control group □ A total of 216 cases was identified, giving a prevalence of 97.9 per 105 (based on patient years at risk in the database for 1996; n=220,538). Sixty‐seven per cent (145/216) of cases were female. The mean age was 46.7 (range 17 to 84 years) □ Gender differences for the MS patients, but not controls were found. For example, although females in both the control and MS population had significantly more consultations than the corresponding males, only the control females had more items prescribed than control males (p=0.033) □ This study warrants further work to elucidate whether specific therapeutic areas or MS‐treated symptoms are influenced by gender