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     

A postal survey to assess the views of community pharmacists on the deregulation of emergency hormonal contraception

□ This was a postal survey undertaken before EHC was available nationally in UK community pharmacies □ The survey aimed to assess attitudes of UK community pharmacists towards the deregulation of EHC □ A response rate of 66 per cent was attained and the consensus was that community pharmacists broadly agreed with the deregulation of EHC □ Pharmacists believed that the supply of EHC through pharmacies would increase their professional status, and there would be need for GP collaboration □ Although pharmacists welcomed EHC deregulation, they had reservations about legal implications     

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.     

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.     

Action learning as an improved method for continuing professional development for pharmacists providing women's health care advice

□ A self‐selected set of pharmacists participated in a formal women's health care advice programme □ The tools (continuing education needs assessment grid and job competency wheels) proved useful in identifying training needs and assisted the implementation of identified training solutions □ Regular meetings of the set were an essential component of the process □ Motivation and encouragement by peers should not be underestimated □ Action learning in association with an organised programme is a successful and appropriate means of facilitating CPD     

Patients' perspectives on medicines and pharmacy: views of patients with Type 2 diabetes

□ The study was conducted to inform the design of pharmaceutical care support to patients with Type 2 diabetes – a recognised health care priority and a target for new pharmacy initiatives □ Interviews in an outpatient clinic revealed an apparent lack of patient‐pharmacist communication and low patient expectations □ Some patients felt a lack of feedback about the results of clinic checks and what they meant for disease control □ Patient information leaflets were not consistently seen as meeting patients' needs for information and advice □ Patients' experiences can be used to develop the role of community pharmacy services within the health care team effort     

Supplying emergency hormonal contraception in the pharmacy: the perspectives of service users

□ Pharmacists have been supplying emergency hormonal contraception via patient group direction in Manchester, Salford and Trafford health action zone since late 1999 □ This paper presents preliminary results of a questionnaire survey of users experiences of obtaining emergency contraception from this source □ Four hundred and thirty out of a total of 5,020 questionnaires distributed by pharmacists were completed □ Ninety‐nine per cent of service users were either very satisfied or satisfied with the manner in which their request for emergency contraception was dealt with □ Ninety‐one per cent of respondents felt either comfortable or very comfortable discussing emergency contraception with the pharmacist     

Clinical medication review by a pharmacist of patients on repeat prescriptions in general practice

□ The government proposes an extension to pharmacists' role to medicine management, including services such as medication review □ We found that pharmacist‐conducted clinical medication review identified medication related problems in nearly half of the patients seen and a quarter of medicines reviewed □ Pharmacist‐conducted clinical medication review is effective in identifying clinical issues related to patients' repeat medication and recommendations are accepted by general practitioners □ There are education and training issues for pharmacy if this model is to be accepted more widely. The pharmacist will need to be part of the primary health care team with access to medical records     

Does social environment affect arthritis patients' ability to remain on methotrexate treatment?

□ Drug toxicity is still a major limiting factor for methotrexate treatment continuation □ Treatment discontinuation within 12 months of start of methotrexate in this UK cohort was 20% (SE 2%) □ The monitoring of tolerance to methotrexate has implications for the dispensing of the drug in primary care □ Although social circumstances may have a role in arthritis patients' psychosocial health status, continuation rates of methotrexate in “affluent” and “deprived” patients were similar at the end of the first and second years of treatment □ The reasons for lower socio‐economic groups being discontinued on lower methotrexate doses warrant further study     

Validity and reliability of the kidney disease questionnaire in patients receiving continuous ambulatory peritoneal dialysis

□ No specific health‐elated quality of life (HRQL) measure exists for patients receiving continuous ambulatory peritoneal dialysis (CAPD) □ This study assessed evaluated the use of the kidney disease questionnaire (KDQ) which has been specifically designed for haemodialysis patients in those undergoing CAPD □ Confirmatory factor analysis was used to assess the validity and reliability of the KDQ which was administered by interview to 41 CAPD patients □ Many of the items in the five dimensions of the KDQ demonstrated high factor loadings, thus indicating good representation of the associated dimension; good reliability scores were also reported □ The KDQ may be a useful measure of HRQL in CAPD patients     

A novel approach for teaching aseptic processing to pharmacy undergraduates

□ Aseptic processing is a fundamental skill required of pharmacy graduates □ Traditional one‐to‐one teaching is not possible with the expanding numbers of undergraduates □ An original computer‐aided learning package was written to aid teaching aseptic processing to pharmacy undergraduates □ The students valued the CAL package as an aid in preparation for practical exercises, but would have preferred more feedback on the questions asked □ Funds have been secured to enable improvements in the CAL package, allowing assessment of questions and better interactivity.     

Compliance and adherence as pragmatic concepts: a study of TB in rural Pakistan

□ Urine tests highlight fewer non‐compliant tuberculosis (TB) patients than do tablet counts □ Face‐to‐face interview techniques are of limited use for the purposes of investigating adherence and compliance issues □ Clinic attendance would need to have been measured for a much greater time duration to reflect compliance □ DOTS (directly observed treatment – short course) and combination formulations seem to improve compliance □ Patients who default or die while being treated have better attendance rates than those discharged (cured, resistant or sick)     

From compliance to concordance: meeting the needs of patients?

□ Compliance has come under increasing criticism as a means by which to organise health care interactions and interest has been expressed in a new model termed concordance □ This research set out to explore the relevance of compliance and concordance to a group of Pakistani people with Type 2 diabetes and the health professionals involved in their care □ Both patients and health professionals remained wedded, to some degree, to traditional notions of compliance with health care instructions □ However, some patients expressed a desire for greater understanding of the practical problems of living with Type 2 diabetes and integrating the regimen into their lives □ On the basis of these findings, it may be more appropriate to link concordance to an approach which seeks to sensitively elicit patients narratives as a basis for shared understanding.     

Training needs analysis for pharmacy technicians in Northern Ireland

□ No structured post‐qualification training programme for pharmacy technicians is available in Northern Ireland and research was conducted to assess current training needs □ A number of research strategies was employed during the training needs analysis including: observational visits, surveys, in‐depth interviews and focus groups □ Details relating to the current role, deployment, qualifications held and post‐qualification training of technicians were obtained during the research □ The need for a structured post‐qualification training programme was highlighted and a number of suitable areas for inclusion in such a programme were identified (eg, supervisory skills, communication skills, medicines management, aseptic technique and information technology) □ It is recommended that a training programme is introduced and that resources are provided to allow this to happen     

The association of psychosocial and diabetes factors to diabetes knowledge

□ In diabetes a good knowledge of the disease state and its treatment is likely to enhance self‐management □ The questionnaire‐based study aimed to determine factors associated with decreased diabetes knowledge to help target patients who may be at risk of poor self‐management □ Factors predictive of increased knowledge about diabetes were lower age, Type 1 diabetes, a longer duration of diabetes, a higher occupational status, higher generalised self‐efficacy and a lower serum triglyceride level □ Patients who fall outside those parameters may be at greater risk of poor management, through having poor knowledge of diabetes □ Diabetes education should be a routine aspect of diabetes care, targeted at those in greatest need.