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     

Pharmaceutical information exchange between primary and secondary health care professionals and cancer patients

□ No single professional takes overall responsibility for the pharmaceutical aspects of cancer patient care □ Information given to cancer patients by health care professionals (HCPs) varies depending on the priority of the professional □ Cancer patients primarily approach primary care HCPs for help and advice for their medication □ Training and support must be available to enable HCPs to address individual cancer patients' information needs.     

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.     

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     

Medianes management and the individual patient

□ For medicines management to fulfil its aim of partnership with patients, the individual patient's perspective needs to be examined □ Study uses discursive analysis of in depth interviews of hypertensive patients to highlight individual patients' experience of hypertension □ Findings suggest that patients may consider condition and care differently than health care professional □ Evaluation of medication may not be completely explained by the clinical paradigm of risk/benefit □ Concordance may be more difficult to achieve in the early stages of treatment.     

Integrating the community pharmacist into the diabetes team: evaluation of a new care model for patients with Type 2 diabetes mellitus

□ Diabetes is a major public health issue affecting 3 per cent of the population □ Integration of the pharmacist into the multidisciplinary care of patients with chronic conditions is supported by the profession and the government □ Community pharmacists engaging with their established customers and access to relevant data can, through use of a systematic process, identify the pharmaceutical needs of this patient group □ The model of care proposed is feasible in a primary care setting, resulting in acceptance of pharmaceutical care issues general practitioners and an improvement in patient care     

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     

Do increasing levels of income deprivation have an effect on the prescribing of OTC medication?

□ People who are on a low income frequently visit their general practitioner to obtain medication that is also available over the counter, because it will be dispensed at no cost to them □ This activity reduces the amount of time available for the GP to treat more serious illnesses □ This leads to inequity when compared with the service provided in more affluent areas □ Pharmacists should be more involved in the provision of free health care to these patients     

Compliance,concordance and the revolving door of care: caring for elderly people with mental health problems

□ The project involved community pharmacists receiving specialised training, becoming integrated into the community mental health teams and providing pharmaceutical care when making joint domiciliary visits with the key workers. □ Community pharmacists, psychiatrists and key workers all wanted the project to develop into a service and had similar views about the general benefits of the study. However, they had contrasting expectations of the project, based on their own perspectives on compliance, concordance and models of care □ The key workers valued the provision of monitored dosage systems for patients with confusion or memory problems. But the pharmacists felt that they were being expected to organise compliance aids; they recognised that it was their role to assess complaince and that other measures could be taken before organising an MDS □ The psychiatrists stated that involuntary non‐compliance with medication, arising from confusion, memory and physical problems, was a major issue and the project had made improvements in this area; they wanted to keep patients in the community and particularly valued reductions in morbidity, relapses and the “revolving door of care”     

Laxative prescribing during pregnancy in primary care

□ Hormonal changes, mechanical pressure and concurrent medication all contribute to altered bowel habit during pregnancy □ It has been suggested that pregnant women are more likely to receive laxatives than the baseline population □ A retrospective case control study using a primary care prescribing database was undertaken to compare laxative prescribing before and during pregnancy with that in matched controls □ Prescribing rate of laxatives increased during pregnancy compared with before becoming pregnant but this was not different to controls □ Pregnant women were more likely to receive a laxative if they were using antibacterials, preparations for haemorrhoids or drugs for nausea and vertigo.     

Minor ailment consultations: a mismatch of perceptions

□ A structured interview with 240 patients immediately before a general practitioner consultation ascertained whether they had experienced any illness or symptoms which they perceived as minor in the previous two weeks and, if so, whether their current consultation was related to this ailment □ For those 93 consultations which the patient perceived as a minor ailment consultation, the GP's view was ascertained on whether the illness was a minor ailment and whether the patient could have managed their condition alone □ The GP's view frequently contrasted with that of the patient □ For the first time, a subgroup of necessary minor ailment consultations, which the patient could not manage alone, has been identified □ Pharmacists are well‐placed to help patients diagnose and manage those minor ailments for which the patient feels they need professional help, but do not require a GP consultation.     

The views of general practitioners on the reuse of patients' own drugs

□ The quality of patient care could potentially improve through patients' own drugs (POD) schemes □ POD schemes need to be promoted to primary care professionals     

A randomised,controlled study to quantify the benefits of community pharmacist interventions on the prescribing of cardiovascular drugs in general practice

□ The impact of a one‐off medication review by a specially trained community pharmacist, with recommendations to the patient's general practitioner was studied □ No differences were observed in any of the physiological or biochemical monitoring indicators □ There was greater improvement post‐intervention in some key quality prescribing indicators (eg, prescribing of antiplatelet and beta blocker or ACE inhibitor post‐MI); others showed equal improvement in both groups (diabetic patients on ACE inhibitor) □ A single review of medication records by a practice‐based pharmacist, with a dependence on the general practitioner to implement change may have limited benefit.     

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     

Identification of the pharmaceutical needs of patients with heart failure

□ An extensive evidence‐base exists to support the treatment of heart failure □ A systematic identification of the pharmaceutical care of heart failure patients is needed to develop a model of pharmaceutical care □ Pharmaceutical care issues may be identified from a number of sources □ Care issues may be based on evidence or accepted “best practice”     

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.     

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.     

Delivering pharmaceutical care: what does it involve?

□ Implementing pharmaceutical care plans requires pharmacists to interact with both patients and health care professionals □ The actions involved in implementation for the majority of drug classes require contact with other health care professionals □ Requests for monitoring make up a substantial proportion of these contacts □ Authorising pharmacists to make requests directly to appropriate staff may enhance pharmaceutical care without increasing general practitioners' workload.