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     

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     

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     

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.     

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.     

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     

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.     

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     

Infant weaning and community pharmacy — the pharmacist's perspective

Community pharmacists' awareness of the COMA report on “Weaning and the weaning diet” and their knowledge of its recommendations was assessed in a questionnaire distributed to all (n=81) community pharmacists in the Western Health and Social Services Board in Northern Ireland. Sources of information and adequacy of training on childhood nutritional issues were determined. A knowledge score was computed for each pharmacist depending on their responses to questions based on key issues in the COMA report. Completed questionnaires were returned by 48 pharmacists (59 per cent). The COMA report had been read by 14.5 per cent of respondents while 12.5 per cent knew of its recommendations. Others had heard of it but not read it (52 per cent) or had never heard of it (21 per cent). The mean knowledge score was 66 per cent (±17.5). Scores ranged from 18 per cent to 90 per cent, indicating wide variability in pharmacists' knowledge of key recommendations for weaning. Only 29 per cent of pharmacists felt that they were adequately trained to give advice on weaning; 50 per cent felt that they did not have sufficient knowledge and 21 per cent were unsure. Pharmacists indicated that, on average, parents approached them weekly about a weaning topic, which emphasises the need for them to be well informed about current weaning recommendations.     

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     

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     

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     

Addressing pharmaceutical and medicines management issues within the cancer network structure

□ The presentation focuses on the contribution that oncology pharmacists make to the work of the cancer networks □ The current contribution varies between networks but includes development of evidence‐based treatment guidelines, the setting up of network oncology pharmacist groups, audit, drug procurement, and research and development □ The recent establishment of the NHS Cancer Research Network will build upon the current contribution made to research and development by oncology pharmacists by their support of clinical trials and other activities □ The presentation reflects on the barriers and facilitators that exist for these roles and invites discussion on the potential for the future role of the pharmacist within the network structure     

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.     

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.     

Patient acceptability of cyclical etidronate and calcium therapy and symptomatic response to treatment

One hundred and seventeen patients (75 per cent women) with established osteoporosis were entered into a clinical trial assessing two regimes of cyclical etidronate and calcium (Cacit). Some subjective parameters of clinical outcome were assessed prior to, and during, treatment. Patient acceptability of therapy was also examined. There was a significant reduction in pain score (median scores from a 10-point visual analogue scale at 0, 6–12 and 15–24 months were 4, 2 and 1, respectively) and in analgesic consumption (32 per cent, 51 per cent and 65 per cent of patients at 0, 6–12 and 15–24 months, respectively, were using no analgesics). Sleeping patterns improved significantly during the study but there was no change in hypnotic consumption. Sixty-four per cent of patients felt there had been an improvement in their condition and 79 per cent felt that attending the clinic had helped them come to terms with osteoporosis. Etidronate was well tolerated: 23 per cent of patients experienced mild gastrointestinal side effects; 94 per cent were prepared to continue with treatment indefinitely. However, 43 per cent felt their daily routine was interrupted by taking etidronate. The Cacit was poorly tolerated: 50 per cent of patients experienced gastrointestinal side effects, 28 per cent had to discontinue calcium because of side effects and 24 per cent felt their daily routine was altered by taking calcium. Eighty-five per cent were, however, prepared to continue with some form of calcium supplement indefinitely. In conclusion, etidronate therapy was an acceptable form of treatment in this group of patients and provided some symptomatic improvement. However, the choice of calcium supplement was less acceptable and may lead to non-compliance with treatment.