Psychometric Properties of a German Version of the "Satisfaction with Information about Medicines Scale" (SIMS-D)

Objective:  The aim of this study was to translate the Satisfaction with Information about Medicines Scale (SIMS) into German and test its psychometric properties in a German primary care setting. The SIMS was developed to assess the extent to which patients feel they have received enough information about their medicines.
Methods:  Three hundred seventy chronically ill patients were included in the study. The SIMS was translated to SIMS-D (German version) and evaluated in terms of acceptability, internal consistency, test–retest reliability, discriminant, and criterion-related validity.
Results:  The SIMS-D showed good internal consistency (Cronbach's α 0.92) and adequate test–retest reliability (Pearson's r  > 0.7). Relationships to external criteria regarding medication management were acceptable (Spearman's ρ > 0.4). The SIMS-D was reasonably well accepted (return rate of 71%); however, older people produced more missing values when filling in the questionnaire.
Conclusions:  Preliminary evidence was given that the SIMS-D is a suitable instrument for measuring patient satisfaction with information about medicines in German primary care settings.     

Using longitudinal mixed methods to study the development of professional behaviours during pharmacy work‐based training

Recent longitudinal investigations of professional socialisation and development of professional behaviours during work‐based training are lacking. Using longitudinal mixed methods, this study aimed to explore the development of professional behaviours during a year of intensive work‐based (pre‐registration) training in pharmacy. Twenty trainee pharmacists and their tutors completed semi‐structured interview and professional behaviour questionnaires at four time points during 2011/2012: months 1, 4 and 9 during training and 4 months after registration; tutors participated in months 1 and 9. Interviews were analysed thematically using template analysis, and questionnaires were analysed using ANOVA and t‐tests. Self‐assessed (trainee) and tutor ratings of all elements of professional behaviours measured in questionnaires (appearance, interpersonal/social skills, responsibility, communication skills) increased significantly from the start of pre‐registration training to post‐registration. Some elements, for example, communication skills, showed more change over time compared with others, such as appearance, and continued to improve post‐registration. Qualitative findings highlighted the changing roles of trainees and learning experiences that appeared to facilitate the development of professional behaviours. Trainees’ colleagues, and particularly tutors, played an essential part in trainees’ development through offering support and role modelling. Trainees noted that they would have benefited from more responsibilities during training to ease the transition into practising as a responsible pharmacist. Longitudinal mixed methods can unpack the way in which professional behaviours develop during work‐based training and allow researchers to examine changes in the demonstration of professional behaviours and how they occur. Identifying areas less prone to change allows for more focus to be given to supporting trainees in areas where there is a development need, such as communication skills and holding increasing responsibility.     

How do patients with cancer pain view community pharmacy services? An interview study

Pain experienced by many patients with advanced cancer is often not well controlled and community pharmacists are potentially well placed to provide support. The study objective was to explore the views and experiences of patients with advanced cancer about community pharmacies, their services and attitudes towards having a community pharmacist pain medicines consultation. Purposive sampling of GP clinical information systems was used to recruit patients with advanced cancer, living in the community and receiving opioid analgesics in one area of England, UK between January 2015 and July 2016. Thirteen patients had a semi‐structured interview which was audio‐recorded and transcribed verbatim. Data were analysed deductively and inductively using Framework analysis and incorporating new themes as they emerged. The framework comprised Pain management, Experiences and expectations, Access to care and Communication. All patients reported using one regular community pharmacy citing convenience, service and staff friendliness as influential factors. The idea of a community pharmacy medicines consultation was acceptable to most patients. The idea of telephone consultations was positively received but electronic media such as Skype was not feasible or acceptable for most. Patients perceived a hierarchy of health professionals with specialist palliative care nurses at the top (due to their combined knowledge of their condition and medicines) followed by GPs then pharmacists. Patients receiving specialist palliative care described pain that was better controlled than those who were not. They thought medicines consultations with a pharmacist could be useful for patients before referral for palliative care. There is a need for pain medicines support for patients with advanced cancer, and unmet need appears greater for those not under the care of specialist services. Medicines consultations, in principle, are acceptable to patients both in person and by telephone, and the latter was perceived to be of particular benefit to patients less able to leave the house.     

'It's the best of two evils': a study of patients' perceived information needs about oral steroids for asthma

Objectives  To explore the sources of patients' knowledge about the potential side-effects of oral steroids prescribed to treat asthma.
Methods  Seventeen in-depth interviews were conducted with patients taking prescribed oral steroid medication (prednisolone) for asthma. The interviews were transcribed verbatim and the data organized according to common themes.
Results  All the respondents acknowledged they had no choice but to take oral steroids but they wanted to be informed about the potential side-effects. Respondents reported that they had not received sufficient information about side-effects from their general practitioner (GP). Information was sought from both medical sources (pharmacists and asthma nurses) and non-medical sources (friends and family, self-help groups and the media) to supplement their knowledge. The conclusions drawn about the risks of taking oral steroids were also influenced by respondents' existing beliefs.
Conclusions  Respondents drew upon information about oral steroids from a variety of professional and lay sources. The findings add weight to calls for doctors and patients to share their respective knowledge in consultations. Developing an understanding of the views of GPs about the provision of information about side-effects would help to identify any perceived barriers to a more open exchange of information in the consultation.     

Adherence to the Grampian joint drug formulary in general practice

A joint drug formulary covering both hospital and general practice prescribing has been in existence in Grampian since 1990. The aims of this study were to measure adherence to this formulary in general practice and to identify who had initiated non-formulary drugs. The drug therapy of elderly patients on presentation to hospital was compared to the formulary. Of the 449 drugs prescribed 377 (84%) were recommended in the formulary. The main areas of non-formulary prescribing were antidepressants, hypnotics, nitrates and diuretics, with some non-formulary drugs being initiated by hospital prescribers. The method described was found to be extremely simple and had the advantage that it reflected actual prescribing at the time of the study.