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Pharmacists' perceptions and communication of risk for alertness impairing medications
Authors:Ibrahim Jomaa  Mariam Odisho  Janet MY Cheung  Keith Wong  Jason G Ellis  Tanya Smyth  Bandana Saini
Institution:1. Faculty of Pharmacy, University of Sydney, Sydney, New South Wales, Australia;2. Faculty of Pharmacy, Uppsala University, Uppsala, Sweden;3. Sleep and Circadian Group, Woolcock Institute of Medical Research, Glebe, New South Wales, Australia;4. Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia;5. Northumbria Centre for Sleep Research, Newcastle-upon-Tyne, United Kingdom;6. The Centre for Accident Research and Road Safety, Brisbane, Queensland, Australia
Abstract:

Background

A core role of the pharmacist is to ensure safe and effective medication use. Therapeutic classes that impair alertness (e.g. sedatives or hypnotics) can pose safety concerns for the consumer when undertaking activities requiring psychomotor vigilance (e.g. driving).

Objective

To explore pharmacists' perceptions and communication strategy of the risks related to alertness impairing medications in clinical practice.

Methods

In-depth semi-structured interviews explored community pharmacists' perceptions of medication-related risks, current medication provision and the feasibility of new practice tools. Interviews were digitally recorded, transcribed verbatim and analysed using Framework Analysis to identify emergent themes. A Psychometric Risk Perception Questionnaire was also used to evaluate pharmacists' perceptions across 7 common psychotropic drug classes.

Results

Synthesis of the qualitative dataset of 30 pharmacist interviews revealed three key themes: ‘Safety and Consequences of AIMs’, ‘Factors that Influence Risk Communication’ and ‘Refining Risk Communication’. Participating pharmacists were generally aware of the therapeutic classes associated with medication-related risks but were concerned about patients' level of understanding. Counselling approaches were largely dictated by perceived patient interest/experience with a medication. Concerns were centred on inter-individual pharmacokinetic differences, which could make the precise risk assignment difficult. Pharmacists also highlighted workflow limitations and the need to bring patients' attention to these resources during the clinical interaction to maximise impact.

Conclusions

Medication-related risk communication is a complex clinical phenomenon dictated by patients' prior experiences and the pharmacists' practice environment. Extending the evidence base in this therapeutic area and refining clinical resources are key steps towards optimising patient medication safety.
Keywords:Risk communication  Sedatives  Consumer  Medication safety  AIMs  Alertness Impairing Medications  DRUID  Driving Under the Influence of Drugs  Alcohol and Medicines in Europe  EPPM  Extended Parallel Process Model  TAC  Transport and Accident Commission  TGA  Therapeutic Goods Administration
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