bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prescribing new drugs: a survey of hospital consultants in the West Midlands
Authors: Jones Miren I , Greenfield Sheila M , Bradley Colin P , Jowett Sue 
Published: February 2011

Abstract

Objective
To investigate the factors that influence how consultants introduce new drugs into their clinical practice.

Method
A postal questionnaire survey of hospital consultants.

Setting
169 consultants in medical specialties in six hospitals (general or teaching hospitals) in the West Midlands region, United Kingdom.

Key findings
Ninety-two completed questionnaires (54 per cent) were returned. Eighty consultants (87 per cent) reported using a new drug in the previous two years; 60 (65 per cent) had used either one or two new drugs and these were generally in their specialist field. There was no significant difference between hospitals in how easy it was to introduce a new drug. Sixty-one consultants (67 per cent) said that the procedure required an application to the hospital drug and therapeutics committee. Consultants frequently asked patients' general practitioners to prescribe a new drug. Consultants rated independent sources of information more highly than non-independent sources. The most important factors reported to influence prescribing decisions about new drugs were drug characteristics, such as efficacy and safety, and evidence from scientific literature. Sixty-four respondents (70 per cent) saw drug company representatives up to once a week and 57 (62 per cent) had been involved in clinical trials of new drugs in the previous five years.

Conclusion
In general, the consultants reported that they used only a small number of new drugs. There is considerable pressure on hospital doctors to control prescribing and costs of new drugs through policies that require approval by the drug and therapeutics committee. Although contact with the pharmaceutical industry was high, consultants reported that independent sources of information were more important. Factors such as clinical trial evidence and improved drug characteristics were said to be the most influential in reaching decisions to prescribe new drugs.
Patient satisfaction with a community pharmacist-managed system of repeat prescribing
Authors: Jones Jan , Matheson Catriona , Bond Christine 
Published: February 2011

Abstract

Background
A randomised controlled trial investigated a community pharmacist-managed system of repeat prescribing. Patients attended their general practitioner for a medication review at intervals of up to 12 months and were monitored on a monthly basis when collecting repeat medicines by a community pharmacist of their choice.

Objective
To establish patient satisfaction with the pharmacist-managed repeat prescribing system, ie, whether they preferred to continue with this new system.

Method
Questionnaires were sent to 2,667 subjects, 1,625 in the group who received their repeat medicines by the intervention method and 1,042 in the control group who continued to receive their medicines by the traditional system.

Key findings
The response rate was 73 per cent. The baseline patient satisfaction with the traditional system of repeat prescribing was 88 per cent. However, the pharmacist-managed repeat prescribing was preferred to the traditional system by 81 per cent of intervention subjects, many of whom felt that the new prescribing system saved time and provided increased convenience. Reduced time and financial costs of obtaining repeat prescriptions influenced satisfaction. Many patients felt reassured by the increased clinical input provided by the community pharmacist. Patients in non-city communities showed greater preference for the new system than their city counterparts.

Conclusion
Results indicate that this or a similar system of pharmacist-managed repeat prescribing may be preferred to the traditional method by many patients who are stabilised on regular medication obtained by repeat prescriptions.
Patients' views of the value of “brown bag” medication reviews
Authors: Nathan Alan , Goodyer Larry , Lovejoy Anne , Savage Imogen 
Published: February 2011

Abstract

Objective
To explore and describe patients' views of the value of brown bag medication reviews.

Method
Semi-structured, tape-recorded interviews were conducted with 20 patients who had participated in a brown bag medication review scheme.

Setting
A health authority area in south-east inner London.

Key findings
Patients perceived the following benefits from brown bag reviews: clinical problems resolved; better understanding of their medications, leading to increased confidence; and appreciation that an interest was being taken in their health care. Reviews had given patients a sense of empowerment, and had made them realise that they had a right to information about their medical treatment and medication. As a result they were likely to be more proactive in seeking information in future. Reviews had made patients realise that pharmacists were knowledgeable about medicines, where previously many had thought that only doctors had sufficient knowledge. Reviews had enhanced relationships between patients and pharmacists. However, some patients still perceived their doctor as the authoritative source of information about medicines. Patients' accounts indicated that much of the information provided by the pharmacist was new, raising the issue of what information was routinely being provided by pharmacists.

Conclusions
Brown bag reviews were regarded by patients as beneficial and they wanted them to be available in the future. Patients' perceptions of pharmacists as health professionals and providers of information on medicines were enhanced by brown bag reviews.
Postal surveys — a view from the other side
Authors: Tully Mary P , Cantrill Judith A 
Published: February 2011

Abstract

Objectives
To explore the reasons why elderly people with arthritis choose to participate in a reliability study conducted by postal survey, and their views of the process of taking part.

Methods
Twenty elderly people suffering from arthritis were interviewed in depth. They were chosen on the basis of how they had completed postal questionnaires about their arthritis, on two separate occasions to assess reliability, two weeks apart. Interviews were taped, with permission, and transcribed verbatim. Content analysis of the interview data, and any telephone calls, comments or letters received from all survey recipients, was conducted using NUD-IST.

Key findings
Many respondents thought that such surveys only involved the worst sufferers and that anyone else was “a fraud”. Part of the motivation for individuals to participate was the desire to help the researcher, others with arthritis or, for some respondents, themselves. The details of the questionnaires were used by the respondents as clues to develop their theories of the survey's purpose. There was commonly a failure to perceive the need to complete the questionnaires twice, regardless of whether there had been a change in their health. Some respondents did not see the point of the second questionnaires, some apologised for their unchanged health, and others actively sought to find further information to put into the second set.

Conclusion
These results have implications for researchers, by identifying the range of detail required by potential survey respondents to reduce response bias. If the purpose of the survey is not clearly communicated, participants will impose their own, probably different, interpretation, with unexpected consequences.
Skin conditions in the pharmacy: consumer satisfaction and economic considerations
Authors: Plunkett Anne , Lau Phyllis , Stewart Kay , Marks Robin 
Published: February 2011

Abstract

Objective
To evaluate whether consumers were satisfied with advice about skin conditions received from community pharmacists in Victoria, Australia, and to estimate costs and potential savings to the consumer and government associated with managing these conditions in the pharmacy.

Methods
In 1997–1998, a consumer survey on costs and satisfaction was carried out in Victoria as part of a statewide education programme with community pharmacists. Pharmacists recorded details of dermatological consultations involving over-the-counter (OTC) products, and recruited pharmacy consumers for follow-up by a member of the research team.

Results
Consumer consultations were recorded at 126 pharmacies. One hundred and five (58.0 per cent) of the 181 consumers who were subsequently interviewed reported being very satisfied with their consultation. One hundred and thirty-two (73.0 per cent) spent up to 10 minutes consulting the pharmacist and 78 (43.1 per cent) spent between $A5 (£1.95) and $A10 on OTC products. A total of 37 consumers (20.4 per cent) consulted a medical practitioner on the advice of their pharmacist. While most of the 37 consumers spent under $A10 in the pharmacy, if the cost of medical consultation and the subsidised nature of items supplied on medical prescription were taken into account, the costs to the consumer and government would have been greater. The direct costs for a pharmacist consultation on the management of skin conditions were lower than the expected direct costs associated with a general practitioner (GP) consultation.

Conclusions
Consumers were satisfied with the advice and treatment they received from the pharmacist on the management of skin conditions. Pharmacists' advice also appeared to be cost-effective for both the consumer and government. Community pharmacists appear to be satisfactory primary providers of advice and treatment for people with minor skin conditions.
Occurrence of potential drug-drug interactions in nursing home residents
Authors: van Dijk K N , de Vries C S , van den Berg P B , Brouwers J R B J , De Van den Berg L T W Jong 
Published: February 2011

Abstract

Objective
It has been suggested that elderly people are at increased risk of drug-related problems such as drug-induced adverse effects, drug-drug interactions and drug-disease interactions. This is particularly the case for nursing home residents because of the often complicated and multiple co-morbidity that occurs in these people. The aim of this study was to develop prescribing indicators to assess systematically the occurrence and nature of potential drug-drug interactions (DDIs) in a cohort of Dutch nursing home residents.

Method
The study was conducted in residents aged 65 years and over in six nursing homes (n=2,355, two-year study period). Computerised medication data for the residents were evaluated with respect to co-prescribing of potentially interacting drugs. All DDIs that were classified as clinically relevant according to the Dutch National Drug Interaction Database were studied. DDIs were classified into three categories according to their pharmacological mechanism: 1 — pharmacokinetic interactions at the level of gastrointestinal (GI) absorption; 2 — pharmacokinetic interactions at the level of metabolism and excretion; and 3 — pharmacodynamic interactions.

Key findings
Thirty-two per cent (n=748) of all residents were exposed to one or more combinations of drugs that could lead to clinically adverse outcomes. The numbers of residents who received drug combinations with a mechanism of interaction from category 1, 2 or 3 were 73 (3 per cent), 164 (7 per cent) and 612 (26 per cent) respectively. The number of medications prescribed was significantly associated with the occurrence of a potential DDI (P&lt;0.05). Drugs most frequently involved were oral anticoagulants, antibiotics and theophylline.

Conclusion
During the two-year study period, about one-third of the residents were exposed to at least one drug interaction considered clinically relevant. Adequate surveillance systems are needed to enable better identification of these interactions with a view to preventing potential clinical problems. Using the prescribing indicators developed in this study, such surveillance could focus on detection and clinical aspects of potential DDIs and possible alternative treatments.
“In the eye of the beholder”: pharmacy students have more positive perceptions of medicines than students of other disciplines
Authors: Horne Robert , Frost Susie , Hankins Matthew , Wright Siobhan 
Published: February 2011

Abstract

Objective
Exploratory study to examine whether pharmacy students differ significantly from students on other courses in their beliefs about medicines.

Method
Questionnaire study assessing beliefs about medicines in general and perceptions of personal sensitivity to the potential adverse effects of medication.

Setting
Undergraduate students sampled from each academic year of five degree courses. Five hundred and seventy completed questionnaires were analysed.

Key findings
The findings indicated significant differences between students on the basis of their chosen course. Pharmacy students were significantly more likely than engineering, accountancy, social policy, and humanities students to believe that medicines in general are beneficial, and were significantly less likely to perceive medicines as potentially harmful. Humanities students were more likely than most other groups to believe that medicines are over-prescribed by doctors. The observed relationship between course and medication beliefs remained statistically significant when controlling for ethnic background, experience of taking prescribed medication, and year of study. A further analysis revealed no significant effect of year of course on medication beliefs, and no significant interaction between course and year of study.

Conclusion
The findings suggest that students' attitudes were formed before they arrived at university, rather than being “shaped” by the course over a three-year period. The implications of these findings for patient-pharmacist communication are discussed.
Older persons' opinions about, and sources of, prescription drug information
Authors: Thompson Sally , Stewart Kay 
Published: February 2011

Abstract

Objectives
(1) To explore older persons' opinions about their receipt of prescription drug information from general practitioners (GPs) and pharmacists, (2) to determine the information older persons wish to know about their prescription medication and the information sources they use, (3) to determine the opinions of older persons about prescription medication labels and patient information leaflets, and (4) to determine any significant differences between those aged 65–74 years and those aged 75 years and over.

Method
Data were gathered via 204 detailed in-home interviews completed between March,1993, and November, 1995. Respondents were identified through GPs.

Setting
The study was conducted in Melbourne, Australia.

Key findings
The vast majority of respondents liked to receive verbal counselling from GPs and pharmacists about their prescription medication and the majority were willing to share responsibility for receiving that information. However, a small minority of patients seemed to receive little information from GPs and pharmacists about their prescription medication and had no real perception of a need for information. As might be expected, the item of information most desired by respondents was when and how to use the medication (89 per cent). This was followed by the condition for which the medication was prescribed (76 per cent) and side effects (72 per cent). For 90 per cent of respondents GPs were their greatest prescription drug information source; pharmacists featured highly as a secondary source (57 per cent of respondents). Almost all respondents (92 per cent) thought that the information pharmacists printed on prescription medication labels was adequate although numerous suggestions were advanced for label improvement. Seventy-six per cent of respondents were of the opinion that, when receiving a prescription medication that was new to them, an information leaflet written for the consumer about that medication would be helpful. The 75 and over age group were less enthusiastic about receiving such leaflets than the 65–74 age group (P=0.015).

Conclusion
Education programmes aimed at improving the quality use of medicines in Australia still need to encourage older persons to actively seek, and health professionals to volunteer, prescription drug information. Patient information leaflets are well accepted by older persons; however, it is important that the information be adequately explained.
European barriers to the implementation of pharmaceutical care
Authors: van Mil J W F , de Boer W O , Tromp T H F J 
Published: February 2011

Abstract

Objective
To establish the perceived barriers to the implementation of pharmaceutical care into community pharmacy practice in different European countries and the relative importance of these barriers.

Method
Structured interviews with representatives from national pharmacists' organisations or pharmaceutical care researchers from 11 European countries known to be actively attempting to implement pharmaceutical care. Respondents were asked to consider a list of 25 potential barriers to pharmaceutical care and to score the relative importance of each for their own country. Data were analysed to produce a European overview of barriers as well as inter-country comparisons.

Key findings
Lack of time and lack of money are major barriers for the implementation of pharmaceutical care in European countries. Many other barriers were identified, but their impact on the implementation of pharmaceutical care seems to differ markedly over Europe. No correlation was found between money and time as barriers. Some clusters of countries were identified with similar barrier patterns.

Conclusion
Time and money are perceived to be major both in absolute and relative rankings. The European pharmaceutical associations need to pay attention to remuneration issues before attempting to implement pharmaceutical care in their countries. The results also show that pharmaceutical organisations need to work continuously to change attitudes among pharmacists. Important barriers have also been identified in the educational domain and changes in the European curriculae for pharmacy are therefore needed. Co-operation between some countries on these issues would appear to be useful.
Haemodialysis patients' beliefs about treatment: implications for adherence to medication and fluid-diet restrictions
Authors: Horne Robert , Sumner Sian , Jubraj Barry , Weinman John , Frost Susie 
Published: February 2011

Abstract

Objectives
To assess haemodialysis patients' beliefs about treatment and to investigate which beliefs correlate with adherence to medication and fluid-diet restrictions.

Methods
Forty-seven haemodialysis patients receiving intermittent hospital haemodialysis completed questionnaires assessing their beliefs about medication and fluid-diet restrictions.

Key findings
Adherence rates varied between and within patients, and were related to specific treatment beliefs in a logically consistent way. Reported intentional non-adherence to medication correlated with concerns about the potential adverse effects of renal medication. Low adherence to fluid-diet restrictions (assessed by inter-dialysis weight gain) was associated with the personal belief that the restrictions were too strict. Most patients (90 per cent) agreed that medicines prescribed for their renal condition were necessary for maintaining health. However, 32 per cent harboured concerns about their medication, arising from beliefs about the potential for dependence, long-term effects, or disruption of life. Concerns about renal medication correlated with more general beliefs that medicines as a whole are harmful, addictive poisons which are overused by doctors. Although specific treatment beliefs (medication or fluid-diet restrictions) were related to specific adherence behaviours, these two areas of beliefs and behaviours were unrelated.

Conclusions
Patients' perceptions of treatment merit further study. Eliciting and addressing patients' perceptions of treatment may be a target for pharmaceutical care and a foundation for partnership in medicine-taking.
Shared care in the UK: failings of the past and lessons for the future
Authors: Duggan C , Beavon N , Bates I , Patel S 
Published: February 2011

Abstract

Aims
To explore and evaluate the implementation of shared care in the UK, to identify failings and to make recommendations for successful implementation of shared care in the future.

Methods
The study utilised a triangulation approach, employing three different methods to explore the production and format of shared care protocols (SCPs) and the perceived use and future trends of shared care. A postal survey of hospital pharmacists and pharmaceutical and medical advisers in health authorities and interviews with health care professionals provided insight into perceptions of shared care and recommendations for the future. A content analysis of a sample of SCPs in current use assessed the utility of SCPs in practice.

Results
A total of 321 SCPs were identified that described 99 different drugs and treatments. The protocols varied considerably with no apparent standard either within or between regions, but there was a correlation between the patient-related information available, information across the health care interface (r=0.355, P=0.05) and pharmaceutical information (r=0.401, P=0.05). There were expressions of uncertainty about the benefit of such protocols to patients. Health authority staff in particular expressed predominantly negative attitudes in the questionnaire whereas the pharmacists were more positive. The transfer of prescribing and associated costs from hospital to community (described as “cost shifting”) was repeatedly identified as a barrier, together with competing professional interests and reluctance to change with the times. General practitioners (GPs) were most commonly excluded from the production of SCPs, which may enforce negative feelings around implementation of SCPs across the health care interface. Improved information technology and better use of evidence-based guidelines and protocols were seen as ways forward in developing shared care.

Conclusions
Since 1991, a large number of SCPs have been produced in the UK but the benefits to patients are not clear. There is a general perception of cynicism about their use; “cost-shifting” is perceived as their main purpose. There appears to have been no formal evaluation of their use or mechanisms for their implementation, and distribution has been erratic. This study highlights that, with greater involvement of health care professionals, better communication systems and the removal of identified barriers, shared care is a concept essential in the evolving NHS.