A national initiative to promote public involvement in medicine safety in Scotland: the use of a population survey to identify candidate behaviours for intervention development
Authors: Gangannagaripalli J , McIver L , Abutheraa N , Brewster R , Dixon D , Watson M 
Published: April 2022

Abstract

Introduction
Medicines are the most commonly used healthcare intervention (1). Every medicine has benefits and harms. One of the five objectives of the WHO Global Patient Safety campaign, Medication Without Harm, is to “empower patients, families and their carers to become actively involved and engaged in treatment or care decisions, ask questions, spot errors and effectively manage their medications” (2). Effective strategies are needed to promote greater public involvement in the safe and effective use of medicines.

Aim
The aim of this study was to explore the prevalence of public behaviour in terms of information-/advice-seeking about medicines in general, newly prescribed medicines, and pain management including their use of oral, over-the-counter (OTC) analgesics. The survey also included exploration of self-reported behaviour regarding their use of pharmacies and OTC analgesics.

Methods
A cross-sectional online survey of 1000 adults (aged &gt;16years) in Scotland was undertaken in collaboration with Ipsos MORI. The content was informed by a multi-stakeholder prioritisation event (held in November 2019) and supplemented with information from earlier studies, including national surveys using Citizen Panels. The following themes were included in the questionnaire:
The data were input online by respondents then cleaned and weighted by Ipsos Mori using random iterative method (RIM) weighting to the known offline population proportions for age, gender, region and working status. All data were analysed and presented using descriptive statistics.

Results
Most respondents (78%, n=777) had used a pharmacy in the previous 12 months to obtain a prescription medicine and slightly fewer (61%, n=610) to obtain an OTC medicine. Low levels of information- and advice-seeking were reported especially on receipt of new prescription medicines.
Few (5%) respondents ‘always’ discussed their new prescription medicine with pharmacy staff and 29% reported ‘never’ engaging in this behaviour. Older people (&gt; 35 years) were less likely to engage in this behaviour. Up to 65% of respondents reported ‘always’ engaging with specific aspects of the appropriate use of OTC analgesics e.g. appropriate dose.
Potentially unsafe behaviours were identified with medicine disposal. Nearly one third (29%) of respondents considered waste bin disposal to be of low or no harm, and 19% considered disposal of medicines via the toilet/sink to be of low/no harm.

Conclusion
Despite the extensive use of pharmacies, low levels of information-/advice-seeking were reported especially on receipt of new prescription medicines. Potentially unsafe behaviours were also identified with medicine use and disposal. The key determinants of these behaviours will be explored in more detail and theory-based interventions will be developed and tested to evaluate their effect.
Respondent opinion (positively or negatively) regarding their perceptions regarding community pharmacies and/or pharmacy personnel could have been influenced by the increased use and/or awareness of community pharmacy services due to the pandemic.

References
(1) National Institute for Health and Care Excellence. Medicines optimisation: the safe and effective use of medicines to enable the best possible outcomes. NICE Guidelines [NG5]. 2015. https://www.nice.org.uk/guidance/ng5 (accessed 13/10/2021).
(2) Medication without harm - Global patient safety challenge on medication safety. Geneva: World Health Organization, 2017. Licence: CCBY-NC-SA3.0IGO.