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  1. Article: Public perceptions and experiences of the minor ailment service in community pharmacy in Scotland.

    Boag, Lee / Maclure, Katie / Boyter, Anne / Cunningham, Scott / Akram, Gazala / Mcquillan, Harry / Stewart, Derek

    Pharmacy practice

    2021  Volume 19, Issue 1, Page(s) 2152

    Abstract: Background: The Minor Ailment Service (MAS) in Scottish community pharmacy allows eligible people to gain improved access to care by providing free treatment for self-limiting conditions.: Objective: To determine the perceptions and experiences of ... ...

    Abstract Background: The Minor Ailment Service (MAS) in Scottish community pharmacy allows eligible people to gain improved access to care by providing free treatment for self-limiting conditions.
    Objective: To determine the perceptions and experiences of individuals using MAS and to quantify the potential impact on usage of other healthcare services.
    Methods: A cross-sectional survey was conducted of patients accessing MAS across Scotland during June and July 2018. Questionnaire items included reasons for choosing treatment through MAS, which other services they may have accessed had MAS not been available, experiences of consultation, overall satisfaction, and perceived effectiveness of treatment. Those accessing MAS were given a study pack including an information sheet, pre-piloted questionnaire, and pre-paid return envelope. Participants had the option to consent to an optional one-week follow up questionnaire that focused on perceived effectiveness of treatment after seven days and any further access to healthcare services such as general practice, emergency departments or repeat pharmacy visits.
    Results: There were 1,121 respondents to the initial questionnaire. Most reported 'convenient Location' as the main reason for their access to community pharmacy (n=748; 67.1%). If MAS had not been available, 59% (n=655) of participants reported that they would have accessed general practice for treatment of their minor ailment. Experience of consultations was also rated highly with all ten outcome measures scoring 'Excellent' overall. Satisfaction was reported positively with most participants reporting full satisfaction with the overall experience (n=960; 87.2%). At one-week follow up, 327 participants responded, over 85% (n=281) did not require further access to care to treat their minor ailment and 99.7% (n=326) said they would use MAS again.
    Conclusions: Positive perceptions and experiences of those using MAS demonstrate a highly regarded service in terms of satisfaction and experience of consultation. The capacity for MAS to impact on the use of higher-cost healthcare services is evidenced through the number of participants who reported these services as a point of access to care should community pharmacy not be available. This national evaluation demonstrates MAS to be a positively experienced service and outlines the factors determining access for treatment of minor ailments.
    Language English
    Publishing date 2021-02-12
    Publishing country Spain
    Document type Journal Article
    ZDB-ID 2414565-8
    ISSN 1886-3655 ; 1885-642X
    ISSN (online) 1886-3655
    ISSN 1885-642X
    DOI 10.18549/PharmPract.2021.1.2152
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article: An initial exploration of the perceptions of preparedness to practise among Saudi Arabian trained hospital pharmacists.

    Ameer, Luma / Maclure, Katie / Tonna, Antonella / Stewart, Derek

    Pharmacy practice

    2018  Volume 16, Issue 2, Page(s) 1192

    Abstract: Background: There is a dearth of literature on perceptions of preparedness to practise, which explores the extent to which educational institutions prepare their students to fulfil their professional role.: Objective: The aim of this study was to ... ...

    Abstract Background: There is a dearth of literature on perceptions of preparedness to practise, which explores the extent to which educational institutions prepare their students to fulfil their professional role.
    Objective: The aim of this study was to explore perceptions of preparedness to practise among Saudi Arabian pharmacy graduates working in hospital.
    Method: Face-to-face, semi-structured interviews were conducted with ten hospital pharmacists based in four hospitals in the Eastern Province of Saudi Arabia who had qualified within the last five years from a Saudi Arabian School of Pharmacy. Interviews focused on expectations of hospital practise, perceptions of preparedness and challenges encountered, and reflections on how to better prepare students. Interviews were audio-recorded, transcribed and analysed thematically by two independent researchers using the Framework Approach.
    Results: Five key themes were identified: expectations versus reality of practise; issues relating to university course; practice related training; adapting to the work environment; and proposed improvements to undergraduate education. Participants were generally disappointed to find practise was not as expected. University training was largely didactic, with skills such as critical thinking not being sufficiently developed. Where practice related training was provided, it was variable in length and content. Cultural issues, most notably working in a mixed sex environment, were also considered to impact preparedness. Suggested improvements included greater focus on skills development and structured training placements.
    Conclusions: Participants experiences in university, and experiential placements varied greatly and were perceived to impact greatly on preparedness to practise. Further multiple perspective exploration of perceptions of preparedness to practise is warranted.
    Language English
    Publishing date 2018-06-26
    Publishing country Spain
    Document type Journal Article
    ZDB-ID 2414565-8
    ISSN 1886-3655 ; 1885-642X
    ISSN (online) 1886-3655
    ISSN 1885-642X
    DOI 10.18549/PharmPract.2018.02.1192
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Non-medical prescribing versus medical prescribing for acute and chronic disease management in primary and secondary care.

    Weeks, Greg / George, Johnson / Maclure, Katie / Stewart, Derek

    The Cochrane database of systematic reviews

    2016  Volume 11, Page(s) CD011227

    Abstract: Background: A range of health workforce strategies are needed to address health service demands in low-, middle- and high-income countries. Non-medical prescribing involves nurses, pharmacists, allied health professionals, and physician assistants ... ...

    Abstract Background: A range of health workforce strategies are needed to address health service demands in low-, middle- and high-income countries. Non-medical prescribing involves nurses, pharmacists, allied health professionals, and physician assistants substituting for doctors in a prescribing role, and this is one approach to improve access to medicines.
    Objectives: To assess clinical, patient-reported, and resource use outcomes of non-medical prescribing for managing acute and chronic health conditions in primary and secondary care settings compared with medical prescribing (usual care).
    Search methods: We searched databases including CENTRAL, MEDLINE, Embase, and five other databases on 19 July 2016. We also searched the grey literature and handsearched bibliographies of relevant papers and publications.
    Selection criteria: Randomised controlled trials (RCTs), cluster-RCTs, controlled before-and-after (CBA) studies (with at least two intervention and two control sites) and interrupted time series analysis (with at least three observations before and after the intervention) comparing: 1. non-medical prescribing versus medical prescribing in acute care; 2. non-medical prescribing versus medical prescribing in chronic care; 3. non-medical prescribing versus medical prescribing in secondary care; 4 non-medical prescribing versus medical prescribing in primary care; 5. comparisons between different non-medical prescriber groups; and 6. non-medical healthcare providers with formal prescribing training versus those without formal prescribing training.
    Data collection and analysis: We used standard methodological procedures expected by Cochrane. Two review authors independently reviewed studies for inclusion, extracted data, and assessed study quality with discrepancies resolved by discussion. Two review authors independently assessed risk of bias for the included studies according to EPOC criteria. We undertook meta-analyses using the fixed-effect model where studies were examining the same treatment effect and to account for small sample sizes. We compared outcomes to a random-effects model where clinical or statistical heterogeneity existed.
    Main results: We included 46 studies (37,337 participants); non-medical prescribing was undertaken by nurses in 26 studies and pharmacists in 20 studies. In 45 studies non-medical prescribing as a component of care was compared with usual care medical prescribing. A further study compared nurse prescribing supported by guidelines with usual nurse prescribing care. No studies were found with non-medical prescribing being undertaken by other health professionals. The education requirement for non-medical prescribing varied with country and location.A meta-analysis of surrogate markers of chronic disease (systolic blood pressure, glycated haemoglobin, and low-density lipoprotein) showed positive intervention group effects. There was a moderate-certainty of evidence for studies of blood pressure at 12 months (mean difference (MD) -5.31 mmHg, 95% confidence interval (CI) -6.46 to -4.16; 12 studies, 4229 participants) and low-density lipoprotein (MD -0.21, 95% CI -0.29 to -0.14; 7 studies, 1469 participants); we downgraded the certainty of evidence from high due to considerations of serious inconsistency (considerable heterogeneity), multifaceted interventions, and variable prescribing autonomy. A high-certainty of evidence existed for comparative studies of glycated haemoglobin management at 12 months (MD -0.62, 95% CI -0.85 to -0.38; 6 studies, 775 participants). While there appeared little difference in medication adherence across studies, a meta-analysis of continuous outcome data from four studies showed an effect favouring patient adherence in the non-medical prescribing group (MD 0.15, 95% CI 0.00 to 0.30; 4 studies, 700 participants). We downgraded the certainty of evidence for adherence to moderate due to the serious risk of performance bias. While little difference was seen in patient-related adverse events between treatment groups, we downgraded the certainty of evidence to low due to indirectness, as the range of adverse events may not be related to the intervention and selective reporting failed to adequately report adverse events in many studies.Patients were generally satisfied with non-medical prescriber care (14 studies, 7514 participants). We downgraded the certainty of evidence from high to moderate due to indirectness, in that satisfaction with the prescribing component of care was only addressed in one study, and there was variability of satisfaction measures with little use of validated tools. A meta-analysis of health-related quality of life scores (SF-12 and SF-36) found a difference favouring usual care for the physical component score (MD 1.17, 95% CI 0.16 to 2.17), but not the mental component score (MD 0.58, 95% CI -0.40 to 1.55). However, the quality of life measurement may more appropriately reflect composite care rather than the prescribing component of care, and for this reason we downgraded the certainty of evidence to moderate due to indirectness of the measure of effect. A wide variety of resource use measures were reported across studies with little difference between groups for hospitalisations, emergency department visits, and outpatient visits. In the majority of studies reporting medication use, non-medical prescribers prescribed more drugs, intensified drug doses, and used a greater variety of drugs compared to usual care medical prescribers.The risk of bias across studies was generally low for selection bias (random sequence generation), detection bias (blinding of outcome assessment), attrition bias (incomplete outcome data), and reporting bias (selective reporting). There was an unclear risk of selection bias (allocation concealment) and for other biases. A high risk of performance bias (blinding of participants and personnel) existed.
    Authors' conclusions: The findings suggest that non-medical prescribers, practising with varying but high levels of prescribing autonomy, in a range of settings, were as effective as usual care medical prescribers. Non-medical prescribers can deliver comparable outcomes for systolic blood pressure, glycated haemoglobin, low-density lipoprotein, medication adherence, patient satisfaction, and health-related quality of life. It was difficult to determine the impact of non-medical prescribing compared to medical prescribing for adverse events and resource use outcomes due to the inconsistency and variability in reporting across studies. Future efforts should be directed towards more rigorous studies that can clearly identify the clinical, patient-reported, resource use, and economic outcomes of non-medical prescribing, in both high-income and low-income countries.
    MeSH term(s) Acute Disease/therapy ; Blood Pressure ; Chronic Disease/drug therapy ; Developed Countries ; Developing Countries ; Diabetes Mellitus/drug therapy ; Drug Prescriptions/standards ; Glycated Hemoglobin/analysis ; Humans ; Interrupted Time Series Analysis ; Lipoproteins, LDL/blood ; Medication Adherence ; Patient Satisfaction ; Pharmacists ; Practice Patterns, Nurses' ; Professional Autonomy ; Quality of Life ; Randomized Controlled Trials as Topic
    Chemical Substances Glycated Hemoglobin A ; Lipoproteins, LDL
    Language English
    Publishing date 2016-11-22
    Publishing country England
    Document type Journal Article ; Meta-Analysis ; Research Support, Non-U.S. Gov't ; Review ; Systematic Review
    ISSN 1469-493X
    ISSN (online) 1469-493X
    DOI 10.1002/14651858.CD011227.pub2
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: A cross-sectional survey of the pharmacy workforce in general practice in Scotland.

    Stewart, Derek / Maclure, Katie / Newham, Rosemary / Gibson-Smith, Kathrine / Bruce, Rachel / Cunningham, Scott / Maclure, Andrew / Fry, Sarah / Mackerrow, James / Bennie, Marion

    Family practice

    2019  Volume 37, Issue 2, Page(s) 206–212

    Abstract: Background: In Scotland, there has been significant investment in pharmacy teams in general medical practices over recent years, aligned to current government policy.: Objectives: To characterize the national pharmacy workforce including activities ... ...

    Abstract Background: In Scotland, there has been significant investment in pharmacy teams in general medical practices over recent years, aligned to current government policy.
    Objectives: To characterize the national pharmacy workforce including activities undertaken, perceived competence and confidence, as well as perception of integration of the intervention.
    Methods: A cross-sectional survey of all pharmacists and pharmacy technicians in general practices. Survey items were demographics, activities undertaken and experiences. The NoMAD tool (Improving the Normalization of Complex Interventions) was included as a measure of perspectives of implementation. Post-piloting, a questionnaire link was sent to all pharmacists (n = 471) and pharmacy technicians (n = 112). A total NoMAD score was obtained by assigning 1 (strongly disagree) to 5 (strongly agree) to each item.
    Results: Responses were received from 393 (83.4%) pharmacists and 101 (91.8%) pharmacy technicians. Three quarters of pharmacists (74.6%) and pharmacy technicians (73.3%) had been qualified for over 10 years. Two-thirds of pharmacists (68.4%) were independent prescribers, with three quarters (72.3%) currently prescribing. Respondents worked in a median of two practices and were providing a range of activities including medication/polypharmacy reviews, medicines reconciliation, prescribing efficiencies and training. Respondents reported high levels of competence and confidence (median 8, scale 0-10 highest). Median NoMAD total score (scale 20-100 highest, Cronbach's alpha 0.89) was 80 for pharmacists and 75 for pharmacy technicians, P ≤ 0.001.
    Conclusions: The general practice pharmacy workforce in Scotland is experienced, well-qualified and integrated within general practices, delivering a range of activities. These findings have implications for workforce planning and future education and training.
    MeSH term(s) Adult ; Cross-Sectional Studies ; Female ; General Practice/organization & administration ; General Practice/statistics & numerical data ; Humans ; Male ; Middle Aged ; Pharmacists/statistics & numerical data ; Pharmacy Technicians/statistics & numerical data ; Scotland ; Surveys and Questionnaires ; Workforce/statistics & numerical data
    Language English
    Publishing date 2019-09-17
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 605939-9
    ISSN 1460-2229 ; 0263-2136
    ISSN (online) 1460-2229
    ISSN 0263-2136
    DOI 10.1093/fampra/cmz052
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    In stock of ZB MED Cologne/Königswinter

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  5. Article ; Online: Pharmacist prescribing in primary care: the views of patients across Great Britain who had experienced the service.

    Stewart, Derek C / Maclure, Katie / Bond, Christine M / Cunningham, Scott / Diack, Lesley / George, Johnson / McCaig, Dorothy J

    The International journal of pharmacy practice

    2011  Volume 19, Issue 5, Page(s) 328–332

    Abstract: OBJECTIVE  To evaluate the views of patients across primary care settings in Great Britain who had experienced pharmacist prescribing. METHODS  All Royal Pharmaceutical Society of Great Britain (RPSGB) prescribers (n = 1622) were invited to participate. ... ...

    Abstract OBJECTIVE  To evaluate the views of patients across primary care settings in Great Britain who had experienced pharmacist prescribing. METHODS  All Royal Pharmaceutical Society of Great Britain (RPSGB) prescribers (n = 1622) were invited to participate. Those consenting were asked to invite up to five consecutive patients who had experienced their prescribing to participate. Patients were mailed one questionnaire and a reminder. The questionnaire included five sections: demographics; you and your pharmacist prescriber; you and your general practitioner; your views and experiences based on your most recent pharmacist prescriber consultation; and additional views. KEY FINDINGS  Of the 482 (29.7%) pharmacists who responded, 92 (19.1%) were eligible to participate, of whom 49 (53.3%) consented. Of those excluded, 193 (49.5%) were prescribing in secondary care and 171 (43.8%) were not prescribing. Between September 2009 and March 2010, 143 patients were recruited. Patient response rate was 73.4% (n = 105/143). Consultation settings were largely general practice (85.7%) or community pharmacy (11.4%). Attitudes were overwhelmingly positive with the vast majority agreeing/strongly agreeing that they were totally satisfied with their consultation and confident that their pharmacist prescribed as safely as their general practitioner (GP). Pharmacists were considered approachable and thorough, and most would recommend consulting a pharmacist prescriber. A slightly smaller majority would prefer to consult their GP if they thought their condition was getting worse and a small minority felt that there had been insufficient privacy and time for all their queries to be answered. CONCLUSIONS  Patients were satisfied with, and confident in the skills of, pharmacist prescribers. However, the sample was small, may be biased and the findings lack generalisability.
    MeSH term(s) Adult ; Drug Prescriptions ; Female ; Humans ; Male ; Middle Aged ; Patient Satisfaction/statistics & numerical data ; Pharmacists/statistics & numerical data ; Primary Health Care/methods ; Professional Role ; Surveys and Questionnaires ; United Kingdom
    Language English
    Publishing date 2011-10
    Publishing country England
    Document type Journal Article
    ZDB-ID 1087040-4
    ISSN 2042-7174 ; 0961-7671
    ISSN (online) 2042-7174
    ISSN 0961-7671
    DOI 10.1111/j.2042-7174.2011.00130.x
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