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McNULTY, HOWARD, LYNDON BRADDICK, CAROL WATT, PAMELA SHEARIN e ALAN MITCHELL. "Developing clinical pharmacy services to prisoners in Scotland". International Journal of Pharmacy Practice 9, S1 (setembro de 2001): 51. http://dx.doi.org/10.1111/j.2042-7174.2001.tb01111.x.
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Boag, Lee, Katie Maclure, Anne Boyter, Scott Cunningham, Gazala Akram, Harry McQuillan e Derek Stewart. "Public perceptions and experiences of the minor ailment service in community pharmacy in Scotland". Pharmacy Practice 19, n.º 1 (12 de fevereiro de 2021): 2152. http://dx.doi.org/10.18549/pharmpract.2021.1.2152.
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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.
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Douglas, Elizabeth, Ailsa Power e Steve Hudson. "Pharmaceutical care of the patient with diabetes mellitus: pharmacists' priorities for services and educational needs in Scotland". International Journal of Pharmacy Practice 15, n.º 1 (março de 2007): 47–52. http://dx.doi.org/10.1211/ijpp.15.1.0008.
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Gidman, Wendy, e Ross Coomber. "Contested space in the pharmacy: Public attitudes to pharmacy harm reduction services in the West of Scotland". Research in Social and Administrative Pharmacy 10, n.º 3 (maio de 2014): 576–87. http://dx.doi.org/10.1016/j.sapharm.2013.07.006.
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Gale, A., e M. C. Watson. "The provision of current and future sexual health services from community pharmacies in Grampian, Scotland". International Journal of Clinical Pharmacy 33, n.º 2 (28 de janeiro de 2011): 183–90. http://dx.doi.org/10.1007/s11096-010-9458-x.
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Preston, Kate, Natalie M. Weir, Tanja Mueller, Rosemary Newham e Marion Bennie. "Implementation of pharmacist-led services in primary care: A mixed-methods exploration of pharmacists’ perceptions of a national educational resource package". Pharmacy Practice 19, n.º 3 (13 de setembro de 2021): 2440. http://dx.doi.org/10.18549/pharmpract.2021.3.2440.
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Background: To help alleviate the global pressure on primary care, there has been an increase in the number of clinical pharmacists within primary care. Educational resources are necessary to support this workforce and their development within this role. An educational resource package was developed in Scotland to support the General Practice Clinical Pharmacists (GPCPs), containing a hard copy Competency and Capability Framework (CCF), an online platform (TURAS) and both clinical and educational supervisors in 2016.
Objective: To examine the implementation of a competency-based educational resource package through the exploration of pharmacists’ perceptions of its adoption, acceptability, appropriateness, and feasibility.
Methods: Participants were GPCPs who had been part of a national training event between 2016 and 2018. The participants were given the opportunity to complete an online questionnaire or a semi-structured telephone interview. Both data collection tools were based on Proctor’s model of implementation outcomes: adoption, acceptability, appropriateness and feasibility. Areas covered included GPCPs’ perceptions and level of adoption of the educational resource package developed to support them in their role.
Results: Of a potential 164 participants, 52 (31.7%) completed the questionnaire and 12 (7.3%) completed the interview. GPCPs indicated widespread adoption and were accepting of the resources; however, it was suggested that its value was undermined, as it was not associated with a qualification. The appropriateness and feasibility of the resources depended on GPCPs’ individual situation (including current role, previous job experience, time available, support received from peers and supervisors, and perceptions of resources available).
Conclusions: The suitability of the CCF was evidenced by participants’ adoption and acceptance of the resource, indicating the necessity of a competence-based framework to support the GPCPs’ role. However, its suitability was hindered in terms of varied perceptions of appropriateness and feasibility. Despite the limited sample size, the results indicate that the value of these resources should be promoted across primary care; nevertheless further facilitation is required to allow GPCPs to fully engage with the resources.
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Mueller, T., K. Preston, N. M. Weir, R. Newham e M. Bennie. "Pharmacists in primary care in Scotland: an exploration of competencies required for the provision of pharmacy services within general practice". International Journal of Pharmacy Practice 30, Supplement_1 (1 de abril de 2022): i31—i32. http://dx.doi.org/10.1093/ijpp/riac019.043.
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Abstract Introduction Efforts are increasingly being made to implement pharmacists working in General Practice to support General Practitioners and alleviate pressure, mainly by providing pharmacotherapy services such as medication reviews and authorising prescribing requests (1). While there is wide interest in the contributions pharmacists can make within primary care, there is limited research exploring the competencies pharmacists need to safely and effectively provide care in this area. Aim The aim of this project was to identify competencies required for pharmacists providing pharmacotherapy services in General Practice. Methods Modified eDelphi study (2), comprising a series of online questionnaires conducted between July 2019 and January 2020. Participants were pharmacists working in General Practice in Scotland. The first questionnaire consisted of open-ended questions aimed at generating a list of competencies; competency categories and individual competency items relating to pharmacotherapy service tasks were identified based on the free text responses using content analysis. Subsequently, the second questionnaire aimed to establish consensus regarding the importance of the collected competencies, using a rating scale from 1 (“not important”) to 10 (“very important”); participants’ scores were aggregated using modes and medians, and the level of agreement among participants with regards to the importance of competencies was evaluated by calculating the percentage of scores between 8 and 10. Due to the novelty of this work and the resultant uncertainty surrounding participants’ responses, no cut-off point for agreement was pre-specified. Results Overall, 10 pharmacists completed the first questionnaire, and 11 completed the second. Building on the findings from the first questionnaire, a framework of competencies necessary to provide pharmacotherapy services in General Practice was developed, comprising eight competency categories, with a total of 31 individual competency items: General Skills (e.g. ability to record patient information); IT Skills (e.g. ability to use GP computer system to update documentation); Legal & Professional Frameworks (e.g. understanding of clinical guidelines); Procedural Skills (e.g. ability to arrange follow-up); Multidisciplinary Team Communication Skills (e.g. ability to communicate with others within the GP practice); Consultation Skills (e.g. ability to take a complete history); Clinical Knowledge (e.g. knowledge related to conditions being treated); and Clinical Skills (e.g. ability to interpret clinical information). All eight competency categories were considered important across the pharmacotherapy service, with high agreement (between 71 and 85%) among participants. Conclusion Using a bottom-up, exploratory approach, this study confirmed that practicing within the General Practice setting requires a wide set of competencies, including – but not limited to – advanced clinical and consultation skills. Nevertheless, findings should be interpreted cautiously due to the limited sample size; although results have tentatively been validated using a paper-based version of the second online questionnaire during an in-person event with General Practice pharmacists, results might not be reflective of all pharmacists working in this setting. References (1) Scottish Government. (2017). The 2018 General Medical Services Contract in Scotland. Retrieved from https://www.glasgowlmc.co.uk/download/contract%20and%20contractural%20Issues/The-2018-General-Medical-Services-Contract-in-Scotland.pdf (2) Hsu, C. C., & Sandford, B. A. (2007). The Delphi technique: Making sense of consensus. Practical Assessment, Research & Evaluation, 12, Article10. https://doi.org/10.7275/pdz9-th90
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Morral, Kim, e Jordi Morral. "The mental health literacy of British community pharmacists". Journal of Mental Health Training, Education and Practice 12, n.º 2 (13 de março de 2017): 98–110. http://dx.doi.org/10.1108/jmhtep-12-2015-0054.
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Purpose The purpose of this paper is to examine the mental health literacy (MHL) of British community pharmacists. Design/methodology/approach A survey instrument was sent by facsimile to a random sample of community pharmacists in England, Scotland and Wales. The survey instrument contained items concerning recognition of the symptoms of depression, bipolar disorder or schizophrenia, the helpfulness of a range of interventions, mental health stigma and the degree of comfort providing pharmaceutical care to people with mental health problems. Findings Among community pharmacists (n=329) symptom recognition was high for depression but lower for bipolar disorder and schizophrenia. Pharmacists showed a preference for evidence-based interventions and support for psychological therapies and physical activity for all three mental health problems. Pharmacists expressed less comfort providing pharmacy services to people with bipolar disorder, schizophrenia and depression than cardiovascular disease. Mental health stigma was higher for schizophrenia and bipolar disorder than depression, with many pharmacists holding misperceptions about schizophrenia and bipolar disorder. Practical implications The study findings indicate the need for enhanced mental health content in the undergraduate pharmacy curriculum which should challenge misperceptions of mental illness. Originality/value This is the first study to investigate the MHL of British community pharmacists.
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Wickens, H. J., S. Simpson, A. Pope e J. Allen. "Pharmacy and Genomic Medicine: A UK-wide survey of pharmacy staff assessing their prior education, confidence and educational needs". International Journal of Pharmacy Practice 31, Supplement_2 (30 de novembro de 2023): ii53. http://dx.doi.org/10.1093/ijpp/riad074.066.
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Abstract Introduction Pharmacy teams are key in helping patients to get the most from genomic medicine.1,2 However, genomics has only recently been included in undergraduate curricula, and it has been suggested that all healthcare professionals could benefit from education in pharmacogenomics2. We surveyed pharmacy staff to gather information on previous education, current practice and future educational needs in genomics and pharmacogenomics. Aim This survey aimed to establish existing levels of education and confidence in genomics and pharmacogenomics in pharmacy staff working in any role, in any sector, across the UK, and to investigate respondents’ preferences in delivery of genomic education. Methods The survey was based on a 2021 survey of genomic knowledge among medical staff by Health Education England (HEE)3, and amended to reflect pharmacy roles and practice following discussion with pharmacy leads from the 7 NHS Genomic Medicine Service Alliances in England, and from Scotland, Wales and Northern Ireland. SmartSurvey software was used to host the survey, with data held securely. The survey was open between 1st March and 16th May 2022, and was publicised via pharmacy groups including the Royal Pharmaceutical Society, National Pharmacy Association, Local Pharmaceutical Committees, chief pharmacists networks in primary and secondary care, and social media. This work was assessed using the NHS Health Research Authority Research screening tool and judged as ‘not research’; therefore ethical approval was not required. Results 1,552 responses were received from pharmacists, pharmacy technicians, dispensers and other pharmacy staff across the UK; 68% of responses were from England, 13% from Scotland, 10% from Northern Ireland and 9% from Wales. The majority of responses (69%) were from Pharmacists, with 24% from Pharmacy Technicians and 4% from Pharmacy support workers. Only 13% of respondents had received any formal training in genomics. Most respondents felt unprepared to use genomic testing in their practice; just 8% of pharmacists (including trainees), and 1% of pharmacy technicians (including trainees) felt prepared. However, 65% of respondents thought that genomics would change their practice within the next 5 years, and over 70% of pharmacists, and 56% of pharmacy technicians, could envisage ordering, advising on, or counselling patients on genomic testing in the future after appropriate training. 29% of respondents (mainly pharmacy managers) did not currently see patients and therefore might not train personally in genomics. Discussion/Conclusion This work suggests that pharmacy teams are likely to require educational support to embrace the opportunities of genomic medicine. High survey engagement suggested that respondents were keen to make their voices heard. Pharmacists appeared more confident in their ability to advise patients on genomics than Technicians, however both groups seemed keen to receive training. One limitation is that respondents were likely interested in genomics; those with no interest may not have completed the survey. Additionally, pharmacy managers who do not see patients might not train personally in genomics, but may influence strategy for pharmacy genomics service development and delivery. National bodies should capitalise on enthusiasm across the sector to help drive pharmacy genomics services forward through education and training. References 1. Royal College of Physicians and British Pharmacological Society. Personalised prescribing: using pharmacogenomics to improve patient outcomes. Report of a working party. London: RCP and BPS, 2022. https://www.rcp.ac.uk/projects/outputs/personalised-prescribing-using-pharmacogenomics-improve-patient-outcomes last accessed 1/6/23 2. Royal Pharmaceutical Society. Collaborative Position statement for Pharmacy professionals and Genomic Medicine. London: RPS, 2023 https://www.rpharms.com/development/pharmacogenomics/genomic-statement last accessed 1/6/23 3. Health Education England. Genomics in your practice: a health and social care survey. Birmingham, Health Education England, 2023 https://www.genomicseducation.hee.nhs.uk/documents/genomics-in-your-practice-a-health-and-social-care-survey/ last accessed 1/6/23
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Rapado, R., A. L. Prior e D. H. James. "Public perceptions of the role of community pharmacy in public health". International Journal of Pharmacy Practice 30, Supplement_1 (1 de abril de 2022): i36. http://dx.doi.org/10.1093/ijpp/riac019.050.
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Abstract Introduction Community pharmacies are well-placed to provide public health interventions, yet they are underutilised for services of this nature (1), which are needed to achieve public health policy goals. Previous qualitative studies have explored public perceptions of the role of community pharmacy in delivering public health services (2). However, to date, these views have not been captured quantitatively, which means it is not clear if the general public shares these views. Aim The aim was to design a questionnaire to obtain public perceptions of the role of community pharmacy in public health interventions and to establish any barriers and facilitators that exist regarding community pharmacy utilisation. Methods A questionnaire was developed based on published literature and semi-structured interviews. Following initial piloting of a paper-based then online format (by ten individuals) a 42-item questionnaire was completed digitally via Qualtrics by a self-selecting sample of the general public recruited through social media (i.e., Twitter, Instagram and Facebook) in May and June 2021. Principal component analysis with Varimax rotation was used to identify the underlying factors (scales) of the questionnaire. Cronbach’s alpha analysis was undertaken to ensure good internal consistency. Information on frequency of community pharmacy use and for what reason was collected. Content and thematic analysis were conducted on the free text qualitative comments. Content analysis was conducted first to observe which aspects of the questionnaire were mentioned the most. Further to this, thematic analysis was conducted as there were responses which did not fit into the content analysis. Results There were 306 valid questionnaire responses, where 235 (76.8%) were females. The mean age was 34.5 years (SD=15.09). Factor analysis identified four scales with a total of 18-items, all demonstrating good internal consistency. Scales were labelled as (n=number of items; ἀ =Cronbach’s alpha value): Expertise (n=3, ἀ =0.815); Role (n=4, ἀ =0.745); Privacy (n=3, ἀ =0.770) and Relationship (n=8, ἀ =0.862). Scale scores indicated that a lack of awareness of their role and expertise was a barrier and adequate privacy was an important facilitator in delivering public health services. In support of the quantitative findings, content analysis identified lack of privacy as a dominant theme, and further thematic analysis uncovered lack of knowledge of community pharmacy’s role in public health as an important barrier to uptake of services. Thematic analysis uncovered the themes ‘lack of knowledge of services’ and ‘accessibility’. Conclusion The outcome of this study was the development of a four scale, 18-item questionnaire to capture public perceptions of the community pharmacy’s role in public health. This can, therefore, be used in future studies aiming to explore public perceptions of community pharmacy. Strengths include being the first questionnaire to explore perceptions of community pharmacy. Weaknesses include the possibility of bias using social media in recruitment. This could be tackled using paper versions of the questionnaire in different settings. Further research is needed to continue testing the psychometric properties of the questionnaire with consideration given to the addition of a fifth scale to measure perceptions of Accessibility. References (1) Kember, J., Hodson, K., & James, D. H. (2018). The public’s perception of the role of community pharmacists in Wales. International Journal of Pharmacy Practice (26), 120-128. (2) Gidman, W., & Cowley, J. (2013). A qualitative exploration of opinions on the community pharmacists’ role amongst the general public in Scotland, International Journal of Pharmacy Practice, (21), 288-296.
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Thayer, N., S. White e M. Frisher. "Investigating the relationship between community pharmacy and GP Emergency Hormonal Contraception (EHC) provision: a linear regression analysis". International Journal of Pharmacy Practice 30, Supplement_1 (1 de abril de 2022): i36—i37. http://dx.doi.org/10.1093/ijpp/riac019.051.
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Abstract Introduction Emergency Hormonal Contraception (EHC) is contracted by Local Authorities to be provided free-of-charge from 46% of community pharmacies in England. (1) There is no difference in EHC consultation outcomes between community pharmacy and GP surgeries. A study in a rural area demonstrated that introduction of a community pharmacy EHC service can reduce GP EHC prescribing rates by approximately 41%, without influencing Family Planning Clinics or Accident and Emergency departments. (2) However, it is not known whether this relationship is universally present, and this relationship has not previously been quantified. Aim To describe the relationship between rates of GP EHC prescribing and commissioned community pharmacy EHC provision. Methods Freedom of Information (FOI) requests were submitted to all Local Authorities in England for numbers of EHC provisions through commissioned services between March 2019 and April 2020. The data were matched to Clinical Commissioning Group (CCG) GP prescribing data, obtained from openprescribing.net. Using population estimates from the Office of National Statistics, rates of supply per 10,000 female population (aged 12-55) were determined. The data indicated small numbers of outliers, which can distort linear regression; boxplots allowed the removal of data points outside 1.5 times the Inter Quartile Range from the 1st or 3rd quarter. Using SPSS v24, linear regressions were calculated between GP prescribing rates and community pharmacy EHC provision rates. This was repeated for community pharmacy EHC provision rates and the proportion of commissioned pharmacies. Results There were 147 Local Authority commissioners identified across England, 113 (76.9%) responded to the FOI request. Of these, 5 did not commission EHC services from community pharmacy. Local Authority and CCG boundaries were compared, 86 areas were identified as ‘co-terminus’ (i.e., greater than 95% overlap). These 86 areas included 82,822 GP prescriptions and 207,731 community pharmacy provisions. The data reflected an estimated female population aged 12-55 of 9,380,153 (Local Authority mean 109,072, SD 83,899), 60% of the total English female (12-55) population. Removing outliers left 92.5% of the data for analysis. The mean GP prescribing rate was 79.3/10,000 (SD 26.3) and the mean community pharmacy provision rate was 200.2/10,000 (SD 154.9). Linear regression indicated a negative correlation between GP prescribing rates and community pharmacy provision rates (R2=0.21) and a positive correlation between community pharmacy provision rates and the proportion of commissioned pharmacies (R2=0.21). Conclusion This study shows that increasing the community pharmacy provision rate by 100/10,000 decreases the GP prescribing rate by 8/10,000. Increasing the proportion of commissioned pharmacies to 100%, through a national service may change GP prescribing rates. This regression analysis predicts this would decrease the GP EHC prescribing rate by 15% to 66.3/10,000. Whilst this data is not fully representative of commissioning in England, this single commissioning change could move 20,706 GP consultations to community pharmacy annually across England. Comparisons with Wales and Scotland (who have national services) suggest this impact could potentially even be doubled. The strength of this study is it’s use of routine data facilitating replication, however local commissioning arrangements mean the conclusions are not necessarily applicable beyond England. References (1) Mackridge AJ, Gray NJ, Krska J. A cross-sectional study using freedom of information requests to evaluate variation in local authority commissioning of community pharmacy public health services in England. BMJ Open. 2017;7(7):e015511 (2) Lloyd K, Gale E. Provision of emergency hormonal contraception through community pharmacies in a rural area. J Fam Plann Reprod Health Care. 2005;31(4):297-300.
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Gangannagaripalli, J., L. McIver, N. Abutheraa, R. Brewster, D. Dixon e M. Watson. "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". International Journal of Pharmacy Practice 30, Supplement_1 (1 de abril de 2022): i7—i8. http://dx.doi.org/10.1093/ijpp/riac021.010.
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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 >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 (> 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.
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Brush, A., M. Lloyd e R. Mullen. "A mixed methods evaluation of the appropriateness of hospital on-call pharmacy service use". International Journal of Pharmacy Practice 32, Supplement_1 (1 de abril de 2024): i45—i46. http://dx.doi.org/10.1093/ijpp/riae013.057.
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Abstract Introduction Most English hospitals provide out-of-hours pharmacy support via an ‘on-call pharmacist’.[1] There is scant published literature characterising these services. Prior research[2] suggests a significant number of calls may be inappropriate requests for non-urgent medication or information readily available elsewhere. Delaying while the on-call pharmacist is unnecessarily contacted may avoidably compromise patient care. Handling inappropriate calls may decrease pharmacist job satisfaction and compromise rest between shifts. Dissatisfaction with the on-call commitment is regularly raised at local departmental meetings and exit interviews. Servicing such calls is not sustainable. Aim To explore and quantify appropriateness of calls to the on-call pharmacy service at a single, large, acute English hospital, and to explore the influencing factors behind any inappropriate calls using a theoretically informed approach. Methods A retrospective review of existing on-call records quantified and characterised service use in 2021. Missed calls, callers who did not want the on-call pharmacist and internal pharmacy handovers were excluded. As per previous work, calls were considered inappropriate where an available resource would have provided a complete solution/answer at the caller’s level.[2] Service users were invited to semi-structured interviews via email to explore their capability, opportunity, and motivation to handle pharmaceutical issues. Interviews were conducted and recorded on Microsoft Teams before being transcribed and analysed using a framework based on the COM-B model of behaviour. Quantitative data were analysed in Excel and SPSS v27. Pearson’s chi-square test of independence was calculated for several pre-defined variables with p<0.05 considered significant Results There were 1139 calls in 2021, with 32 meeting exclusion criteria. Of the 1107 remaining, 410 (37%) were inappropriate and 697 (63%) appropriate. Eighty-one (20%) inappropriate calls occurred overnight (22:00-08:30). Almost 90 hours were spent on inappropriate calls, generating £3,144.96 in additional overtime payments to pharmacists. Appropriateness was found to be significantly higher on weekdays (66%) versus weekends (58%), p=0.008, from surgical wards (67%) versus medical wards (58%), p = 0.042 and from doctors (74%) versus nurses (54%), p<0.001. All respondents (five doctors) were interviewed. Analysis found limited training and familiarisation led to low awareness of available resources. Access was often restricted by a cumbersome Trust intranet rather than lack of time. Participants were highly motivated to resolve issues themselves, believing this to be best practice. Conclusion The high proportion, high volume and high cost of inappropriate calls warrants further investigation and intervention. Unfortunately, no nurses responded to interview invitations; this is a significant limitation as nurses were more likely to place inappropriate calls. Future work should consider how nurses can be recruited more effectively. However, analysis of calls combined with elucidation of doctors’ behavioural determinants makes it possible to propose informed interventions. Doctors would benefit from improved awareness of/ability to use resources and improved access to them. Therefore, a searchable electronic “signpost” highlighting resources relevant to common on-call queries is proposed. This would leverage the doctors’ high motivation and the rich data collected in a sustainable, evidence-based intervention designed around service user needs. References 1. Cheeseman MP, Rutter P. On-call hospital pharmacy services in NHS England: service provision and documentation of medicines advice calls. European Journal of Hospital Pharmacy. 2016;23(1):11-5. 2. Dunn J. On-call hospital pharmacy services: a perspective from NHS Tayside, Scotland. European Journal of Hospital Pharmacy. 2018;25(2):72-8.
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Dunn, John. "On-call hospital pharmacy services: a perspective from NHS Tayside, Scotland". European Journal of Hospital Pharmacy 25, n.º 2 (11 de janeiro de 2017): 72–78. http://dx.doi.org/10.1136/ejhpharm-2016-001138.
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Duncan, Edward, Kay Cooper, Julie Cowie, Lyndsay Alexander, Jacqui Morris e Jenny Preston. "A national survey of community rehabilitation service provision for people with long Covid in Scotland". F1000Research 9 (26 de março de 2021): 1416. http://dx.doi.org/10.12688/f1000research.27894.2.
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Background: Over 50 million cases of COVID-19 have been confirmed globally as of November 2020. Evidence is rapidly emerging on the epidemiology of COVID-19, and its impact on individuals and potential burden on health services and society. Between 10–35% of people with COVID-19 may experience post-acute long Covid. This currently equates to between 8,129 and 28,453 people in Scotland. Some of these people will require rehabilitation to support their recovery. Currently, we do not know how to optimally configure community rehabilitation services for people with long Covid. Methods: This national survey aimed to provide a detailed description of current community rehabilitation provision for people with long Covid in Scotland. We developed, piloted, and conducted a national electronic survey of current community rehabilitation service provision for people presenting with long Covid symptomatology. Our sample were the Allied Health Professions Directors of all 14 territorial NHS Health Boards in Scotland. Fixed response and narrative data were analysed descriptively. Results: Responses were received from all respondents (14/14), enabling a national picture to be gained. Almost all Health Boards (13/14) currently deliver rehabilitation for people with long Covid within pre-existing services. Fatigue (11/14) and respiratory conditions (9/14) were the two most common presenting problems of patients. Most long Covid community rehabilitation services are delivered through a combination of face-to-face and digital contact (13/14). Conclusions: Community rehabilitation for people with long Covid is an emerging reality. This survey provides a national picture of current community rehabilitation for people with long Covid. We do not know how community rehabilitation can be optimally delivered for this population. This is vital as community rehabilitation services were already under pressure prior to the emergence of COVID-19. Further research is urgently required to investigate the implementation, outcomes and cost-effectiveness of differing models of community rehabilitation for this patient population.
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McKeague, Peter. "The whole is other than the sum of its parts: the untapped potential of spatial data from archaeological fieldwork". F1000Research 12 (30 de janeiro de 2023): 112. http://dx.doi.org/10.12688/f1000research.126361.1.
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Spatial data is fundamental to documenting our past, underpinning research questions and informing the decisions we – and others – take in the protection, understanding and stewardship of the historic environment. Investing in organising and sharing spatial data typically delivers a benefit to cost ratio of up to sixteen times the outlay. In contrast, existing practices are saturated with inefficiency. Even if the spatial data reaches an archive, it can be hard to find, access and use. It is often in the wrong format and incompatible with similar data from different projects. Through the European Union Infrastructure for Spatial Information in Europe (INSPIRE) Directive curators of protected sites data (scheduled monuments, listed buildings etc.) are required to publish metadata, view and download services. In contrast to these ‘curated’ datasets there is neither the mandate, nor the mechanisms to coordinate, curate and share, data created through archaeological fieldwork and research. The degree of standardisation in documenting fieldwork recording and archival deposition varies considerably, posing challenges to the reuse of data. Both are key factors in not realising the potential of ‘collated data’ from multiple sources. The opportunities to develop a consistent approach for making greater use of data routinely created through fieldwork and research are explored using case studies from Scotland. Despite the obvious benefits of developing a consistent approach to spatial data from fieldwork, the framework, standards, specifications, guidance and infrastructure to realise that potential are absent. Archaeological data can and should contribute to delivering wider societal benefits, including environmental monitoring, digital twins and climate change. To contribute meaningfully to these and other societal challenges, archaeological data needs to be accessible and consistent.
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Mair, Alpana, Eleftheria Antoniadou, Anne Hendry e Branko Gabrovec. "Appropriate polypharmacy: a barometer for integrated care". Journal of Integrated Care ahead-of-print, ahead-of-print (18 de dezembro de 2020). http://dx.doi.org/10.1108/jica-04-2020-0019.
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PurposePolypharmacy, the concurrent use of multiple medicines by one individual, is a common and growing challenge driven by an ageing population and the growing number of people living longer with chronic conditions. Up to 11% of unplanned hospital admissions in the UK are attributable to, mostly avoidable, harm from medicines. However, this topic is not yet central to integrated practice. This paper reviews the challenge that polypharmacy presents to the health and care system and offers lessons for integrated policy and practice.Design/methodology/approachTwo commonly encountered scenarios illustrate the relevance of addressing inappropriate polypharmacy to integrated practice. An overview of the literature on polypharmacy and frailty, including two recent large studies of policy and practice in Europe, identifies lessons for practitioners, managers, policy makers and commissioners.FindingsComprehensive change strategies should extend beyond pharmacist led deprescribing initiatives. An inter-professional and systems thinking approach is required, so all members of the integrated team can play their part in realising the value of holistic prescribing, appropriate polypharmacy and shared decision making.Practical implicationsAwareness and education about polypharmacy should be embedded in inter-professional training for all practitioners who care for people with multimorbidity or frailty.Originality/valueThis paper will help policy makers, commissioners, managers and practitioners understand the value of addressing polypharmacy within their integrated services. Best practice national guidance developed in Scotland illustrates how to target resources so those at greatest risk of harm from polypharmacy can benefit from effective pharmaceutical care as part of holistic integrated care.
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Hayden, Anders, e Clay Dasilva. "The wellbeing economy: Possibilities and limits in bringing sufficiency from the margins into the mainstream". Frontiers in Sustainability 3 (10 de outubro de 2022). http://dx.doi.org/10.3389/frsus.2022.966876.
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The idea of sufficiency faces great obstacles in contemporary political economies in which production and consumption growth has long been considered imperative. Despite evidence supporting calls for a sufficiency-oriented, post-growth approach to environmental challenges, only pro-growth environmental perspectives have found significant mainstream political support until now. However, one recent formulation that has a strong affinity with a sufficiency approach—a wellbeing economy—has found growing support among mainstream political actors including governments and international organizations. Does the growing support for a wellbeing economy represent the long-sought breakthrough for a sufficiency-oriented, post-growth environmental approach? To help answer this question, we conduct case studies of New Zealand, Scotland, and Iceland—the three founders of the Wellbeing Economy Governments (WEGo). These nations have (to varying degrees) taken steps to downplay the centrality of economic growth and instead highlight wellbeing as the ultimate goal. They have also moved “beyond GDP” by introducing new wellbeing measurements and using them in policymaking. However, movement in a post-growth direction is limited by continuing dependence on economic growth to achieve intermediate goals, such as employment creation and provision of welfare state services, that are closely associated with the goal of wellbeing. We therefore characterize the emerging practice of the wellbeing economy as a “weak post-growth” approach. To become a “strong post-growth” perspective, it needs to be linked to a much more challenging project of disentangling contemporary societies' dependence on economic growth. The article includes a discussion of ways that WEGo nations could contribute to addressing that considerable challenge and build on the sufficiency-oriented elements evident in the wellbeing economy.
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Thrimawithana, Thilini R., Meredith Spence, Madison Lee, Nancy Naysoe, Shereen Hanna, Ghaith Yako, Stan Goma, Ieva Stupans e Chiao Xin Lim. "The role of pharmacist in community palliative care—a scoping review". International Journal of Pharmacy Practice, 8 de abril de 2024. http://dx.doi.org/10.1093/ijpp/riae015.
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Abstract Objectives Dynamic and adaptive services that provide timely access to care are pivotal to ensuring patients with palliative needs experience high-quality care. Patients who have palliative care needs may require symptomatic relief with medicines and, therefore, may engage with community pharmacists frequently. However, there is limited evidence for pharmacists’ involvement in community palliative care models. Therefore, a scoping review was conducted to identify pharmacists’ role in community palliative care. Methods A systematic search strategy was implemented across PubMed, PsychINFO, CINAHL, and Embase databases. Articles were screened by abstract and full text against inclusion and exclusion criteria. Key findings Five articles (two from Australia, two from England, and one from Scotland) met the inclusion criteria and described interventions involving pharmacists in community palliative care. This review has identified that the inclusion of trained pharmacists in community palliative care teams can improve the quality of care provided for patients with palliative needs. Pharmacists are able to undertake medication reviews and provide education to patients and other healthcare professionals on the quality use of palliative care medicines. Additionally, the underutilization of community pharmacists in palliative care, the need for further training of pharmacists, and improved community pharmacy access to patient information to deliver community palliative care were identified. Conclusion Pharmacists can play a vital role in community palliative care to enhance the quality of life of patients. There is a need for greater pharmacist education/training, improved interprofessional communication, improved access to patient information and sustainable funding to strengthen community-based palliative care.
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MacFarlane, Andrew David, Andrew Carruthers e John Dunn. "On-call pharmacy services: a perspective from the Royal Alexandra Hospital (NHS Greater Glasgow & Clyde) and comparison with NHS Tayside, Scotland". European Journal of Hospital Pharmacy, 29 de agosto de 2019, ejhpharm-2019-001938. http://dx.doi.org/10.1136/ejhpharm-2019-001938.
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