DMU research suggests better advice could help reduce hospital admissions and save lives

Better advice from pharmacy staff could help reduce hospital admissions and save lives, according to new research led by a De Montfort University Leicester (DMU) expert.

Dr Peter Rivers, Reader in Pharmacy Practice at DMU, is the lead author on a new study which has surveyed more than 1,000 pharmacy users in an East Midlands city.

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Researchers approached people who had just left a pharmacy after collecting prescription medication. They were asked whether, apart from checking the name address on the prescription, someone in the pharmacy had given information or advice about the medicine they collected. 

The survey of 29 community pharmacies – a collaborative piece of work by DMU and the University of Leeds - found that less than one third were given any advice at all.

Currently, tax payers in England pay £2 billion each year to provide a dispensing service and £90,000 over four years to train a new trainee pharmacist.

The study found that in some pharmacies just over one in 10 people were given advice whereas in others there were seven in 10.

People who collected prescriptions in the morning were more likely to receive advice compared with those who visited a pharmacy in the afternoon.

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Community pharmacist and lecturer, Theo Ansong, said in response to the study: “We need to create a professional health care environment in community pharmacies where it is normal practice for pharmacy staff and patients to talk, in private, about prescription medicines”.

“The sheer volume of prescriptions is one reason why we are not always able to spend quality time with patients. We should take another look at the skill-mix and roles within pharmacies to see how pharmacy technicians and assistants could assist with the dispensing process. This would help to free up time for pharmacists to concentrate upon the advisory side of our work”.

Dr Rivers said: “It’s a shame because pharmacy staff are often not able, within the constraints of the current system, to find time to provide prescription advice that they have been trained, over five years, to provide.

“Currently, we do not know enough about how pharmacy staff decide when someone needs advice and when they do not. More research is needed to better understand the working environment within community pharmacies – the motivating factors and the barriers that influence advice-giving when medicines are dispensed”

“Apart from being an extortionate waste of money on training and fees, lack of advice may be putting people’s health at risk.

“Based upon the latest estimates, 800,000 of the 16.25 million admissions to hospital in England in 2015/16 were caused by the avoidable adverse effects of medicines. 

“Recent research indicates that between 0.15% of all adverse drug reactions are fatal which suggests that about 1,200 deaths occur in England each year due to the unintended consequences of taking prescription medication.”

From the patient’s perspective, Nick Hartshorne-Evans, Chief Executive Officer of the heart failure charity Pumping Marvellous Foundation, said: “I don’t think the public fully understand the role that pharmacy staff can play as health care professionals – if staff communicated more with patients, I think their value within the NHS would be more apparent.”

Dr. David Branford, an independent pharmacy advisor and immediate past Chair of the English Pharmacy Board said in response to the study: “The need for community pharmacists to be more ‘patient focused’ has been recognised for many years - so the findings from this survey are a wake-up call for the pharmaceutical profession to create a more consultative environment within community pharmacies so that the provision of information and advice becomes the norm, rather than the exception, and is fully embedded within the prescription dispensing service”.

Professor Sir Munir Pirmohamed, Director of the Medical Research Council’s Centre for Drug Safety Sciences at the University of Liverpool said: “There is a need for community pharmacists to be much more involved in discussing, with service users, the therapeutic and potential adverse effects of prescription medicines so that harm, resulting in undesirable and costly admission to hospital, can be avoided.

“Community pharmacists are an important part of the multi-disciplinary healthcare team.”

Access the full paper here.

Posted on Wednesday 17th May 2017

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