How was patient empowerment portrayed in information leaflets describing the community pharmacy Medicines Use Review service in the UK?

2010 ◽  
Vol 80 (2) ◽  
pp. 274-276 ◽  
Author(s):  
Melandi van den Berg ◽  
Parastou Donyai
2018 ◽  
Vol 103 (2) ◽  
pp. e2.49-e2
Author(s):  
Jeff Aston

AimTo identify the experiences of community pharmacists in caring for children/young people, or their parents/carers, taking long-term medicines.MethodA pre-piloted 13 point semi-structured survey, participant information leaflet, consent form and pre-paid return envelope were posted to all 354 community pharmacists who had dispensed a prescription from a single specialist paediatric hospital during November and December 2015. Community pharmacy addresses were obtained from the National Health Service Business Services Authority ePACT system. Telephone follow-up of non-responders and, if necessary, a repeat mailing was made from 3 weeks after the original return by date.Participants were asked about their experiences of undertaking a medication review with either children/young people or their parents/carers, medication-related problems presenting to them, adherence, information needs of patients/carers and what issues were reported to them from this group.The data were analysed using SPSS version 22 and NVivo version 10.ResultsA response rate of 76/354 (21.5%) was achieved. Eighteen (23.7%) respondents had undertaken a Medicines Use Review (MUR),122 (28.9%) a New Medicines Service (NMS)2 review and 16 (21.1%) had undertaken another type of medication review in a child/young person. Respondents reported that patients or their carers had presented to them with adherence issues including stopping the medicine (24, 31.6%) and changing the dose (28, 36.8%) without informing the prescriber. Patients or their carers had requested information from them about the indication (59, 77.6%), dose regime (63, 82.9%), administration (64, 84.2%) and adverse effects (58, 76.6%). Respondents also reported patients/carers experiencing difficulties obtaining further supplies of a medicine from their community pharmacy (47, 61.8%) and patients’ general practitioners declining to prescribe a medicine recommended by the patient’s hospital-based specialist (27, 35.5%).ConclusionThis study has demonstrated that children, and their carers, taking long-term medicines experience a range of issues that they present to community pharmacists. Many of these issues would fall within the purview of currently funded medication review services namely the NMS and MUR.1,2 However, the proportion of pharmacists in this study undertaking formal medication review with children or their parents/carers was low. Further work is required to demonstrate the outcomes that such a review could have in this cohort of patients.ReferencesPharmaceutical Services Negotiating Committee. MURs: The basics. What is the medicines use review and prescription intervention service? [Internet] 2016. Available from: MURs: The basics http://psnc.org.uk/services-commissioning/advanced-services/murs/murs-the-basics/ [Available: 19 May 2016].Pharmaceutical Services Negotiating Committee. New Medicines Service (NMS) [Internet] 2016. http://psnc.org.uk/services-commissioning/advanced-services/nms/ [Available: 19 May 2016].


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Urška Nabergoj Makovec ◽  
Igor Locatelli ◽  
Mitja Kos

Abstract Background Based on several existing patient-oriented activities, Medicines Use Review (MUR) service was standardized and officially adopted in Slovenia in 2015. Service aims to provide adherence support and ensure safe and effective medicines use. Therefore, the aim of the study was to evaluate the benefits of MUR in Slovenia, primarily the impact on medication adherence. Methods A randomised controlled trial was performed in community pharmacies to compare MUR with standard care. Patients were randomised into either the test (patients received MUR by a certified MUR provider at visit 1), or control group. The study primary outcome was self-reported adherence to multiple medications, assessed by electronic ©Morisky Widget MMAS-8 Software at the first visit (V1) and after 12 weeks (V2). A sub-analysis of intentional and unintentional non-adherence was performed. MUR impact was defined as the relative difference in ©MMAS-8 score after 12 weeks between the test and control group. A multiple linear regression model was used to predict MUR impact based on baseline adherence (low versus medium and high). Several secondary outcomes (e.g. evaluation of drug-related problems (DRPs)) were also assessed. Results Data from 153 (V1) and 140 (V2) patients were analysed. Baseline adherence was low, moderate and high in 17.6, 48.4 and 34.0% patients, respectively. In the low adherence subpopulation, test group patients showed a 1.20 point (95% CI = 0.16–2.25) increase in total ©MMAS-8 score (p = 0.025) compared to control group patients. A 0.84 point (95% CI = 0.05–1.63) increase was due to intentional non-adherence (p = 0.038), and a 0.36 point (95% CI = − 0.23-0.95) was due to unintentional non-adherence (p = 0.226). Additionally, statistically significant decrease in the proportion of patients with manifested DRPs (p < 0.001) and concerns regarding chronic medicines use (p = 0.029) were revealed. Conclusion MUR service in Slovenia improves low medication adherence and is effective in addressing DRPs and concerns regarding chronic medicines use. Trial registration ClinicalTrials.gov - NCT04417400; 4th June 2020; retrospectively registered.


2022 ◽  
Vol 6 ◽  
Author(s):  
Gill Green

Powerlessness generally denotes loss of control and may be experienced among those with a terminal diagnosis and, as such, empowerment is a dominant discourse in end-of-life policy in the western Anglo-Saxon world. This paper analyzes thematically blogs authored by three people with a terminal diagnosis to examine the “power to be oneself,” a concept which was identified in the “Ethics of Powerlessness” project conducted in the UK. The analysis demonstrates that the bloggers assert the “power to be themselves” which is expressed in three principal ways. Firstly, through assertion of agency to promote self-affirmation and control. Secondly, through claiming a “moral authority” expressed by providing advice not just on illness and death but also on how life should be lived. Thirdly, through discussing ideas about the future and creating a legacy. The blogs are a mechanism used to express and reinforce self-identity and to carve out a “sacred space” between life and death to nurture personal change and to project this onto a public arena. This analysis demonstrates the key role patient empowerment plays in constructing an identity with a terminal diagnosis, an element that is often overlooked in end-of-life policy.


BMJ Open ◽  
2020 ◽  
Vol 10 (9) ◽  
pp. e037994
Author(s):  
Lydia O'Sullivan ◽  
Prasanth Sukumar ◽  
Rachel Crowley ◽  
Eilish McAuliffe ◽  
Peter Doran

ObjectivesThe first aim of this study was to quantify the difficulty level of clinical research Patient Information Leaflets/Informed Consent Forms (PILs/ICFs) using validated and widely used readability criteria which provide a broad assessment of written communication. The second aim was to compare these findings with best practice guidelines.DesignRetrospective, quantitative analysis of clinical research PILs/ICFs provided by academic institutions, pharmaceutical companies and investigators.SettingPILs/ICFs which had received Research Ethics Committee approval in the last 5 years were collected from Ireland and the UK.InterventionNot applicable.Main outcome measuresPILs/ICFs were evaluated against seven validated readability criteria (Flesch Reading Ease, Flesh Kincaid Grade Level, Simplified Measure of Gobbledegook, Gunning Fog, Fry, Raygor and New Dale Chall). The documents were also scored according to two health literacy-based criteria: the Clear Communication Index (CCI) and the Suitability Assessment of Materials tool. Finally, the documents were assessed for compliance with six best practice metrics from literacy agencies.ResultsA total of 176 PILs were collected, of which 154 were evaluable. None of the PILs/ICFs had the mean reading age of <12 years recommended by the American Medical Association. 7.1% of PILs/ICFs were evaluated as ‘Plain English’, 40.3%: ‘Fairly Difficult’, 51.3%: ‘Difficult’ and 1.3%: ‘Very Difficult’. No PILs/ICFs achieved a CCI >90. Only two documents complied with all six best practice literacy metrics.ConclusionsWhen assessed against both traditional readability criteria and health literacy-based tools, the PILs/ICFs in this study are inappropriately complex. There is also evidence of poor compliance with guidelines produced by literacy agencies. These data clearly evidence the need for improved documentation to underpin the consent process.


2019 ◽  
Vol 104 (7) ◽  
pp. e2.56-e2
Author(s):  
Anna Kinsella ◽  
J Delaney ◽  
◽  

AimPatient information leaflets (PILs) have been a legal requirement in the UK for all medicines for almost 20 years. However, as many of the drugs used in children with cancer are unlicensed or used outside the terms of their licence ‘off- label’, information provided by the manufacturer does not always tell parents/patients everything they need to know about the use of the medicine in children and young people. In 2014, a survey conducted by the Children’s Cancer and Leukaemia Group (CCLG) revealed 92% of parents wanted more drug specific information. The aim of this piece of work was to address these information needs through the development of standardised drug specific factsheets for children and young people with cancer.MethodsInformation was collated on the availability of paediatric drug specific PIL’s at primary treatment centres (PTC’s) in the UK and Ireland. The CLLG and members of the Paediatric Oncology Pharmacists (POP) group worked together in reviewing and comparing a selection of PIL’s already available, in addition to agreeing a standardised format and outline of headings for proposed factsheets. Drafts were produced for 10 of the most common oral chemotherapy drugs used in children. These were reviewed for content, language, punctuation, grammar and structure by a wide range of end users, such as parents of children on treatment, parents of children whose treatment had finished, clinical nurse educators, paediatric oncology/haematology consultants, clinical nurse specialists, ward managers and different members of the POP group. Feedback and comments were collated. Proposed changes suggested were either actioned or reasons for not actioning documented on a change log. This process repeated until a final version was agreed.ResultsOf the 12 PTC’s, 5 had their own oral chemotherapy PIL’s, with the range of leaflets available varying across these five centres. Only 1 PTC had their own intravenous (IV) chemotherapy PIL’s. Information provided varied from centre to centre with drug information also provided from treatment protocols, the Macmillan website or from the manufacturers summary of product characteristics (SPC). Factsheets for the following oral chemotherapy drugs have been produced; chlorambucil, cyclophosphamide, dexamethasone, etoposide, imatinib, lomustine, mercaptopurine, methotrexate, procarbazine and temozolomide. A factsheet on the ‘safe handling of oral chemotherapy’ was developed alongside these to further support parents in managing their child’s oral chemotherapy safely at home.ConclusionUser engagement is paramount in producing information that is clear, accurate, up-to-date, easy to understand and practical. Factsheets are available to order/download free of charge providing equal access to all healthcare professionals, parents/carers and patients across the UK and Ireland, ensuring families are not disadvantaged by geographical treatment location. Current multimedia technology offers the benefit of increased and fast access to information; however, a further survey of families is required to establish whether parents drug information needs have been met though the availability of these factsheets.ReferencesStandardised IV chemotherapy factsheets and additional oral drug factsheets for dasatanib, hydroxycarbamide and isotretinoin are currently in development. MHRA Medicines and Healthcare Products Regulatory Authority (2012) Best practice guidance on patient information leaflets [Online]. Available from: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/328405/Best_practice_guidance_on_patient_information_leaflets.pdf (accessed 12 Jun 2018)Shinfield, C. Chief Information Officer. Children’s Cancer and Leukaemia Group. Personal communication. 25thNovember 2015


BMJ Open ◽  
2019 ◽  
Vol 9 (1) ◽  
pp. e026710 ◽  
Author(s):  
Corine Rollema ◽  
Eric M van Roon ◽  
Anne GM Schilder ◽  
Tjalling W de Vries

ObjectivesIn this study, we analysed patient information leaflets (PILs) of intranasal corticosteroid sprays (INCS) of different manufacturers in the UK to determine if instructions for the use of INCS are complete and uniform.SettingPILs of all INCS of all manufacturers, available for patients in the UK, were collected from the British National Formulary website and the Medicines and Healthcare products Regulatory Agency website. All instructions in these PILs were analysed.ParticipantsWe identified PILs of INCS from 21 different manufacturers, available for patients in the UK.ResultsWe analysed the instructions for the use of INCS in 21 different PILs and there is large variation in the PIL instructions for the technique of using INCS across PILs.ConclusionComplete and uniform instructions for the use of INCS are lacking in PILs for registered preparations in the UK. Structured and standardised instructions to be used by both professionals and patients are essential in order to optimise daily use of INCS.


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