The Health Services Research and Pharmacy Practice Conference (HSRPP) is taking place on the 12th and 13th April at Newcastle University. Pharmacy Research UK (PRUK) is delighted to showcase some of the new research that will be presented at the conference, which include projects that PRUK have funded. All the papers presented are published in the prestigious International Journal of Pharmacy Practice (IJPP).
“A mixed methods evaluation of factors impacting on the community pharmacist’s role in providing access to palliative medicines in Sheffield, UK: incorporating pharmacist, GP and other healthcare professional views” was led by Elizabeth Miller from the University of Bradford. The study aimed to determine factors impacting on the Community Pharmacist’s (CP) role in supporting access to palliative medicines (PM) through investigating the factors facilitating or hindering access and examining views of CPs and other community healthcare professionals. It employed a sequential mixed methods study, collecting anonymised prescription data from a sample of five community pharmacies in Sheffield followed by in-depth individual semi-structured interviews with 16 community healthcare professionals. The research found that attempts to increase CP’s involvement in palliative care lack clinical information and integration into primary care teams. It recommends that better integration and sharing of information between primary care teams will support timely access to treatments.
“Deprescribing practice at a UK teaching hospital: reactive or proactive?” is led by Sion Scott at Norfolk and Norwich University Hospital NHS Foundation Trust. Deprescribing is the process of identifying and discontinuing inappropriate medicines and has been associated with positive patient outcomes in certain circumstances. GPs endorse the idea of deprescribing medicines that might have adverse outcomes but have concerns over monitoring its effects due to the short amount of time allocated to patient appointments. Hospitals have been offered as an alternative, as they provide a place where patients are closely monitored, and specialist healthcare staff are available.
Sion’s study aims to describe the extent and nature of hospital deprescribing practice, through undertaking a retrospective analysis of Electronic Prescribing and Medicines Administration data at Norfolk and Norwich University Hospital. This evaluation demonstrates very limited deprescribing activity is taking place, with the proportion of inappropriate pre-admission medicines prescribed estimated at almost 30%. The research suggests that opportunities to deprescribe are potentially being missed, as there may be significant scope for increasing deprescribing activity in hospital as well as a role for hospital pharmacists to either facilitate or implement this. Nevertheless, the extent to which deprescibing is acceptable is still unknown and further research is prudent.
“Evaluating pharmacy interventions targeted to people affected by dementia: a systematic review of identified interventions to inform the development of a new community pharmacy tool” was led by Eleanor Dann-Reed from the University of East Anglia. The project aimed to design an evidence-based community pharmacy service through conducting a review of the literature to identify any existing services provided by pharmacists for those with dementia. To inform the design, the research team addressed the following objectives: describing the extent and nature of services provided through pharmacy, identifying elements that worked and those that didn’t and assessing the quality of evidence to inform decision making with respect to service design.
The review found that a new service will provide an alternative and highly accessible place for dementia sufferers to receive support for their diagnosis and a comprehensive medication review focussed on dementia medicines optimisation. It will also enable patients to speak to a specially trained pharmacist about specialised advice on their medicines and local dementia related services. For pharmacists, improved knowledge of local dementia support and difficulties associated with medicine can be achieved as well as awareness of those affected by dementia in the community and new relationships with other healthcare professionals. The results of this study rationalise the need for funding of larger and higher quality studies in this area, which could lead to a more effective and creditable service or tool being implemented nationwide.
“Managing medicines and the role of social networks following hospital discharge: qualitative insights from patients with chronic obstructive pulmonary disease (COPD)” was led by Tom Fegan at the University of Manchester, with Dr Ellen Schafheutle as the lead Author. The project aimed to explore the unique and individualised routines and medicines-taking behaviours of patients with COPD after discharge from hospital. It places focus on the role of patients’ social networks (e.g. family, friends, healthcare professionals) in enabling patients to take medicines. Qualitative interviews were conducted to generate in-depth accounts from patients discharged from an NHS Acute Adult Trust.
The research found that whilst participants’ social networks were small – where involved – they played significant roles in medication articulation. This appreciation will help pharmacists explore patient’s medicines taking behaviours and identify those social network members that are instrumental to medicines taking. With this additional insight, pharmacists will be able to consider how best to support their patients to optimise their medicines use.
“Patterns and indications for antipsychotic utilisation in older adults with intellectual disability: a cross sectional study” is being led by Maire O’Dwyer at the School of Pharmacy and Pharmaceutical Sciences, Trinity College Dublin. There are concerns within the medical community that antipsychotics are used inappropriately in adults with intellectual disabilities (ID) for behaviours with challenge (BWC) in the absence of diagnosed mental illness. The objectives of this project are therefore to determine the prevalence and patterns of antipsychotic use and antipsychotic polypharmacy among a nationally representative sample of older adults with ID in Ireland. The research aims to determine the reasons why antipsychotics are used, including whether they are prescribed for psychosis and psychotic conditions.
For pharmacists, this research highlights the pharmaceutical care challenges for providing care to adults with ID and the importance of medicines use reviews as part of multidisciplinary teams to prevent inappropriate use of antipsychotics and optimise medicine use. It is envisaged that for patients and carers, increased awareness of issues and risks associated with inappropriate use of antipsychotics in adults with ID will reduce inappropriate use.
Angela King, Interim CEO at Pharmacy Research UK said, “Once again, the HSRPP conference will showcase results from some of the best research in Health Services and Pharmacy Practice research but will also provide an invaluable opportunity for individuals wishing to become involved in research to network with established researchers. The knowledge gained and the stimulating dialogues that take place at the conference provide a lasting resource which delegates drawn on when they return to their places of work and study, thus spreading the impact of this important event. PRUK is especially pleased that Sion and Elizabeth are presenting findings from their PRUK funded projects.”