Misuse of over the counter medicines in community pharmacies in Scotland

The general public are taking more responsibility for their health, using community pharmacy as a source to access medication. There are a reported increase and change in the misuse of OTC medication from community pharmacies in Scotland (Wright et al, 2015). This article was designed to examine the self-reported use of medication from a small sample of community pharmacies in Scotland. The questionnaire gathered patient demographics and details of medicines used. The study concentrated on two treatment areas, opioid analgesics, and sedative antihistamines licensed as a sleep aid. Both previously identified as the most prevalent OTC medications that were perceived to being misused (Matheson et al, 2007). Data were collected over a short time period in 2015 from 15 community pharmacies. The data demonstrate the widespread misuse of OTC. The most prevalent group identified as females, 41–60 years old and employed. It was most commonly reported that the recommended treatment duration is exceeded rather than the maximum recommended daily dose. The recommendations from the article are that there needs to be greater awareness for pharmacists, pharmacy staff, and general public on the potential dangers of misusing OTC medications and the importance of adhering to the recommended dosing and duration guidelines

Piloting the United Kingdon 'Prescribing Safety Assessment' with pharmacist prescribers in Scotland.

Background: Prescribing is a complex task requiring considerable knowledge and skills. The Prescribing Safety Assessment (PSA) was developed by the British Pharmacological Society and the United Kingdom (UK) Medical Schools Council. Between February and June 2014, over 7000 final year medical students undertook the PSA, with an overall pass rate of 94%. Independent prescribing for suitably trained pharmacists was introduced in the UK in 2006. To date there has been little focus on any objective measures of prescribing safety. Objective: To determine the PSA performance of a pilot group of pharmacist prescribers in Scotland relative to medical students and to test the feasibility and acceptability of running the PSA. Methods: A group of 59 pharmacist prescribers took part in ten events. The PSA consisted of 30 questions to be completed over 60 min. All questions had been used in the 2014 assessments for final year medical students. The PSA was undertaken online under invigilated conditions, mirroring the medical student assessment. One month later, participants were invited to complete an online evaluation questionnaire. Results: The mean overall PSA scores (±SD) were 87.5% ± 8.7 (range 52–98) compared to a 88.5% for medical students. Based on an Angoff passmark of 76.0%, 53 pharmacists (89.8%) passed compared to an overall pass rate in PSA 2014 of 94%. Pharmacists performed equivalently to medical students in all assessment areas, with a slightly lower performance in the prescribing, drug monitoring and data interpretation questions offset by better performance in prescription review and adverse drug reactions. Feedback was positive in relation to appropriateness, relevance and level of difficulty of the PSA although several commented that they were practicing in very specific clinical areas. Conclusion: These pilot events have benchmarked the PSA performance of pharmacist prescribers with final year medical students, and feedback confirmed feasibility and acceptability

Adherence to medication guideline criteria in cancer pain management

The medication-assessment tool for cancer pain management (MAT-CP) is a novel tool for measuring the quality of drug use in chronic pain management in relation to guideline standards. MAT-CP has recently been revised and validated for use in the U.K. clinical setting. This article presents a measure of the adherence of current practice to specific cancer pain guideline criteria in two palliative care settings. Adult patients with malignant disease experiencing pain and/or receiving analgesics were identified by clinical pharmacists at two hospitals and five hospices in Scotland, United Kingdom. The MAT-CP was applied to data extracted from case notes. Results were quantified in terms of applicability and adherence to guideline criteria and the presence of insufficient data. MAT-CP was applied to 192 cancer patients experiencing pain; 103 (54%) were males and the mean (standard deviation) age was 68.5 (13.0) years. Overall guideline adherence was 75% (confidence interval [CI]: 74%, 77%; n=3460 applicable criteria). Low adherence (75%). Overall adherences for 56 (29%) hospitalized patients and 136 (71%) hospice patients were 65% (CI: 62%, 68%) and 79% (CI: 78%, 81%), respectively. Although good overall guideline adherence was found, there were gaps in both the hospice and hospital palliative care settings in the implementation of certain treatment recommendations, particularly in relation to pain assessment. The application of the tool has highlighted issues for feedback to health care providers and for further study

A medication assessment tool to evaluate adherence to medication guideline criteria in cancer pain management

The medication assessment tool for cancer pain management (MAT-CP) is a novel tool for measuring quality of drug use in chronic pain management in relation to guideline standards, and has been developed and tested in Norway with UK collaboration. The present paper describes the revision of the assessment tool for use in the UK, and its subsequent validation. Setting Three hospitals and one hospice in Scotland, UK. The MAT-CP was field-tested to produce preliminary data on its applicability in a UK clinical setting. The tool was then modified by peer review among clinical specialists before and after a pilot. The revised tool was further validated by wider application to a study sample of cancer inpatients. The outcome was the evaluation of the tool's utility in relation to clinical documentation in terms of applicability, clarity, reliability and perceived relevance of each criterion. The findings also included a quantification of adherence to the guideline criteria. The revised tool comprised 37 criteria covering six different aspects of cancer pain management. The field testing and pilot informed the modification of the MAT-CP to optimise its clarity and utility when applied to patients' clinical documentation. The revised tool was tested on 101 cancer patients experiencing pain (56 males), mean (standard deviation) age 68.9 (13.5) years. Overall guideline adherence was 68% (n = 1850 applicable criteria). Good inter-rater reliability (Cohen's kappa κ = 0.92) was demonstrated in the application. The preliminary application of the tool during validation and field-testing has highlighted several issues for further study. A clinical tool to examine prescribing in cancer pain management that was designed for use in Norway has been revised for use in UK clinical settings. Reliability, face and content validity have been informed by applying the tool to patient data in clinical settings