Exploring UK attitudes towards unlicensed medicines use: a questionnaire-based study of members of the general public and physicians

Alison ChisholmOmega Scientific, Yately, UKAims: To undertake a questionnaire-based study to evaluate attitudes towards the use of unlicensed medicines among prescribing doctors and members of the general public (ie, patients). The study also aimed to explore the factors that influence physicians' prescribing decisions and priorities, and to understand the knowledge of the medicines licensing system among members of the public.Methods: Novartis Pharmaceuticals UK Ltd funded the online interview of 500 members of the general public and 249 prescribing physicians. Best practice standards were followed for questionnaire-based studies; no specific treatments or conditions were mentioned or discussed.Results: Few of the participating physicians, only 14%, were very familiar with the UK General Medical Council (GMC) guidelines on the use of unlicensed medicines and just 17% felt very comfortable prescribing an unlicensed medication when a licensed alternative was available. Key physician concerns included the lack of safety data (76%), legal implications (76%), and safety monitoring associated with unlicensed medicine use (71%). Patients and physicians agreed that safety and efficacy are the most important prescribing considerations, although 48% of participating physicians were worried that budget pressures may increase pressure to prescribe unlicensed medications on the basis of cost. A high proportion of patients (81%) also indicated some degree of concern, were they to be prescribed an unlicensed medication when a licensed alternative was available specifically because it costs less.Conclusions: This UK-based questionnaire study suggests pervasive concerns among prescribers over the safety, monitoring, and legal implications of unlicensed prescribing. High levels of concern were expressed among patients and physicians if cost were to become an influential factor when making decisions between licensed and unlicensed medications.Keywords: patient, physician, unlicensed treatment, concern, safety, trus

Integrating evidence for managing asthma in patients who smoke

Peer reviewedPublisher PD

Real-world research and its importance in respiratory medicine

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A practical tool for primary care antimicrobial stewardship in children

Peer reviewedPublisher PD

‘Team ethnography visual maps’:Methods for identifying the ethnographic object in multiple sites of fieldwork

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Wild Data::How Frontline Hospital Staff Make Sense of Patients’ Experiences

Acknowledgements The authors would like to thank the ward teams and senior management teams at the six participating case study sites, as well as the US‐PEx team of investigators and lay panel members. All authors were employed by the Nuffield Department of Primary Care Health Sciences at the University of Oxford at the time of undertaking the research. The views expressed are those of the authors and do not necessarily reflect the views and opinions of the authors' institutions. This research was funded by the NIHR Health Services and Delivery Research Programme 14/156/06, with scholarship by CM supported in part by the Wellcome Trust through (grant number 209519/Z/17/Z). LL was supported by Oxford NIHR Biomedical Research Centre. The views expressed are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health and Social Care.Peer reviewedPublisher PD

'Team Capital’ in Quality Improvement Teams::Findings from an Ethnographic Study of Frontline Quality Improvement in the NHS

Acknowledgements: The authors would like to thank the ward teams and senior management teams at the six participating case study sites, as well as the US-PEx team of investigators and lay panel members. All authors were employed by the Nuffield Department of Primary Care Health Sciences at the University of Oxford at the time of undertaking the research. The views expressed are those of the authors and do not necessarily reflect the views and opinions of the authors' institutions. Funding: This research was funded by the NIHR Health Services and Delivery Research Programme 14/156/06, with scholarship by CM supported in part by the Wellcome Trust through grant number 209519/Z/17/Z. LL was supported by Oxford NIHR Biomedical Research Centre. The views expressed are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health and Social Care.Peer reviewedPublisher PD

“It Doesn’t Feel Like a Conversation”: Digital Field Experiences and Preservice Teachers’ Conceptions of Writing Response

Research shows that preservice English teachers (PSETs) lack opportunities to respond to student writing and that they may view student writing through a deficit lens. To address this need, the authors developed the Writing Mentors (WM) program, a digital field placement that gave PSETs experience providing feedback to high school writers. In this analysis, we examine how PSETs’ views of response were shaped by their digital interactions with high school writers. The challenges of interacting asynchronously created opportunities for PSETs to identify limitations in the mode of communication, propose approaches to providing feedback, and reflect on how teacher feedback can nurture or constrain relationships with students. These findings point to the promise of critical reflection on the disruptive potential of digital feedback for supporting PSTs’ response to student writing

“I Didn’t Want to Make Them Feel Wrong in Any Way”: Preservice Teachers Craft Digital Feedback on Sociopolitical Perspectives in Student Texts

This qualitative multicase analysis investigated the role of “educational niceness” and “neutrality” (e.g., Baptiste, 2008; Bissonnette, 2016) in preservice English teacher feedback on sociopolitical issues in student writing. As part of the field experiences for several ELA methods courses at two universities, one urban and one rural, the teacher-researchers used Google Docs and other technologies (e.g., screencasts and Google Community) to connect preservice teachers (PSTs) with high school writers at a geographical distance so that urban-situated PSTs could mentor rural-situated writers and vice versa. Five methods courses over two semesters served as cases, and 12 PSTs from those courses participated in focus groups. Data included audio recordings of nine focus groups and PSTs’ digital responses to student writing. Using thematic analysis, the authors explored how PSTs responded to sociopolitical perspectives in students’ writing — both engaging them and staying neutral. Although authentic opportunities for responding to student writers supported PSTs’ critical reflection on teaching writing, analysis of PSTs’ responses indicate that such authentic practice may not be sufficient for preparing PSTs to navigate sociopolitical issues and may, in fact, exacerbate PSTs’ impulse to enact educational niceness

“I Didn’t Want to Make Them Feel Wrong in Any Way”: Preservice Teachers Craft Digital Feedback on Sociopolitical Perspectives in Student Texts

This qualitative multicase analysis investigated the role of “educational niceness” and “neutrality” (e.g., Baptiste, 2008; Bissonnette, 2016) in preservice English teacher feedback on sociopolitical issues in student writing. As part of the field experiences for several ELA methods courses at two universities, one urban and one rural, the teacher-researchers used Google Docs and other technologies (e.g., screencasts and Google Community) to connect preservice teachers (PSTs) with high school writers at a geographical distance so that urban-situated PSTs could mentor rural-situated writers and vice versa. Five methods courses over two semesters served as cases, and 12 PSTs from those courses participated in focus groups. Data included audio recordings of nine focus groups and PSTs’ digital responses to student writing. Using thematic analysis, the authors explored how PSTs responded to sociopolitical perspectives in students’ writing — both engaging them and staying neutral. Although authentic opportunities for responding to student writers supported PSTs’ critical reflection on teaching writing, analysis of PSTs’ responses indicate that such authentic practice may not be sufficient for preparing PSTs to navigate sociopolitical issues and may, in fact, exacerbate PSTs’ impulse to enact educational niceness