Yes / Objective: To investigate timely access to palliative
medicines/drugs (PMs) from community pharmacies to
inform palliative care service delivery.
Design: Mixed methods in two sequential phases: (1)
prospective audit of prescriptions and concurrent survey
of patients/representatives collecting PMs from pharmacy
and (2) interviews with community pharmacists (CPs) and
other healthcare professionals (HCPs).
Setting: Five community pharmacies in Sheffield, UK and
HCPs that deliver palliative care in that community.
Participants: Phase 1: five CPs: two providing access to
PMs within a locally commissioned service (LCS) and three
not in the LCS; 55 patients/representatives who completed
the survey when accessing PMs and phase 2: 16 HCPs,
including five phase 1 CPs, were interviewed.
Results: The prescription audit collected information on
75 prescriptions (75 patients) with 271 individual PMs;
55 patients/representatives (73%) completed the survey.
Patients/representatives reported 73% of PMs were
needed urgently. In 80% of cases, patients/representatives
received all PMs on the first pharmacy visit. One in five
had to travel to more than one pharmacy to access PMs.
The range of PMs stocked by pharmacies was the key
facilitating factor. CPs reported practical issues causing
difficulty keeping PMs in stock and playing a reactive
role with palliative prescriptions. Confidentiality concerns
were cited by other HCPs who were reluctant to share
key patient information proactively with pharmacy teams.
Inadequate information transfer, lack of CP integration into
the care of palliative patients and poor HCP knowledge
of which pharmacies stock PMs meant patients and their
families were not always able to access PMs promptly.
Conclusions: Consistent routine information transfer and
integration of pharmacy teams in the care of palliative
patients are needed to achieve timely access to PMs.
Commissioners of PM access schemes should review and
monitor access. HCPs need to be routinely made aware
and reminded about the service and its locations. / EJM received research funding from Pharmacy Research UK and Sheffield Teaching Hospitals NHS Foundation Trust as well as support from St Luke’s Hospice, Sheffield. AB and JDM report grants from Pharmacy Research UK during the conduct of the study.
| Identifer | oai:union.ndltd.org:BRADFORD/oai:bradscholars.brad.ac.uk:10454/17656 |
| Date | 12 February 2020 |
| Creators | Miller, E.J., Morgan, Julie D., Blenkinsopp, Alison |
| Source Sets | Bradford Scholars |
| Language | English |
| Detected Language | English |
| Type | Article, Published version |
| Rights | © Author(s) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/. |
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