Community pharmacists are increasingly expected to improve disease management both by aiming to improve the effective use of medicines and by reducing the occurrence and severity of preventable adverse drug reactions (ADRs). The current PhD research began by assessing the challenges to the medicines reconciliation from patients' perspectives. A questionnaire based audit identified two important risk factors for reporting ADRs: being unaware of why medicines were prescribed and not recalling prior warnings about possible ADRs. These findings led to the evaluation of pharmacists' engagement with patients within pharmacy services such as the New Medicine Service (NMS). A questionnaire-based service evaluation of the NMS provided support for this service as an opportunity to improve identification and management of ADRs. This evaluation also highlighted the poor contribution of pharmacists towards reporting of ADRs. The findings led to the evaluation of ADR reporting by community pharmacists. This audit-based study identified lack of time and uncertainty about the seriousness of ADRs as the main barriers towards spontaneous reporting. The reporting of ADRs linked to high blood pressure medicines in this study indicated the need to assess the role of community pharmacists in the management of high blood pressure. A systematic review and meta-analysis suggested that pharmacist-led interventions made a significant impact on the management of systolic and diastolic blood pressure. Learning from two audits, a service evaluation and a systematic review led to the development of a randomised controlled trial that assessed the impact of written pharmacistled education on patients with high blood pressure. Interventions by pharmacists working in community pharmacies were associated with improvements in the control of hypertension, however, the mean difference in blood pressure between the intervention and control group was not statistically significant. Compared to participants in the control group, there was a significant improvement in the knowledge about hypertension and its treatment in the intervention group. The participants in this study gave a positive response about the involvement of pharmacists in the management of long-term medical conditions such as hypertension. The UK government wants to see a central role for pharmacists in patient care. The evidence presented in this research suggests that pharmacists have the potential to play a bigger role in patient care. Patients also recognize this potential and appear to be willing to seek pharmacists' advice on health-related issues. Pharmacists would need to identify their specific learning needs to help them deliver a more patient-centred care. They would also require the support and recognition from other stakeholders in particular the GPs.
| Identifer | oai:union.ndltd.org:bl.uk/oai:ethos.bl.uk:682853 |
| Date | January 2015 |
| Creators | Cheema, Ejaz |
| Publisher | University of Warwick |
| Source Sets | Ethos UK |
| Detected Language | English |
| Type | Electronic Thesis or Dissertation |
| Source | http://wrap.warwick.ac.uk/77080/ |
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