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The Pharmaceutical Journal Vol 265 No 7114 September 16, 2000
Pharmacy Practice Research
Papers presented at the British Pharmaceutical Conference, Birmingham, September 10 to 13, 2000 pR46

Informal carers and medicines management: information exchange with the pharmacist

By N. J. Gray, S-A. Francis and F. J. Smith

Introduction Many studies have investigated the roles of informal carers, but few have focused on the management of medicines. Carers have been found to have poor knowledge of the medications that they administer1,2 and difficulty accessing pharmacy services.3 Our own preliminary fieldwork found that medicines management was often viewed by informal carers as an integral part of the caring role and a source of anxiety and uncertainty.
The overall aim of the study is to identify the prevalence and nature of drug-related problems and to characterise the roles of carers in the management of their care-recipient's medication. This abstract focuses on one aspect of this study - the exchange of information between pharmacists and carers.

Method The study was conducted in four English health authorities, randomly selected following stratification for the proportion of elderly people and ethnic minorities in the population and socio-economic status.
Pharmacies in each area were randomly selected from health authority lists and teams of local interviewers were recruited. An interviewer was based in each of the pharmacies for set periods and approached all pharmacy customers collecting a prescription. Using a screening questionnaire, informal carers were identified as those customers who were collecting a prescription for someone else aged over 60 years and for whose care they were not paid.
Following consent to take part, carers were interviewed in their own homes. The interview schedule comprised open and closed questions on medication-related activities and problems. It included a section on medicines information provision to carers by pharmacists. Interviews lasted approximately 30 minutes and were tape-recorded.
Data gathered in response to the closed questions was entered into SPSS for quantitative analysis. Responses to associated open questions were analysed qualitatively using content analysis.

Focal points

  • Local interviewers recruited informal carers (unpaid friends or relatives) who collected a prescription for someone else aged over 60
  • Fifty-nine per cent of these carers did not cite the pharmacist as a source of professional advice about their care-recipient's medicines
  • Those who did talk to the pharmacist reported both actively requesting information and/or receiving unsolicited advice
  • Pharmacists could seek more opportunities to support these carers, and to address the medication-related problems they experience

Results The data presented here is taken from the first health authority area (North Oxfordshire) and focuses on information exchange between carers and pharmacists. Forty-nine carers were interviewed. Twenty-nine carers (59 per cent) reported that they received no information from the pharmacist about their care-recipient's medicines. Twenty-five of these 29 respondents commented that they did not require information from the pharmacist. Despite this, 18 of these 25 carers reported between one and five medication-related problems: for example, obtaining medication, assistance with administration and identifying adverse effects.
The 20 remaining carers (41 per cent) cited the pharmacist as a source of information from whom they actively requested information or received unsolicited advice. Eighteen of these respondents also described having at least one medication-related problem.

Discussion Over half of the 49 informal carers did not receive information from the pharmacist about their care-recipient's medicines. Many of these carers perceived no need for information from the pharmacist although they described experiencing medication-related problems.
The profession could be more proactive in raising carers' awareness of the advice and services available.

Acknowledgments: We would like to acknowledge the input of the project steering group, Ms Jennifer Newbould (Oxfordshire project manager) and funding from the Wellcome Trust.

Centre for practice and policy, he School of Pharmacy, University of London, 29-39 Brunswick Square, London WC1N 1AX, England UK.

References

1. White H, Clipp EC, Hanlon JT, Schmader K. The role of the caregiver in the drug treatment of dementia. CNS Drugs 1995;4: 58-67.
2. Mallet L, King T. Evaluating family caregivers' knowledge of medication. J Geriatric Drug Ther 1993;7(4): 47-58.
3. Goldstein R, Rivers P. The medication role of informal carers. Health and Social Care in the Community 1996;4: 150-8.