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Natalie Lane is production editor for
journals with the Pharmaceutical Press, London
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Other articles in the March issue of IJPP
· Evaluation of a pharmacist-managed repeat dispensing
system: the GP perspective (T. Porteous
and C. Bond).
· Medication reviews provided by general medical practitioners
(GPs) and nurses: an evaluation of their quality (J. Krska,
S. M. Ross
and M. Watts). |
Expert reports have highlighted the fact that pharmacists are a frequent
point of contact for the public when seeking information and advice about
health and medicines, and that there is a role for pharmacists providing
information and advice relating to drug misuse. Pharmacists are viewed
as an under-used knowledge source for drug-users and health care professionals.
Yet, there is little published research exploring the nature of such
information provision.
An intervention study was carried out examining a pharmacist-led information
and advice service, which was set up at a voluntary sector harm reduction
drugs agency in Aberdeen. The pharmacist was based at the agency for
one three-hour session a week and was contactable by telephone otherwise.
The drug agency service users could contact the pharmacist direct during
the three-hour session at the agency or via other staff at other times.
The service was provided for 26 weeks. Details of each enquiry were noted
and the pharmacist subjectively judged whether an enquiry was “general
knowledge” common to all pharmacists, or was “specialist” to
a pharmacist with a substance misuse background.
The results of the enquiries made meant that final progressive focusing
analysis provided 11 different categories. These were drug information
(prescribed), drug information (not prescribed), drug testing, drug-related
health problem, drug identification, harm-reduction techniques, other,
medical information, pharmaceutical services, adverse drug reaction
(prescribed), adverse drug reaction (not prescribed). The majority of
enquiries were in categories related to medicines or illicit drug substances
and the client’s welfare. This suggests that clients viewed the
pharmacist as a source of information about drugs and their effects.
The drug agency staff were the most frequent users of the service — an
expected result because of their direct access to it. However, they also
referred 27 per cent of the agency’s service users to the pharmacist.
The study considers whether the working relationship between staff and
the pharmacist served to inform staff expectation of the pharmacist’s
experience and thus the contribution the pharmacist could provide. Certainly,
in discussion, it was believed that staff use of the service meant that
a pharmacist could contribute to the multidisciplinary team of a voluntary
sector agency.
Although the research did not evaluate users’ perceptions of the
service, the nature of the enquiries illustrates that drug-users have
concerns about the effects of drugs and want information to allow them
to make informed decisions about their illicit drug use and treatment.
The authors comment that this provides an alternative view to one that
the media or the public may hold, which is that drug users are individuals
who have no regard for the risks that they take.
There was no exploration of the outcomes of the pharmacist’s advice,
which would have provided further information about the usefulness of
a drug information service provided by pharmacists. Yet, the study did
illustrate that such a service was possible. Further exploration should
be made of pharmacists’ role in this setting, as well as in other
settings and areas.
Improved folic acid supplementation
Another published study assesses the effect of informing and motivating
woman using oral contraceptives to start taking folic acid supplements
a few weeks before they attempt to become pregnant via the provision
of unsolicited information from community pharmacies in the Netherlands.
Folic acid supplementation reduces the risk of neural tube defects
by more than 50 per cent and women are advised to take folic acid
supplements
from four weeks before conception until eight weeks after. Current
and recent programmes may leave at least 50 per cent and as much
as 80 per
cent of women without the the benefits of folic acid. A programme was
developed using Dutch community pharmacies. For six months during the
intervention period, seven pharmacies put stickers on the boxes of
oral contraceptives and handed out leaflets to women with a prescription
for
oral contraceptives. A random selection of women were sent questionnaires,
with each woman being contacted six months after an oral contraceptive-related
visit.
The data studied suggest that women who received information about
folic acid with their oral contraceptives seemed to have a greater
knowledge
of, and positive attitude towards, folic acid. There is also a strong
suggestion that information about folic acid from community pharmacies
can reach and inform women who are planning a pregnancy. With no widespread
preconception care in the Netherlands, such women are considered difficult
to reach. The results of the study indicate that the intervention had
a positive effect on whether women planning a pregnancy, or in the
early stages of pregnancy, took folic acid. The study shows that involving
pharmacists and technicians in informing and stimulating women to take
folic acid before becoming pregnant leads to a greater awareness and
use of folic acid.
This approach is now being measured across the Netherlands and the
effects will be evaluated. The authors believe that it is applicable
to other
countries and encourage others to test the approach. IJPP online
The IJPP is available online via Ingenta.com. The full text is available
only to online subscribers or print/online subscribers. Print-only
subscribers and non-subscribers can purchase papers on a “pay-per-view” basis.
Abstracts are available free of charge to all users. Further information
is available here (e-mail ijpp@rpsgb.org). |
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Pharmaceutical Journal