Christina Raae Hansen1,2, Stephen Byrne3, Denis O'Mahony4,5, Patricia M Kearney6, Laura J Sahm3,7. 1. Pharmaceutical Care Research Group, School of Pharmacy, Cavanagh Pharmacy Building Room UG06, University College Cork, College Road Cork, Cork, Ireland. christina.raaehansen@ucc.ie. 2. Section for Social and Clinical Pharmacy, Department of Pharmacy, Faculty of Health and Medical Sciences, University of Copenhagen, Universitetsparken 2, 2100, Copenhagen Ø, Denmark. christina.raaehansen@ucc.ie. 3. Pharmaceutical Care Research Group, School of Pharmacy, Cavanagh Pharmacy Building Room UG06, University College Cork, College Road Cork, Cork, Ireland. 4. Department of Medicine, School of Medicine, University College Cork, Western Gateway Building Room 2.59, Western Road, Cork, Ireland. 5. Department of Geriatric Medicine, Cork University Hospital, Wilton, Cork, Ireland. 6. School of Public Health, University College Cork, Western Gateway Building 4th Floor, Western Road, Cork, Ireland. 7. Pharmacy Department, Mercy University Hospital, Greenville Place Centre, Cork, Ireland.
Abstract
PURPOSE: Older people are at risk of potentially inappropriate prescribing (PIP) due to polypharmacy arising from multi-morbidity. Despite available explicit criteria to reduce PIP, it is highly prevalent. Whilst community pharmacists have the required knowledge to help reduce PIP, they are not currently engaged with the problem. This study explores the views of community pharmacists on their potential involvement in reducing PIP and determines the challenges to its implementation. METHODS: Semi-structured interviews with pharmacists working in community pharmacies in Ireland. The theoretical domains framework (TDF) was used to develop the topic guide and to analyse the transcripts. Domains of highest relevance for PIP reduction were identified based on their frequency or whether the participants emphasised the impact of constructs within a domain. Local ethical approval was obtained. RESULTS: Of 18 participants, 12 were female, median age was 30 years (IQR, 27-35) with a median of 6 years (IQR, 3-8) of experience. Seven TDF domains were identified as relevant to PIP reduction. Pharmacists were uncertain about their role in reducing PIP and reluctant to challenge physicians' prescribing decisions. Challenges pertained to the environment, knowledge, social influences, professional role and identity. CONCLUSIONS: Pharmacists welcomed new responsibilities in reducing PIP as part of their daily practice but expressed a need for removal of social and environmental barriers as well as, provision of relevant guidelines and education about PIP. This study provides useful insights into the target domains for overcoming barriers of pharmacist involvement in reducing PIP.
PURPOSE: Older people are at risk of potentially inappropriate prescribing (PIP) due to polypharmacy arising from multi-morbidity. Despite available explicit criteria to reduce PIP, it is highly prevalent. Whilst community pharmacists have the required knowledge to help reduce PIP, they are not currently engaged with the problem. This study explores the views of community pharmacists on their potential involvement in reducing PIP and determines the challenges to its implementation. METHODS: Semi-structured interviews with pharmacists working in community pharmacies in Ireland. The theoretical domains framework (TDF) was used to develop the topic guide and to analyse the transcripts. Domains of highest relevance for PIP reduction were identified based on their frequency or whether the participants emphasised the impact of constructs within a domain. Local ethical approval was obtained. RESULTS: Of 18 participants, 12 were female, median age was 30 years (IQR, 27-35) with a median of 6 years (IQR, 3-8) of experience. Seven TDF domains were identified as relevant to PIP reduction. Pharmacists were uncertain about their role in reducing PIP and reluctant to challenge physicians' prescribing decisions. Challenges pertained to the environment, knowledge, social influences, professional role and identity. CONCLUSIONS: Pharmacists welcomed new responsibilities in reducing PIP as part of their daily practice but expressed a need for removal of social and environmental barriers as well as, provision of relevant guidelines and education about PIP. This study provides useful insights into the target domains for overcoming barriers of pharmacist involvement in reducing PIP.
Authors: Jill J Francis; Marie Johnston; Clare Robertson; Liz Glidewell; Vikki Entwistle; Martin P Eccles; Jeremy M Grimshaw Journal: Psychol Health Date: 2010-12
Authors: Joanne E McKenzie; Simon D French; Denise A O'Connor; Jeremy M Grimshaw; Duncan Mortimer; Susan Michie; Jill Francis; Neil Spike; Peter Schattner; Peter M Kent; Rachelle Buchbinder; Sally E Green Journal: Implement Sci Date: 2008-02-22 Impact factor: 7.327