Community pharmacists' attitudes towards, and experiences of, providing medication reviews after hospital discharge: a questionnaire survey.

Objectives: To investigate the attitudes and experiences of community pharmacists providing medicines-use review (MUR) and post-discharge medicines-use review (PD-MUR) services.

Methods: An online survey for community pharmacists who had experience providing the MUR service.

Key Findings: In total, 495 community pharmacists responded to the survey.

Evaluation of Antibiotic Supply Decisions by Community Pharmacists in Thailand: A Vignette Study.

In Thailand, antibiotics are available lawfully from community pharmacies without a prescription. Inappropriate supply of antibiotics from Thai community pharmacies to the public for common, self-limiting diseases has been reported. The study aimed to evaluate the appropriateness of antibiotics selected by community pharmacists in Thailand in response to vignettes.

The rise of non-medical prescribing and medical dominance.

This article contributes to the continuing debate on the professional dominance of medicine given the rising number of professions allied to medicine that now have the legal authority to prescribe and could potentially threaten this dominance. The key questions addressed are whether non-medical prescribers represent a threat to the dominance of medicine and if they do not, what has mediated doctors' response to these newer prescribers such that they are able to retain dominance? Drawing on Abbott's work on jurisdictional claims, this paper explores how the rise of non-medical prescribing has led to competing jurisdictional claims over prescribing between doctors and non-medical prescribers. This paper particularly focuses on pharmacist prescribing and how competing jurisdictional claims could be settled.

Characteristics of good quality pharmaceutical services common to community pharmacies and dispensing general practices.

Background: In the United Kingdom, pharmaceutical services can be delivered by both community pharmacies (CPs) and dispensing doctor practices (DPs). Both must adhere to minimum standards set out in NHS regulations; however, no common framework exists to guide quality improvement. Previous phases of this research had developed a set of characteristics indicative of good pharmaceutical service provision.

A qualitative thematic review: emotional labour in healthcare settings.

Aims: To identify the range of emotional labour employed by healthcare professionals in a healthcare setting and implications of this for staff and organisations.

Background: In a healthcare setting, emotional labour is the act or skill involved in the caring role, in recognizing the emotions of others and in managing our own.

Design: A thematic synthesis of qualitative studies which included emotion work theory in their design, employed qualitative methods and were situated in a healthcare setting.

Dispensing doctor practices and community pharmacies: exploring the quality of pharmaceutical services.

Aims: This research sought (a) to investigate the similarities and differences in how pharmaceutical services are provided by community pharmacies (CPs) and dispensing doctor practices (DPs) and (b) to identify the issues relevant to determining the quality of pharmaceutical services in these settings.

Background: UK pharmaceutical services, including dispensing prescriptions and public health advice, can be provided from both (CP) and, in rural areas, (DP). While there is much similarity between CPs and DPs in the types of services provided, there is also the potential for variation in service quality across settings.

Medication decision making and patient outcomes in GP, nurse and pharmacist prescriber consultations.

Unlabelled: Aim The aims of this study were twofold: (a) to explore whether specific components of shared decision making were present in consultations involving nurse prescribers (NPs), pharmacist prescribers (PPs) and general practitioners (GPs) and (b) to relate these to self-reported patient outcomes including satisfaction, adherence and patient perceptions of practitioner empathy.

Background: There are a range of ways for defining and measuring the process of concordance, or shared decision making as it relates to decisions about medicines. As a result, demonstrating a convincing link between shared decision making and patient benefit is challenging.

Solicitations in GP, nurse and pharmacist prescriber consultations: an observational study.

Background: The opening solicitation is a key element of the primary care consultation as it enables patients to express their ideas, concerns and expectations that can lead to improved patient outcomes. However, in practice, this may not always occur. With nurses and pharmacists now able to prescribe, this research explored the opening solicitation in a multi-professional context.

A comparison of GP, pharmacist and nurse prescriber responses to patients' emotional cues and concerns in primary care consultations.

Objective: Recognising patients' cues and concerns is an important part of patient centred care. With nurses and pharmacists now able to prescribe in the UK, this study compared the frequency, nature, and professionals' responses to patient cues and concerns in consultations with GPs, nurse prescribers and pharmacist prescribers.

Methods: Audio-recording and analysis of primary care consultations in England between patients and nurse prescribers, pharmacist prescribers and GPs.

Diagnostic decision making: the last refuge for general practitioners?

Nurses and pharmacists gained the right to prescribe as independent prescribers in the UK in 2007. Independent prescribers are responsible for the initial assessment of patients with diagnosed and undiagnosed conditions. Public policy discourse and the views expressed by health care professionals have conceptualised diagnostic decision making as being at a 'higher level' and more difficult than prescribing decision making.

Use of simulated patients to assess the clinical and communication skills of community pharmacists.

Objective: To investigate the quality and appropriateness of Emergency Hormonal Contraception (EHC) supply from community pharmacies.

Setting: Community pharmacies in the southwest of England during 2007.

Method: Two simulated patient ('mystery shopper') scenarios to each participating pharmacy, one where the supply of EHC would be appropriate (scenario 1) and one where there was a drug interaction between EHC and St John's Wort, and the supply inappropriate (scenario 2).

The changing nature of prescribing: pharmacists as prescribers and challenges to medical dominance.

This paper investigates the potential threat to medical dominance posed by the addition of pharmacists as prescribers in the UK. It explores the role of prescribing as an indicator of professional power, the legitimacy and status of new pharmacist prescribers and the forces influencing professional jurisdictional claims over the task of prescribing. It draws upon 23 interviews with pharmacist supplementary prescribers.

Measuring shared decision making in the consultation: a comparison of the OPTION and Informed Decision Making instruments.

Objective: To investigate the applied and conceptual relationship between two measures of shared decision making using the OPTION instrument developed in Wales and the Informed Decision Making instrument developed in Seattle, USA using audio-taped consultation data from a UK general practice population.

Methods: Twelve general practitioners were recruited from 6 general practices in the southwest of England. One hundred twenty-three GP-patient consultations were audio-recorded.

The community pharmacy and discursive complexity: a qualitative study of interaction between counter assistants and customers.

The present paper examines the developing role of the medicines counter assistant (MCA) based in community pharmacies in the UK. In recent years, community pharmacies have been promoted as sources of primary care advice, and this has been accompanied by an increase in the number of pharmacy-only medicines made available for purchase without prescription. At the forefront of these changes is the MCA, who responds to requests for medicines and also advises customers seeking guidance on treating minor illness.

Decision analysis for newly diagnosed hypertensive patients: a qualitative investigation.

This study adopted a qualitative approach to explore patients' views on the usefulness of a decision analytic decision aid (DA). Semi-structured interviews were conducted with 15 newly diagnosed hypertensive patients who had been recruited for a factorial randomised controlled trial of two decision aids. Issues investigated included respondents' attitudes to information, their views on the nature of their relationship with their general practitioner (GP) (paternalistic, shared or consumerist), the ease of use and potential wider application of the computerised decision aid and its influence upon their decision-making about whether or not to begin anti-hypertensive treatment.

The value of the managed entry of new drugs: a case study of donepezil.

Objective: A United Kingdom Department of Health directive (EL[94]72) asked Health Authorities to manage the entry of new drugs into practice. There seem to be costs associated with the decision-making process of managed entry, but no clear evidence of benefit to patient populations. The objective of this study was to assess the potential costs and outcomes of different models of managed entry, using the example of donepezil in the North West Health Region of the U.

Cost to the patient or cost to the healthcare system? Which one matters the most for GP prescribing decisions? A UK-Italy comparison.

Background: Charges for health services help contain healthcare costs. Despite showing that medicine consumption decreases when charges are increased there is little research that illuminates how doctors 'manage' the charge system to help patients who cannot afford treatment. This paper describes how the charge system influences the prescribing decisions of Italian and UK physicians.

Access to medicines: cost as an influence on the views and behaviour of patients.

The present paper explores how charges for medicines incurred by patients influence their decisions for managing acute or chronic conditions, and whether prescription cost and affordability issues are discussed in the general practitioner (GP)-patient encounter. People suffering from dyspepsia, hay fever or hypertension, or those taking hormone replacement therapy, were recruited through three community pharmacies in the North-west of England. Six focus groups were conducted with a total of 31 participants, the majority of whom were non-exempt from prescription charges.