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ABSTRACTBackground Atrial Fibrillation (AF) increases the risk of stroke by a factor of five, leading a significant cost burdens on healthcare system. Pharmacists, especially those based in a primary care environment are well placed to support patients in this therapeutic area.Objectives To assess primary care pharmacists’ actual knowledge on the management of AF symptoms and anticoagulation. Furthermore, to investigate the resources used by pharmacists.Methods A cross-sectional study using survey was conducted, targeting UK-based registered pharmacists employed within primary care settings. Quantitative data were analysed utilising descriptive univariate and bivariate statistics.Results 349 pharmacists completed the adapted 19-questions of the pharmacists’ knowledge. Out of a maximum of 19 points, the mean score was 14.34 ± 2.2 (75 ± 11.6%). The questionnaire revealed several significant gaps in pharmacists’ knowledge. Most of the surveyed pharmacists (62.8%) reported that they used sources of information to support their consultations. Half reported that they used the National Institute for Health and Care Excellence (NICE) guidance (52.4%) and the British National Formulary (BNF) (50.7%).Conclusions Primary care pharmacists are knowledgeable about AF and its management; however, some gaps exist which may require addressing. Although pharmacists use a variety of information resources, it is the traditional resources that remain the most frequently used.

Background Atrial fibrillation (AF) affects up to 2% of the UK population. AF is a potentially long-term condition that needs management, and as such primary care pharmacists may have a substantial role in supporting the management of AF. Objectives This study aims to explore the role of primary care pharmacists, working in community pharmacies and general practices (GPs), in supporting the management of AF. Furthermore, this study investigates pharmacists’ confidence in their knowledge and their attitudes towards incorporating AF-associated mobile apps use into their current practice. Methods A qualitative study was conducted, using one-to-one semi-structured, audio-recorded interviews with primary care pharmacists. The topic guide was developed based on pharmacy visits and included the most relevant constructs from the ‘consolidated framework for implementation research (CFIR)’. All interviews were audio-recorded, transcribed verbatim and thematically analysed until saturation was achieved, guided by Braun and Clarke’s 6-step research method. This study was given a favourable opinion on 5 September 2019 by the University of Birmingham (UOB) Research Ethics Committee (Reference ERN_19-0908). Results Thematic saturation was achieved after 11 interviews with primary care pharmacists (seven community pharmacists, and four GP pharmacists). Three main themes emerged relating to (1) the clinical role of pharmacists in the management of AF; (2) knowledge and awareness; and (3) prioritisation of resources. The first highlighted that primary care pharmacists were an underutilised resource within AF management. The second demonstrated that pharmacists, especially those based in the community, felt a lack of confidence in their knowledge of AF and its management, mainly community pharmacists due to other roles taking precedence over clinical roles. Both community and GP pharmacists expressed the need to have further training in this therapeutic area to be able to effectively support patients with AF. The third shed light on the pharmacists’ views relating to the technological revolution in healthcare. Pharmacists expressed an interest in using apps to support their current practice. Conclusions Primary care pharmacists supported an extended care to AF management from screening to consultations, yet the provision of such services remains limited and inconsistent. Future research should focus on understanding the ways in which pharmacists’ role can be adapted toward greater involvement in clinical care.

Objective: The aim of this study was to investigate the provision of community pharmacy services to children and young people with a focus on advanced services such as medicines use review. Perceptions and experiences of community pharmacists, pharmacy staff, young people and their parents or carers on the provision of such services were also explored. Methods: Four different cross-sectional, self-administered questionnaires were distributed in parallel to pharmacists, pharmacy staff members, children and young people and parents in the United Kingdom. Results: An outline of pharmacist’s current involvement with children and young people was provided by 92 pharmacists. A different group of 38 community pharmacists and 40 non-pharmacist members of pharmacy staff from a total of 46 pharmacies provided information and views on the conduct of Medicines use review with children and young people. Experiences of advanced pharmacy service provision were collected from 51 children and young people and 18 parents. Most pharmacists offered public health advice to children and young people (73/92; 79.3%) and even more (83/92; 90.2%) reported that they often interacted with children and young people with long-term condition. Despite their high levels of interaction, and a majority opinion that medicines use reviews could benefit children (35/38; 92.1%), the number of pharmacies reporting to have conducted medicines use reviews with children was low (5/41). Pharmacists perceived the main barriers to recruitment as consent (17/29; 58.6%), guideline ambiguity (14/29; 48.3%) and training (13/29; 44.8%). A considerable proportion pharmacists (12/29; 41.4%) and other personnel (14/33; 42.4%) working in community pharmacies were unaware that children were potentially eligible for medicines use reviews. Only 29.4% of the 51 children and young people participants had received advice about their long-term condition from a pharmacist and the majority (46/51; 90.2%) had not taken part in an advanced service focused on adherence. Conclusions: While general engagement with children and young people appears high from the pharmacist’s perspective, advice specific to children and young people with long-term conditions and the provision of advanced services in this group remains a challenge.

Recent evidence has shown that the incidence of long-term illnesses in young people aged 10−24 years is increasing. It is essential to highlight the importance of long-term health conditions in this age group and understand young people’s health needs to be able to improve current support for young people. Pharmacists, as medicine experts, are in a unique position to promote young people’s health. The role of primary care pharmacists in the management of chronic illnesses in young people has not been widely researched. The aim of this review was to explore the current role of primary care pharmacists in the management of chronic illnesses in young people aged 10−24 years. A systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement using Medical Subject Headings (MeSH) and Embase subject headings (Emtree) terms, covering three main themes: Pharmacists, young people and chronic illnesses. Articles were critically appraised using Critical Appraisal Skills Programme (CASP) tools. Eight articles were included in this review. Seven articles included original research studies (one observational study, two surveys, two qualitative interview studies and two interventions). The remaining article was a literature review. All of the articles made reference to community pharmacists, while there was no information about GP pharmacists. Roles that community pharmacists identified as high-priority in their practice when dealing with young people included supporting young people to develop generic healthcare skills, counselling and building trusted relationships directly with young people, helping young people to find credible health information and the provision of specialist services. Community pharmacists feel that they have a role to play in supporting young people with chronic illness and have identified many areas where they can provide services and support.

To engage with high risk groups to identify knowledge and awareness of oral cancer signs and symptoms and the factors likely to contribute to improved screening uptake.Focus group discussions were undertaken with 18 males; 40+ years of age; smokers and/or drinkers (15+ cigarettes per day and/or 15+ units of alcohol per week), irregular dental attenders living in economically deprived areas of Teesside.There was a striking reported lack of knowledge and awareness of oral cancer and its signs and symptoms among the participants. When oral/mouth cancer leaflets produced by Cancer Research UK were presented to the participants, they claimed that they would seek help on noticing such a condition. There was a preference to seek help from their general practitioner rather than their dentist due to perceptions that a dentist is 'inaccessible' on a physical and psychological level, costly, a 'tooth specialist' not a 'mouth specialist', and also not able to prescribe medication and make referrals to specialists. Interestingly, none of the 18 participants who were offered a free oral cancer examination at a dental practice took up this offer.The uptake of oral cancer screening may be improved by increasing knowledge of the existence and signs and symptoms of oral cancer. Other factors that may increase uptake are increased awareness of the role of dentists in diagnosing oral cancer, promotion of oral cancer screening by health professionals during routine health checks, and the use of a "health" screening setting as opposed to a "dental" setting for such checks.