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Background: Evidence has shown that there is a significant problem with medication safety when patients are transferred between settings. The role of community pharmacists and hospital pharmacists in facilitating transition of care has been well-researched. However, with the developing role of pharmacists in general practice as part of a multi-disciplinary team, little is known about their role in improving transition of care when patients move from secondary to primary care. The key objective of this scoping review is to understand the nature and extent of the role of primary care pharmacists for patients recently discharged from secondary care. Methods: This scoping review will follow the Joanna Briggs Institute (JBI) methodology for scoping review underpinned by the Arksey and O'Malley methodology and reported in accordance with the Preferred Reporting Items for Systematic Reviews Extension for Scoping Reviews (PRISMA-ScR) guidelines. The following electronic databases will be systematically searched: MEDLINE, EMBASE, PubMed, Cochrane Central Register of Controlled Trials (CENTRAL), Web of Science and NICE Evidence. Reference lists of included full texts will be searched for relevant papers, in addition to grey literature which includes websites of relevant professional organisations. Primary studies, published in the English language that involved a primary care pharmacist-led intervention post-hospital discharge will be included. Two independent reviewers will screen studies against eligibility criteria and use a piloted data extraction form to extract data related to the review questions. The data will be presented in tabular form and assessed for key themes to identify gaps and inform future research. Discussion: This scoping review will map current evidence surrounding the role of primary care pharmacists in the post-hospital discharge care of patients. Findings will inform ongoing research to support safer transfer-of-care post-hospital discharge and identify ways in which collaboration between healthcare professionals can be improved. This review anticipates guiding the inclusion of patient and public involvement (PPI) at the consultation stage to validate and build on the findings. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to examine trends in prescribing of antidementia drugs in primary care in England between 2009 and 2019, and investigate the impact of deprivation, regional demography and disease prevalence on prescribing practices. Methods: Analysis of publicly available government data from various sources pertaining to primary care prescribing and demographics was conducted. All primary care prescription data pertaining to antidementia drugs in England between 2009 and 2019 were extracted and adjusted for inflation and population changes. Data across English clinical commissioning regions were compared to explore the association between prescribing trend, deprivation, regional demography and dementia prevalence. Results: The number of prescription items for antidementia drugs in England increased by approximately 3‐fold (195.4%) from 24 items/1000 population in 2009 to 70.9 items/1000 population in 2019. In 2019, the least‐deprived areas had approximately twice the rate of prescribing of antidementia drugs compared to the most‐deprived areas (median [IQR] values of 46.7 [36.6‐64.8] vs 91.23 [76.2‐95.1] items/1000 population, respectively). In the multivariable analysis, the number of prescription items showed an inverse relationship with deprivation (coefficient −0.046, 95% CI −0.47 to −0.045) after adjustment for number of populations aged 65+ years and prevalence of dementia. Conclusions: The 3‐fold rise in the number of prescription items for antidementia drugs in the study period reflects the policy emphasis on early diagnosis and treatment of dementia. Higher rates of prescribing in the least‐deprived areas may be reflective of better and early diagnoses and access to treatments. Such inequality in access to the treatments needs to be investigated further. [ABSTRACT FROM AUTHOR]

Background: Studies conducted in Qatar have reported a high prevalence of diabetic nephropathy, retinopathy, and neuropathy. These complications are often associated with poor medication adherence and uncontrolled diabetes. The objectives of this study were to determine the rate of medication adherence among patients with uncontrolled diabetes, and to compare the characteristics and identified barriers between patients with good and those with poor medication adherence.Method: A cross-sectional quantitative study was conducted among patients living in Qatar with uncontrolled diabetes attending primary healthcare clinics from October 2016 to January 2017. An interviewer-administered questionnaire comprising three sections was utilized in the study: patients' characteristics, Adherence to Refill and Medications Scale in Diabetes (ARMS-D), and barriers to medication adherence. ARMS-D is a validated tool that is used to identify adherence level among patients with diabetes. Descriptive and inferential statistics including regression analysis were used for data analysis.Results: A total of 260 patients were included in the analysis. Overall, 73% (n=191) were nonadherent to their diabetes medications (ARMS-D score above 11). Nonadherent patients reported the majority of the pre-determined barriers to medication adherence with forgetfulness being the most commonly reported barrier. Multivariate linear regression analysis found age, ethnicity, education level, income level and HbA1c to be independent predictors of adherence.Conclusion: The findings of this study reaffirm the notion that non-adherence to medications among patients with uncontrolled diabetes within primary care setting is higher than the general diabetes population. This high prevalence is concerning and necessitates urgent interventions. Nonetheless, an in-depth understanding of barriers to medication adherence often requires qualitative research approach as these barriers are very complex and multifactorial in nature. [ABSTRACT FROM AUTHOR]

Background Chronic pain is predominantly managed in primary care, although often ineffectively. There is growing evidence to support the potential role of nurses and pharmacists in the effective management of chronic pain. Objectives To evaluate the effectiveness of a pain clinic jointly managed by a nurse and pharmacist. Design A mixed-methods design consisting of qualitative interviews embedded within a quasi-experimental study. Settings A community-based nurse-pharmacist led pain clinic in the north of England. Participants Adult chronic pain (non-malignant) patients referred to the pain clinic. Methods Pain intensity was the primary outcome. Questionnaires (the Brief Pain Inventory, the Hospital Anxiety and Depression Scale, the SF-36 and the Chronic Pain Grade questionnaire) were administered at the baseline, on discharge and at 3-month post-discharge (Brief Pain Inventory and Hospital Anxiety and Depression Scale only). Patient satisfaction was explored using face-to-face, semi-structured qualitative interviews. Results Seventy-nine patients with a mean age of 46.5 years (SD ± 14.4) took part in the quasi-experimental study. Thirty-six and nine patients completed the discharge and 3-month follow-up questionnaires respectively. Compared to baseline, statistically significant reductions were noted for two of the outcome measures: pain intensity ( P = 0.02), and interference of pain with physical functioning ( P = 0.02) on discharge from the service. Nineteen patients participated in qualitative interviews. The patients were, in general, satisfied with the quality of service. Four contributing factors to patient satisfaction were identified: ample consultation time, in-depth specialised knowledge, listening and understanding to patients’ needs, and a holistic approach. Conclusions Nurse and pharmacist managed community-based pain clinics can effectively deliver quality pain management services as they offer an interdisciplinary holistic approach to pain management. Such services have the potential not only to reduce the burden on secondary care but also decrease long waiting times for referral to secondary care. Further research is required to support the development of evidence based referral guidelines to such services. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has impacted on public access to health services. This study aimed to investigate the impact of COVID-19 pandemic on commonly prescribed first-line antibiotics in English primary care. A secondary analysis of publicly available government data pertaining to primary care prescribing was conducted. A list of twenty first-line antibiotics used to treat common infections was developed following the National Institute of Clinical Excellence (NICE) guidelines. All primary care prescription and cost data pertaining to commonly prescribed first-line antibiotics in England between March and September of 2018–2020 were extracted and adjusted for inflation. Analysis suggests prescribing of antibiotics significantly reduced by 15.99% (p = 0.018) and 13.5% (p = 0.002) between March and September 2020 compared with same time period for 2018 and 2019, respectively. The most noticeable decrease in 2020 was noticed for prescribing for meningitis (−62.3%; p = 0.002) followed by respiratory tract infections (−39.13%; p = 0.035), in terms of indications. These results are suggestive of reduced transmission of infections in the community due to national lockdowns, social distancing and hygiene practices. In addition, the impact of reduced face-to-face consultations in general practices needs to be investigated as a potential reason for reduced prescribing. The pandemic also offers an opportunity to rationalize antibiotics use in the community. [ABSTRACT FROM AUTHOR]