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Objective: Pharmacotherapeutic Follow-up is the Professional Pharmaceutical Care Service aimed at detecting Drug-Related Problems for the prevention and resolution of negative medicine outcomes. The Dader Method is considered a clear and simple tool to develop Pharmacotherapeutic Follow-up. This research aims to analyze the evolution of the international scientific production related to Pharmacotherapeutic Follow-up and the Dader Method to show the current situation of this Professional Pharmacy Assistance Service. In addition, from the data obtained, we give a critical perspective on the implementation of the Dader Method in Community Pharmacy, considering its advantages and disadvantages based on the published scientific literature. Methods: Using bibliometrics tools, indicators were obtained to analyze the international production of scientific articles on Pharmacotherapeutic Follow-up and the Dader Method during the period (1999-2022) through the Scopus database. Results: The results showed a growth in the international scientific production of publications on Pharmacotherapeutic Follow-up, obtaining 30,287 papers, placing the United States, the United Kingdom, Australia, Canada and Spain as the five most productive countries. The publication of 83 papers on the Dader Method places Spain with the highest number of publications, followed by other Spanish or Portuguese speaking countries, among which Brazil and Colombia have the most prominent number of published papers in Latin America. The most frequent international journal covering the topic of Pharmacotherapeutic Follow-up was the American Journal of Health-Pharmacy (12.4%), while on the Dader Method, the journal Pharmaceutical Care Spain (21.7%) is in the first position, followed by Farmacia Hospitalaria (8.4%). Conclusion: The publications on the Dader method highlighs the greater productivity of the University of Granada and the author María José Faus Dáder. The inclusion of patients in the PTF service using the Dader Method, is more frequent in the hospital context, and is based on the presence of defined chronic pathologies (mainly diabetes), polymedication or specialized care follow-up, with elderly population being the most represented in all cases. [ABSTRACT FROM AUTHOR]

Objectives: There are approximately 5.3 million informal carers in the United Kingdom, many of whom support family in their health despite being unpaid and often unsupported. Many visit pharmacies to collect medicines and look for advice. This work explores informal carer support within community pharmacies (CP)., Methods: Semi-structured video interviews exploring perspectives on the role of CP in supporting carers were conducted in autumn 2022. The study received institutional ethical approval. Interviews were audio-recorded, transcribed verbatim, and analysed using a reflexive thematic approach., Key Findings: In total 25 interviews were conducted with 13 carers and 12 pharmacy staff. Three themes were identified:-What support do carers need through CP?-medicines management, navigating services, and carers health and wellbeing.-Barriers to CP better supporting carers-relationships with CP, carer needs, identification as a 'carer'.-Enablers to CP better supporting carers-support is a team effort, and CP as a community 'hub'., Conclusions: There is a trusted relationships between carers and pharmacy staff which can contribute to establishing pharmacies as a safe space of support, this includes medicines-specific support and navigating services, but also carer health and wellbeing support. Pharmacy staff may need to reconsider approaches to identifying and supporting carers and not just treating them as an extension of supporting a patient. In making this support accessible, relationships with pharmacy staff are important, as well as embracing CP as a 'community hub', although pharmacy staff may need training and information to facilitate them in this role., (© The Author(s) 2024. Published by Oxford University Press on behalf of the Royal Pharmaceutical Society.)

Background: Failure of the Falsified Medicines Directive (FMD) in the UK could mean that substandard and falsified medicines (SFs) enter the supply chain. Does this risk patients' health? Readiness to implement FMD, and prevalence of SFs vs. regulator detection were assessed., Research Design and Methods: A total of 12,040 primary care pharmacies across England were invited (April 2021-March 2022). Respondent postcodes were used to extract deprivation scores. Information request was placed with the medicine's agency. Survey findings were used to calculate probability and power of a simulated trial., Results: A total of 208 participants responded: Of the seven who identified SFs, all but one reported it; 61% were ready to implement FMD, 74.1% had adequate resources, 54.8% expected improved patient safety, and 17.8% had ever reported SFs. SFs were prevalent in deprived areas. Bayesian simulation shows 438 ( p = 0.030) incidences with a 3% probability of SFs prevalence. The agency identified 15,238 SFs units in the supply chain (2019 and 2020). Results are credible, reliable, and generalisable, with corroborated longitudinal persistence., Conclusions: FMD or equivalent processes need to be urgently reinstated. Deprived children may be more affected. Pharmacists are worried about liability. All health consultations should assess safety, and effectiveness of medicines. Findings should inform policy, systems planning, surveillance, and evaluations.

The article examines laws in Great Britain ensuring patients to get reliable information about their illness and treatment options. Topics discussed include relation between transparency and trust in pharmaceutical regulators; need of integrating transparency in effective, evidenced- and science based benefit/risk communication; and need of different regulatory domains to obtain a understanding of the role of the institutional and situational context.

Objectives The Department of Health in England developed the 'You're Welcome' framework, comprising criteria for all health services seeing 11- to 19-year olds, to improve their quality and coverage and reduce access inequities. To date, however, the 'You're Welcome' criteria have not been considered within community pharmacy service development policy. The aim of this article was to assess the relevance of the 'You're Welcome' criteria to community pharmacy, and examine ways in which they are currently met, or not met, to guide future service development. Methods The project employed three methods. Checklist-guided observations and face-to-face semistructured interviews with staff members were undertaken in eight community pharmacies across England and Scotland, purposively selected because of their known focus on provision of young people's services. This was complemented by a cross-sectional online survey for completion by pharmacy staff across a wider range of pharmacies recruited through targeted Local Pharmaceutical Committees (LPC). Study instruments were designed to gather information relevant to each of the 'You're Welcome' criteria. Key findings Eight pharmacies took part in observations and interviews. Six LPCs posted the online survey link on their website, which was returned by 56 respondents. The results demonstrate applicability of the 'You're Welcome' criteria to community pharmacy services, highlighting particular strengths of community pharmacy services for young people (e.g. accessibility) as well as opportunities and priorities for service development to meet their specific needs (e.g. staff training, engagement and integration with local service provision). Conclusions The 'You're Welcome' criteria can be applied to community pharmacy services without adaptation providing an appropriate framework to guide service development to promote young people friendly pharmacy services. [ABSTRACT FROM AUTHOR]

Objective: To introduce the training of clinical pharmacists and the service mode of pharmaceutical care，so as to provide reference for further development of clinical pharmaceutical care in our country，and more importantly to achieve the goal of better service for patients. Methods:Through personal experience of the training in the UK，the authors introduced in detail the school education，the training in hospitals and the present working mode of clinical pharmacists in the UK. Results: The service mode of pharmaceutical care in British hospitals was worth our study，including the hierarchy management of pharmacists，the electronic medical advice review system，integrated pharmaceutical care，outpatient service by pharmacists and so on. Conclusion: As a member of the medical team，clinical pharmacists should learn from mature experience of other countries，extend the coverage of pharmaceutical care and blaze new trails in their work. [ABSTRACT FROM AUTHOR]

Background: Many countries, including the United Kingdom, have established Emergency Department (ED) pharmacy services where some ED pharmacists now work as practitioners. They provide both traditional pharmaceutical care and novel practitioner care i.e. clinical examination, yet their impact on quality of care is unknown., Aim: To develop a framework of structures, processes and potential outcome indicators to support evaluation of the quality of ED pharmacy services in future studies., Method: Framework components (structures, processes and potential outcome indicators) were identified in three ways: from a narrative review of relevant international literature, and separate panel meetings with ED pharmacists and then other ED healthcare professionals. Structures and processes were collated into categories developed iteratively throughout data collection, with outcome indicators collated into six domains of quality as proposed by the Institute of Medicine. These raw data were then processed e.g. outcome indicators screened for clarity i.e. those which explicitly stated what would be measured were included in the framework., Results: A total of 190 structures, 533 processes, and 503 outcome indicators were identified. Through data processing a total of 153 outcome indicators were included in the final framework divided into the domains safe (32), effective (50), patient centred (18), timely (24), efficient (20) and equitable (9)., Conclusion: The first framework specific to the quality evaluation ED pharmacy services, service evaluators should validate potential outcome indicators prior to their use. The minimum expected of a high-quality service should also be defined to enable interpretation of relevant measurements., (© 2022. The Author(s).)

Background: In 2017, the General Pharmaceutical Council (UK) issued new Standards for Pharmacy Professionals and supporting guidance, Guidance on Religion, Personal Values and Beliefs, to help pharmacists when their religion, personal values or beliefs might impact on their provision of services., Objective: To understand how pharmacists in the UK experience and perceive conflicts between their personal ethical commitments (matters of conscience) and professional obligations in guidance from their regulator., Methods: Twenty-four registered pharmacists were interviewed using semi-structured interviews. Interviews were transcribed verbatim and analysed using thematic analysis., Key Findings: Participants were generally aware of the Council's consultations and responded if they had something to say, or it was their role to respond. Age and stage, confidence, and workload impacted on whether participants responded to Council consultations, and, therefore, on the range of views heard. The professional obligation to provide person-centred care (PCC) was central to participants' practice, and personal ethical commitments were important to some. Conflicts between such commitments and professional obligations were rare, and it was generally believed that the former should be accommodated, as far as possible, but not imposed on others. Personal ethical commitments could affect PCC, and some suggested that the Council's Guidance was not clear on pharmacists' responsibilities in this regard., Conclusions: Clarification on the role of personal ethical commitments in professional practice, particularly in relation to providing PCC, would be useful. Clearer guidance on how pharmacists should manage perceived conflicts between their personal ethical commitments and their professional obligations would also be welcomed., (© The Author(s) 2022. Published by Oxford University Press on behalf of the Royal Pharmaceutical Society. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

The article presents a synopsis of legal developments in the pharmaceutical industry. The Preliminary Report gleams a light on European Union's (EU's) chief concerns in the pharmaceutical sector. Great Britain Medicines and Healthcare Products Regulatory Agency guidance provides helpful advice to suppliers of medicine aiming Great Britain customers on the use of websites as a tool to boost their services. The European Patent Office (EPO) rules that European law would not permit the patenting of inventions, which led in the destruction of human embryo.

This paper provides the generic pharmaceutical executive with a legal roadmap for acquiring pharmaceutical assets. It describes the three main steps to product acquisition, which are as follows: (1) negotiation and execution of a detailed letter of intent; (2) performance of buyer's due diligence; and (3) negotiation and closing of the acquisition agreement. It also explains the relationship among these three steps and why each step is important to the buyer. In discussing each step of the acquisition process, this paper identifies the key considerations and issues for the buyer to help the buyer mitigate the risks inherent in the acquisition of generic pharmaceutical assets.Journal of Generic Medicines (2008) 6, 9–14. doi:10.1057/jgm.2008.28; published online 28 October 2008 [ABSTRACT FROM AUTHOR]

This article reports about the time when pharmaceutical companies are outsourcing manufacturing to cut costs, and is expanding its award-winning plant in the UK where it makes some of the biggest healthcare brands. An approach is taken to minimise costs and to maximise performance and get the most out of people-which means investing in them. In a global marketplace where UK factories continue to face pressures of closures and outsourcing overseas, healthcare operation looks set to buck the trend and remain in its historic Hull location. [ABSTRACT FROM AUTHOR]

As the world of work changes, UK pharmacists are increasingly required to recognise and articulate lifelong learning. College of Pharmacy Practice (CPP) portfolios were made available to 25 pharmacists in a single Workforce Development Confederation area. The evaluation reported here formed one strand of a larger study exploring CPD activity in the NHS. This strand aimed to describe and consider the ways in which pharmacists used the CPP portfolio as a vehicle to articulate their acquisition and use of practice based knowledge. Data were obtained through semi-structured interviews with nine pharmacists before and after using the portfolios ( n = 18 interviews) and were analysed using “framework technique”. Key emergent themes were “socialised learning” and “learning amplification”, in particular the findings emphasised the importance of recognising:the advantages/disadvantages of work based (socialised) learning approaches; andthe environment in which learning takes place and ensuring that learning can be “amplified” for the individual and the organisation. [ABSTRACT FROM AUTHOR]

Social pharmacy is a relatively recent introduction into the curricula of UK pharmacy schools. As little is known of how this subject area is currently taught, an investigation was undertaken to establish the nature and content of social pharmacy teaching in UK schools of pharmacy. A self-completed questionnaire was issued electronically and via post to the member of academic staff responsible for the design and development of social pharmacy teaching within each UK school of pharmacy. A 100% response rate was achieved. Currently, all pharmacy students in the UK are taught and assessed in social pharmacy. Courses vary in content and emphasis throughout the UK, but they have in common an emphasis on defining and measuring health and illness, social factors and health and health inequalities. Social theory was taught in less than half the schools surveyed. Student contact hours in social pharmacy varied from 7 to 83 h, with a mean of 30 h. In six schools social pharmacy was taught in each year of the course, whilst in three schools it was taught in one year only. Social pharmacy was seen as bringing an additional perspective to both scientific, drug-focussed aspects of the course as well as to the clinical and practice components. In conclusion, social pharmacy is an established and often integrated component of the pharmacy degree at UK schools of pharmacy, which those responsible for teaching see as maintaining or extending its position within the curriculum in future years. [ABSTRACT FROM AUTHOR]

This paper describes an empirical study of market segmentation practice in the pharmaceutical industry. It finds that, by comparison with best practice observed both in other sectors and within the industry, most firms have been slow to adopt approaches that are known to be effective. Although practical explanations for this are cited, this research indicates that the real reasons that pharmaceutical firms are slow to develop such strategically important competencies lie in the industry mind-set and culture. [ABSTRACT FROM AUTHOR]

Abstract: Objective: The objective of this study was to implement a brief intervention in asthma within a UK national pharmacy chain, and through the use of mystery customers, measure the extent of delivery of the intervention over a 4-month period. Methods: Mystery customers gathered information on which of the asthma intervention questions were asked, and any lifestyle advice that was given. Additional information was collected on the type of store they visited and the personnel who served them. Results: Mystery customer results indicate delivery rates of the intervention between 48.1 and 84.3% across the 4-month assessment period. This intervention was delivered by both pharmacists and healthcare staff, although the extent and content of delivery varied across the 4 months. Conclusion: The use of mystery customers has helped to assess the successful take up and delivery of this intervention. Based on the learning points gained throughout this study, future services can be designed for other condition areas. Practice implications: Each service that is designed needs to be simple to implement and deliver, and have the flexibility for pharmacists and staff to adapt the services to meet local requirements. [Copyright &y& Elsevier]

Purpose. The methods currently used by English National Health Service (NHS) hospitals to manage the use of medicines were studied. Methods. A questionnaire was mailed to directors of pharmacy at all English NHS hospitals in May 2001. Results. The response rate was 57% (157/ 275). Sixty-six percent of the responding hospitals provided general acute care services, and 34% provided mental health services. About 1 responder in 5 (19%) was a specialty hospital functioning either as a freestanding institution or alongside other hospitals. The average total expenditure by the hospital trusts was £94 million ($175 million), of which drugs accounted for £3.5 million ($6.5 million). Many hospitals either had formularies or were constructing them (86%), and most hospitals used a process to manage the introduction of new medicines. About three fourths of the hospitals had ≤20 pharmacist full-time equivalents. The implementation of national guidelines was variable, although some of this variation may have been due to differences in service provision. Few hospitals were actively monitoring compliance with guidelines (31%), but audits of current care were common (72%). Conclusion. A survey of English NHS hospitals provided information on pharmacy staffing, drug expenditures, and measures taken to ensure rational medication use. [ABSTRACT FROM AUTHOR]

Background: This trial aims to investigate the effectiveness and cost implications of 'pharmaceutical care' provided by community pharmacists to elderly patients in the community. As the UK government has proposed that by 2004 pharmaceutical care services should extend nationwide, this provides an opportunity to evaluate the effect of pharmaceutical care for the elderly. Design: The trial design is a randomised multiple interrupted time series. We aim to recruit 700 patients from about 20 general practices, each associated with about three community pharmacies, from each of the five Primary Care Trusts in North and East Yorkshire. We shall randomise the five resulting groups of practices, pharmacies and patients to begin pharmaceutical care in five successive phases. All five will act as controls until they receive the intervention in a random sequence. Until they receive training community pharmacists will provide their usual dispensing services and so act as controls. The community pharmacists and general practitioners will receive training in pharmaceutical care for the elderly. Once trained, community pharmacists will meet recruited patients, either in their pharmacies (in a consultation room or dispensary to preserve confidentiality) or at home. They will identify drug-related issues/problems, and design a pharmaceutical care plan in conjunction with both the GP and the patient. They will implement, monitor, and update this plan monthly. The primary outcome measure is the 'Medication Appropriateness Index'. Secondary measures include adverse events, quality of life, and patient knowledge and compliance. We shall also investigate the cost of pharmaceutical care to the NHS, to patients and to society as a whole. [ABSTRACT FROM AUTHOR]

Based on an 'independent contractor' model, most community pharmacies have traditionally been owned by self-employed pharmacists running them as small businesses. With the rapid erosion of this pattern of ownership, issues arise for public, professional and commercial policy makers. For health policy purposes, particular consideration needs to be given to options for fully utilizing the expertise of community pharmacists; securing equal access to services; and ensuring rationality and transparency in making decisions about the location of pharmacies. [ABSTRACT FROM AUTHOR]

In Britain, there are a wide range of agencies providing many types of service to drug users. Such provision, it is argued, should be monitored and evaluated in the same way as provision to other client groups. To this end, the paper focuses on one aspect of drug service evaluation; users' views of service providers. Semi-structured qualitative interviews were conducted with 124 illicit drug users in rural, urban and inner city areas of Scotland and the respondents' comments were analysed inductively using the software package, Winmax. The study revealed three main findings. First, there was a high level of consensus amongst users regarding desired and undesired provider characteristics; and these characteristics held regardless of agency type. Secondly, users simultaneously retained different expectations of the different agencies and did not consider these agencies to be interchangeable. Thirdly, gender differences in attitudes to, and use, the different providers were apparent. The paper concludes that it is necessary to recognize the fundamental role that process factors, particularly providers' attitudes, play in terms of drug users' overall perception and evaluation of services. Additionally, although agencies should aim to provide a broad range of flexible forms of assistance, providers are not interchangeable and the continued development of a flexible mixture of interactive drug services and providers is recommended. Finally, drug users do not provide the definitive statement about the value of drug service provision. Nevertheless, their views and experiences are an important aspect of service evaluation and consequently deserve careful attention from policy, practice and research. [ABSTRACT FROM AUTHOR]

The article discusses the machinery for complaints in the National Health Service of Great Britain. The machinery for complaints in the health service is particularly interesting and important because part of it, that part which is the responsibility of the National Health Service Executive Councils. There are in England and Wales, 138 National Health Service Executive Councils based upon county and county borough areas, with some Executive Councils covering more than one county area where the population is very small and in Scotland there are twenty-five Executive Councils. Service Committee hearings are not always concerned with complaints from patients. Many hearings by Pharmaceutical Service Committees, for example, follow upon the specimen testing of chemists' prescriptions carried out on the instructions of Executive Councils.

Pharmacy has developed many novel patient-facing roles across the globe, typically delivered through the lens of pharmaceutical care. The macro-level implementation of such interventions is, however, fraught with difficulty. At an individual-level, psychological barriers of pharmacists and their ability to deliver autonomous complex clinical care are key considerations. As the United Kingdom imminently plans to launch a new advanced pharmacist practice curriculum and credentialing process to support advanced skills development, this commentary discusses where progress to date has taken us and what other developmental, environmental and cultural changes are needed to support this. The commentary also challenges some of pharmacy's historic dogma, discusses a requirement for teaching to transcend simplistic concepts of medicines-harm, considers the need for the standardisation of clinical skills and discusses the necessity of formal advanced practice programmes and preceptorship models. It finally proposes the concept of Advanced Pharmacist Practitioners as the ultimate future vision of autonomous practice and the need for Government Policy to support their creation., (© 2021. Crown.)

The article offers an analysis of the Australian Pharmaceutical Benefits Scheme (PBS). PBS guarantees Australians access to subsidized medicines. It is a central feature of Medicare, the universal health care program in Australia. The Pharmaceutical Benefits Advisory Committee decides which drugs should be subsidized, the prices at which they are cost effective, and what restrictions should be applied to their use. This article compares PBS to the British National Institute for Health and Clinical Excellence (NICE). NICE, unlike PBS, is independent from the government. NICE and PBS have different relationships with the pharmaceutical industry.

The article discusses the unnoticeable concern of several drug companies in Great Britain. The House of Commons Health Committee has recommended that pharmaceutical companies should publish the results of all their trials and follow guidelines for responsible publication practice. However, faultfinders argued that the recommendation rarely have much influence over powerful commercial companies.

Introduction: Globally, pharmacy undergraduate programs are evolving to reflect a more patient-centered approach to clinical practice. The importance of teaching communication skills in any undergraduate pharmacy curriculum cannot be overstated. This article compares current literature and practices related to pharmacy services and communication skills training (CST) in pharmacy undergraduate education in the United Kingdom (UK) and Turkey and discusses the need for an urgent change in the CST curriculum in Turkey. Additionally, the article provides potential strategies for improving the quality of CST and for expanding pharmacy practice to ensure students and graduates are motivated to use communication skills., Commentary: The traditionally structured curriculum in Turkey, where the basic sciences components are in the early years and clinical experiences in the later years, should be changed into an integrated environment so that CST could be more effectively incorporated. The CST offered at the University of Nottingham could be considered as a framework., Implications: To meet patient care and educational needs, the authors have identified three key strategies to develop a change in CST for curriculum planners and policy makers in Turkey., (Crown Copyright © 2020. Published by Elsevier Inc. All rights reserved.)

Background: The 'Clinical Pharmacists in General Practice' (CPGP) pilot provided a template for general practice pharmacy professionals' (GPPPs) roles encouraging NHS England to fund >2000 practice-based pharmacists. However, many GPPPs work outside the CPGP initiative and little is known about the services they provide., Objectives: To explore services provided by all UK GPPPs (pharmacists/pharmacy technicians), including the types of services, perceived benefits and barriers to role development., Methods: A 26-item electronic questionnaire was developed using SurveyMonkey and piloted during cognitive interviews. A cross-sectional survey was conducted via social media, primary care organisations and emails to CPGP pilot sites between November 2018 and March 2019. Three reminders were sent 1 week apart., Key Findings: Ninety-one complete responses were received (81 pharmacists; 10 technicians). Over 80% of pharmacists provided clinical services, such as medication reviews or management of long-term conditions. More pharmacists within CPGP pilot managed repeat prescribing requests (P = 0.035). Technicians took responsibility for primarily non-clinical roles, including commissioning or safety alerts/drug recalls. A third of GPPPs wished to develop care home services. Perceived benefits of GPPPs' services included improved utilisation/development of professional skills, identifying medicines-related issues and reduction in medication waste. Respondents were satisfied with professional relationships but reported workload issues, limited patient awareness of their roles and restricted opportunities to contribute to service development, which was associated with unsatisfactory support/mentorship (P < 0.001)., Conclusion: General practice pharmacy professionals deliver clinical and non-clinical services which may benefit patients, general practice and the healthcare system. General practices and national organisations should provide GPPPs with tailored support and exploit the combined strengths of pharmacists and pharmacy technicians to tackle increased workload., (© The Author(s) 2020. Published by Oxford University Press on behalf of the Royal Pharmaceutical Society. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Non-medical prescribing was introduced into the United Kingdom to improve patient care, but early research indicated a third of Allied Health Professionals may not use their prescribing qualification. A previous literature review, highlighting factors influencing prescribing, identified only papers with nursing and pharmacy participants. This investigation explored consensus on factors affecting physiotherapist and pharmacist non-medical prescribers. A three round Delphi study was conducted with pharmacist and physiotherapist prescribers. Round One comprised information gathering on facilitators and barriers to prescribing participants had experienced, and underwent content analysis. This was followed by two sequential consensus seeking rounds with participants asked to rate the importance of statements to themselves. Consensus criteria were determined a priori, including median, interquartile range, percentage agreement and Kendall's Coefficient of Concordance (W). Statements reaching consensus were ranked for importance in Round Three and analysed to produce top ten ranks for all participants and for each professional group. Participants, recruited October 2018, comprised 24 pharmacists and 18 physiotherapists. In Round One, content analysis of 172 statements regarding prescribing influences revealed 24 themes. 127 statements were included in Round Two for importance rating (barriers = 68, facilitators = 59). After Round Two, 29 statements reached consensus (barriers = 1, facilitators = 28), with no further statements reaching consensus following Round Three. The highest ranked statement in Round Three overall was: "Being able to prescribe to patients is more effective and really useful working [in my area]". Medical support and improved patient care factors appeared the most important. Differences were noted between physiotherapist and pharmacist prescribers regarding the top ten ranked statements, for example team working which pharmacists ranked higher than physiotherapists. Differences may be explained by the variety of practice areas and relative newness of physiotherapy prescribing. Barriers appear to be post or person specific, whereas facilitators appear universal., Competing Interests: The authors have declared that no competing interests exist.

Background: Emergency contraception (EC) was approved in the UK as a pharmacy medicine for purchase without prescription in 2001. Twenty years later we conducted a study to characterise routine practice pharmacy provision of EC., Study Design: Mystery shopper study of 30 pharmacies in Edinburgh, Dundee and London participating in a clinical trial of contraception after EC., Methods: Mystery shoppers, aged ≥16 years, followed a standard scenario requesting EC. After the pharmacy visit, they completed a proforma recording the duration of the consultation, where it took place, and whether advice was given to them about the importance of ongoing contraception after EC., Results: Fifty-five mystery shopper visits were conducted. The median reported duration of the consultation with the pharmacist was 6 (range 1-18) min. Consultations took place in a private room in 34 cases (62%) and at the shop counter in the remainder. In 27 cases (49%) women received advice about ongoing contraception. Eleven women (20%) left the pharmacy without EC due to lack of supplies or of a trained pharmacist. Most women were generally positive about the consultation., Conclusions: While availability of EC from UK pharmacies has undoubtedly improved access, the necessity to have a consultation, however helpful, with a pharmacist introduces delays and around one in five of our mystery shoppers left without getting EC. Consultations in private are not always possible and little advice is given about ongoing contraception. It is time to make EC available without a pharmacy consultation., Competing Interests: Competing interests: AG is a member of HRA Pharma scientific advisory board. PB is a Clinical Director of the not-for profit community interest company SH:24 that provides online sexual health services in partnership with the NHS. AR is in receipt of research grants, educational grants and consultancy with Gilead, research grants from Roche and BMS, and educational grants from Abbvie. JN is Deputy Chair of the NIHR/HTA General Board Committee. NIHR/HTA funded this research., (© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY. Published by BMJ.)

Objective. To explore the lived experiences of pharmacy students undertaking an early preregistration training placement in the United Kingdom, particularly with respect to the development of different aspects of their professionalism. Methods. Fourteen students returning from an early preregistration placement (during the third year of their pharmacy degree) were interviewed, using a semi-structured approach. Grounded theory methods were used to analyze the transcripts and a theory was developed. Results. Developing a professional identity was the core process that occurred during the placement. This included four stages: reflection, selection of attributes, professional socialization, and perception of role. As a consequence of developing a professional identity, participants had a strong vision of the kind of pharmacist they wanted to be when qualified. They articulated an increased responsibility as students, and began to see themselves as a "trainee professional." Conclusion. The findings of this study strongly support having an early preregistration period for pharmacy students to develop a sense of professional identity and strengthen their motivation to learn., (© 2020 American Association of Colleges of Pharmacy.)

Background: Prescribing, monitoring and administration of medicines in care homes could be improved. A cluster randomised controlled trial (RCT) is ongoing to evaluate the effectiveness of an independent prescribing pharmacist assuming responsibility for medicines management in care homes compared to usual care., Aims and Objectives: To conduct a mixed-methods process evaluation of the RCT, in line with Medical Research Council (MRC) process evaluation guidance, to inform interpretation of main trial findings and if the service is found to be effective and efficient, to inform subsequent implementation., Objectives: 1. To describe the intervention as delivered in terms of quality, quantity, adaptations and variations across triads and time. 2. To explore the effects of individual intervention components on the primary outcomes. 3. To investigate the mechanisms of impact. 4. To describe the perceived effectiveness of relevant intervention components [including pharmacist independent prescriber (PIP) training and care home staff training] from participant [general practitioner (GP), care home, PIP and resident/relative] perspectives. 5. To describe the characteristics of GP, care home, PIP and resident participants to assess reach. 6. To estimate the extent to which intervention delivery is normalised among the intervention healthcare professionals and related practice staff., Methods: A mix of quantitative (surveys, record reviews) and qualitative (interviews) approaches will be used to collect data on the extent of the delivery of detailed tasks required to implement the new service, to collect data to confirm the mechanism of impact as hypothesised in the logic model, to collect explanatory process and final outcome data, and data on contextual factors which could have facilitated or hindered effective and efficient delivery of the service., Discussion: Recruitment is ongoing and the trial should complete in early 2020. The systematic and comprehensive approach that is being adopted will ensure data is captured on all aspects of the study, and allow a full understanding of the implementation of the service and the RCT findings. With so many interrelated factors involved it is important that a process evaluation is undertaken to enable us to identify which elements of the service were deemed to be effective, explain any differences seen, and identify enablers, barriers and future adaptions., Trial Registration: ISRCTN17847169. Date registered: 15 December 2017.

Background: Prescribing, monitoring and administration of medicines in care homes could be improved. Research has identified the need for one person to assume overall responsibility for the management of medicines within each care home. and shown that a pharmacist independent prescriber service is feasible in this context., Aims and Objectives: To conduct a cluster randomised controlled trial to determine the effectiveness and cost-effectiveness of a pharmacist-independent prescribing service in care homes compared to usual general practitioner (GP)-led care., Objectives: To perform a definitive randomised controlled trial (RCT) with an internal pilot to determine the intervention's effectiveness and cost-effectiveness and enable modelling beyond the end of the trial., Methods: This protocol is for a cluster RCT with a 3-month internal pilot to confirm that recruitment is achievable, and there are no safety concerns. The unit of randomisation is a triad comprising a pharmacist-independent prescriber (PIP) based in a GP practice with sufficient registered patients resident in one or more care homes to allow recruitment of an average of 20 participants. In the intervention group, the PIP will, in collaboration with the GP: assume responsibility for prescribing and managing residents' medicines including medication review and pharmaceutical care planning; support systematic ordering and administration in the care home, GP practice and supplying pharmacy; train care home and GP practice staff; communicate with GP practice, care home, supplying community pharmacy and study team. The intervention will last 6 months. The primary outcome will be resident falls at 6 months. Secondary outcomes include resident health-related quality of life, falls at 3 months, medication burden, medication appropriateness, mortality and hospitalisations. A full health economic analysis will be undertaken. The target sample size is 880 residents (440) in each arm) from 44 triads. This number is sufficient to detect a decrease in fall rate from 1.5 per individual to 1.178 (relative reduction of 21%) with 80% power and an ICC of 0.05 or less., Discussion: Recruitment is on-going and the trial should complete in early 2020. The trial results will have implications for the future management of residents in care homes and the ongoing implementation of independent pharmacist prescribing., Trial Registration: ISRCTN, ID: 17847169. Registered on 15 December 2017.

Objectives: The National Health Service (NHS) in England recently introduced general practice pharmacists (GPPs) to provide medication-focused support to both patients and the general practice team. This healthcare model may benefit people with asthma, who currently receive suboptimal care and demonstrate low medication adherence. This study aimed to explore the perspectives of adults with asthma on the potential for pharmacist-led adherence support delivered in general practice, with a focus on how these perspectives are formed., Design and Setting: The study was conducted in the United Kingdom (UK) utilising a qualitative interview methodology. Participants were invited to partake in a telephone-based semistructured interview, followed by an online questionnaire for demographic details and asthma history. Qualitative data were analysed using thematic analysis., Participants: Participants (n=17) were adults with asthma in the UK with a prescription for an inhaled corticosteroid. Participants did not have previous experience with GPPs and were asked to provide their views on a proposed GPP-led service., Results: Participant perspectives of GPPs were determined by trust in pharmacists, perceived gaps in asthma care and the perceived strain on the NHS. Trust was based on pharmacists' perceived clinical competency, established over time, and gauged through a 'benchmarking' process. GPP's fit in current asthma care was assessed based on potential role overlap with other healthcare professionals, continuity of care and medication-related support needs. Participants navigated the NHS based on a perceived hierarchy of healthcare professionals (general practitioners on top, nurses, then pharmacists), and this influenced their perspectives of GPPs., Conclusion: While the GPP scheme shows promise based on the perspectives of people with asthma, the identified barriers to optimal patient engagement and service implementation will need to be addressed for the service to be effective., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY. Published by BMJ.)

Background The involvement of community pharmacists in oral health promotion is being increasingly recognised and studied. However, a large proportion of interactions in community pharmacies take place with pharmacy counter assistants rather than the pharmacist, and the role of pharmacy counter assistants in oral health promotion has received little or no attention until now.Aims To clarify the current state of affairs on pharmacy counter assistants' involvement with oral health promotion.Design and methods A postal-questionnaire-based survey of pharmacy counter assistants across East Yorkshire, North Lincolnshire and the Doncaster area. One hundred addresses were included and 35 responses were received.Results Pharmacy counter assistants are infrequently approached by the public for advice on matters of oral health and advice is not often volunteered despite a reasonable knowledge of the subject. Respondents identified a role for themselves in educating patients/customers, which they are keen to expand.Conclusions The expansion of the pharmacy counter assistant's role in oral health promotion would be of value to patients/customers. This should include increased opportunistic education and a more integrated position of pharmacy within a holistic health promotion strategy. [ABSTRACT FROM AUTHOR]

The article presents an editorial about the interrelationship between the pharmaceutical industry and the medical profession in Great Britain. According to the authors, health professionals have undoubtedly relied too greatly on the industry in the past, leading to accusations of bias. They opine that it is now time for the industry to think about the ethical consequences of its profitability decisions.

Comments on the need for drug information. Reluctance of the pharmaceutical industry to release compounds for commercial and legal reasons; Consequences of stricter implementation of research governance in the Universities and the National Health Service in Great Britain.

Discusses the quality and quantity of the information that is supplied to patients from the pharmaceutical manufacturers that provide their medicines. Launch of the Expert Patient initiative in 2001 by the government in England to encourage patients to become better informed; How companies in the pharmaceutical industry are forbidden to communicate with individual customers about their quality; Efforts to have lift the ban on advertising medicines directly to the public; Advocation of the provision of high quality patient information.