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Pitchaya Nualdaisri,1,2 Sarah A Corlett,2,3 Immaculate Akaso,4 Barbra Katusiime,5 Freddy Eric Kitutu,4 Siew Siang Chua,6 Janet Krska2 1Faculty of Pharmaceutical Sciences, Prince of Songkla University, Hat Yai, Thailand; 2Medway School of Pharmacy, Universities of Kent and Greenwich, Chatham Maritime, Kent, UK; 3Pharmacy Department, Medway Foundation NHS Trust, Kent, UK; 4Department of Pharmacy, School of Health Sciences, Makerere University, Kampala, Uganda; 5School of Life Sciences, Pharmacy and Chemistry, Department of Pharmacy, Kingston University, London, UK; 6School of Pharmacy, Faculty of Health and Medical Sciences, Taylor’s University, Subang Jaya, Selangor, MalaysiaCorrespondence: Pitchaya Nualdaisri, Email pitchaya.n@psu.ac.thBackground: Verbal and written medicine information are available to the public but the quality, ease of access, ease of understanding and use of these resources varies greatly between countries. Timely access to quality medicine information is essential to support patient safety.Objective: This international cross-sectional survey, conducted in low-to high-income countries, aimed to compare experiences of and preferences for medicine information sources among respondents with recent medicine use.Methods: The survey was originally developed in England (Kent), then adapted and translated for use in southern Thailand (Songkhla), Malaysia (Klang Valley), and central Uganda (Kampala). Data were analysed using simple descriptive statistics and Chi-squared tests.Results: A total 1588 respondents were involved in the study. Community pharmacies were the primary source of medicines in all four countries (40.7 to 65.3%). Most respondents (1460; 92%) had received at least one form of information with their medicine, but provision of written medicine information (WMI) varied between countries. A manufacturer’s leaflet was the most frequent information source for patients in England, while verbal information was common in Thailand, Malaysia a

Katusiime B, Corlett SA, Krska J. Patient Relat Outcome Meas. 2018;9:155-168. The authors have advised the correspondence address on page 155 is incorrect. The correct correspondence details are as follows. Correspondence: Barbra Katusiime Department of Pharmacy, Kingston University London, Penrhyn Road campus, Kingston upon Thames, KT1 2EE, UK Tel +44 (0)20 8417 5097 Email bkatusiime@gmail.com The authors apologize for this error.

Kamonphat Wongtaweepkij,1 Sarah Corlett,2 Janet Krska,2 Juraporn Pongwecharak,3 Narumol Jarernsiripornkul1 1Division of Clinical Pharmacy, Faculty of Pharmaceutical Sciences, Khon Kaen University, Khon Kaen, Thailand; 2Medway School of Pharmacy, The Universities of Greenwich and Kent, Kent, UK; 3Pharmacy Practice and Management Research Unit, Division of Pharmaceutical Care, Faculty of Pharmacy, Rangsit Center, Thammasat University, Pathumthani, ThailandCorrespondence: Narumol JarernsiripornkulDivision of Clinical Pharmacy, Faculty of Pharmaceutical Sciences, Khon Kaen University, Khon Kaen, 40002, ThailandEmail narumol@kku.ac.thSarah CorlettMedway School of Pharmacy, The Universities of Greenwich and Kent, Chatham, Maritime, Kent, UKEmail S.A.Corlett@kent.ac.ukPurpose: Written medicine information informs patients about the benefits and risks of medicines and supports their safe and effective use. In Thailand, patient information leaflets (PILs) are not obligatory and therefore not routinely supplied. This study aimed to explore the experiences and information needs of patients, their views on PILs and the likely impact of PILs on their knowledge, perceptions and behaviors towards medicines. These factors are important to establish the value of PILs.Methods: Semi-structured interviews with outpatients who received simvastatin or atorvastatin were conducted exploring their experiences of receiving medicine information, their views on the utility of and need for PILs, the impact of PILs on their behaviors, and recommendations for how PILs could be improved. All interviews were audio-recorded, transcribed verbatim, and analyzed using a framework approach.Results: Thirty interviews were conducted from which four themes emerged: experience of receiving medicine information, views of package inserts and PILs, impact of PILs on knowledge, perceptions and behaviors, and patients’ need for medicine information. Most participants received verbal information from he

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

Reducing AF-related stroke risk is both clinically and economically important, with AF-related illness costing the NHS over £2 billion per annum. Despite this, there is no national screening programme for AF. Growing medical consensus backed by public health policy, agrees that there is an unmet need to improve diagnosis and that primary care is an appropriate setting. This model is likely to be convenient for patients and cost effective, but with the current shortage of GPs and nurses, and increasing GP workloads, it is unlikely to succeed. Huge investment by NHS England to introduce new work role models to GP practices, could mean, by 2021, that over 34 million patients will have access to the expertise of a clinical pharmacist, making clinical pharmacists a viable option for such screening initiatives. AIM: To determine whether clinical pharmacists based within GP practices, were able to accurately and effectively screen and diagnose patients for AF, using pulse palpation and a single-lead ECG device (AliveCor Kardia Mobile®) during the influenza vaccination season.

Introduction: Atrial fibrillation (AF) affects >6% of people aged 65 years or older. Left undetected and untreated, patients may develop significant cardiovascular complications and have a fivefold increased risk of suffering a stroke. For 40% of all sufferers, AF can be asymptomatic. Every year in the UK, £2.2 billion is spent on AF-related strokes, so there is an urgent need to improve early detection of AF. This study aims to determine the feasibility of using trained clinical pharmacists based in general practices, to screen for AF, using pulse palpation and a single-lead ECG device on participants aged 65 years or older, attending influenza vaccination clinics. Methods and analysis: Seven clinical pharmacists will be trained by a cardiologist to pulse palpate and record single-lead ECGs using the AliveCor Kardia Mobile device. Quantitative analysis will assess the accuracy and ability of the clinical pharmacist to identify pulse irregularities using pulse palpation and to record and interpret a singlelead ECG. The level of agreement of pulse irregularities detected by pulse palpation will be compared with those detected by the single-lead ECG device, as will the level of agreement between the cardiologist and the device’s interpretation of the ECG. The proportion of people identified with AF (confirmed by the cardiologist) will be determined. Additional demographic data will be obtained from all participants through a questionnaire. Qualitative data will be captured from the participants, from the clinical pharmacists and from the general practitioners and practice staff to determine their views on this method of AF screening. We aim to recruit 600 participants across general practices within Kent. Ethics and dissemination: This protocol was approved by the London–Riverside Research Ethics committee. The findings of this study will be disseminated through forums including, but not limited to, peer-reviewed journals, national and international conferences.

Barbra Katusiime, Sarah A Corlett, Janet Krska Medway School of Pharmacy, The Universities of Greenwich and Kent, Chatham Maritime, UK Objectives: To revise the Living with Medicines Questionnaire version 2 (LMQ-2), which measures the burden of using prescribed medicines, to include cost and expand side effects and social issues. Methods: New statements were developed and validated through cognitive interviews with medicine users, and these and a global visual analog scale (VAS) were added to the 42-item LMQ-2. Construct validity was assessed through exploratory and confirmatory factor analyses using an online public survey. Criterion-related validity was measured against the Treatment Satisfaction Questionnaire with Medication (TSQM-II) and the EuroQoL 5-level quality of life measure (EQ-5D-5L), in patients using community pharmacies, general practices, and outpatient clinics. Reliability was assessed by test–retest using online public distribution. Results: The 58-item interim instrument (n=729) was reduced to 41 items after factor analysis, which confirmed an eight-domain structure: relationships with health professionals, practicalities, interferences, effectiveness, side effects, concerns, cost, and autonomy, constructed as medicine burden. All subscales, except autonomy, were loaded onto this construct and showed acceptable internal consistency. LMQ-VAS correlated with total LMQ scores (r=0.571). Criterion validation (n=422) demonstrated total LMQ scores negatively correlated with TSQM scores for global satisfaction (r=– 0.616); domain scores showed similar correlations: effectiveness (r=–0.628), side effects (r=–0.597), and practicalities (r=–0.529). Total LMQ score was negatively correlated with EQ VAS (r=–0.383) and showed weak/moderate relationships with individual EQ-5D-5L dimensions. Test–retest (n=30) reliability showed intra-class correlation coefficients of 0.954 (total LMQ score)

Janet Krska, Barbra Katusiime, Sarah A Corlett Medway School of Pharmacy, The Universities of Kent and Greenwich, Chatham Maritime, UK Background: Medicine-related burden is an increasingly recognized concept, stemming from the rising tide of polypharmacy, which may impact on patient behaviors, including nonadherence. No instruments currently exist which specifically measure medicine-related burden. The Living with Medicines Questionnaire (LMQ) was developed for this purpose. Objective: This study validated the LMQ in a sample of adults using regular prescription medicines in the UK. Methods: Questionnaires were distributed in community pharmacies and public places in southeast England or online through UK health websites and social media. A total of 1,177 were returned: 507 (43.1%) from pharmacy distribution and 670 (56.9%) online. Construct validity was assessed by principal components analysis and item reduction undertaken on the original 60-item pool. Known-groups analysis assessed differences in mean total scores between participants using different numbers of medicines and between those who did or did not require assistance with medicine use. Internal consistency was assessed by Cronbach’s alpha. Free-text comments were analyzed thematically to substantiate underlying dimensions. Results: A 42-item, eight-factor structure comprising intercorrelated dimensions (patient–doctor relationships and communication about medicines, patient–pharmacist communication about medicines, interferences with daily life, practical difficulties, effectiveness, acceptance of medicine use, autonomy/control over medicines and concerns about medicine use) was derived, which explained 57.4% of the total variation. Six of the eight subscales had acceptable internal consistency (α>0.7). More positive experiences were observed among patients using eight or fewer medicines compared to nine or more, and those independent with managing/using th

Background: Services provided by community pharmacists designed to support people using medicines are increasing. In England, two national services exist: Medicine Use Reviews (MUR) and New Medicines Service (NMS). Very few studies have been conducted seeking views of the public, rather than service users, on willingness to use these services or expectations of these services, or determined whether views align with pharmacist perceptions. Objective: To compare the perceptions of pharmacists and the general public on medicines-related services, particularly MUR and NMS services. Methods: Two parallel surveys were conducted in one area of England: one involved the general public and was administered using a street survey, and the other was a postal survey of community pharmacists. Similar questionnaires were used, seeking views of services, awareness, reasons for using services, and perceived benefits. Results: Response rates were 47.2% (1,000/2,012 approached) for the public and 40.8% (341/836) for pharmacists. Few people had experienced a discussion in a private consultation room or were aware of the two formal services, although their willingness to use them was high. Pharmacists estimated time spent on service provision as 10 minutes for MUR and 12 minutes for NMS, which aligned with acceptability to both pharmacists and the public. Pharmacists underestimated the willingness of the public to wait for an informal discussion or to make appointments for formal services. Both pharmacists and the public had high expectations that services would be beneficial in terms of increasing knowledge and understanding, but public expectations and experiences of services helping to sort out problems fell well below pharmacists’ perceptions. People who had experienced a pharmacy service had different perceptions of pharmacists. Conclusion: Views differed regarding why people use services and key aspects of service delivery. For services to improve, the pharmacy profession needs a

Shivaun M Gammie, Ruth M Rodgers, Ruey Leng Loo, Sarah A Corlett, Janet Krska Medway School of Pharmacy, The Universities of Greenwich and Kent, Chatham Maritime, Kent, UK Background: Public awareness of pharmacy services designed to support the use of medicines is low, yet little is known about how the public view promotion of these services, or their preferences for the attributes of pharmacies from which they would like to receive them.Objective: To compare the public’s preferred attributes of pharmacies and methods for promoting medicine-related services with community pharmacists’ perceptions of their customers’ views.Methods: Parallel surveys were conducted in South East England, using a street survey for the general public and a postal survey for community phar­macists.Results: Response rates were as follows: public 47.2% (1,000/2,012) and pharmacists 40.8% (341/836). Pharmacists’ perceptions of customer preferences for using the same pharmacy, independent ownership, and personal knowledge of the pharmacist were higher than actual public preferences. More pharmacists than public respondents also believed that approachability and previous good service would be important. The public’s desires for long opening hours and for a pharmacy with a good relationship with their doctor’s surgery were higher than pharmacists believed. The majority of the public prefer not to interrupt a pharmacist who is busy in the dispensary, which was not perceived by pharmacists as a factor. Pharmacists’ perceptions aligned more with the preferences of regular medicine users and frequent pharmacy users. Both groups viewed direct recommendation as the most effective approach for promoting pharmacy services, particularly by doctors and pharmacy staff. Pharmacists’ expectations of the effectiveness of posters and mass media methods were much higher than those of the public.Conclusion: Pharmacists and

Ruth M Rodgers, Shivaun M Gammie, Ruey Leng Loo, Sarah A Corlett, Janet Krska Medway School of Pharmacy, The Universities of Greenwich and Kent, Chatham Maritime, UK Background: Services provided by community pharmacists designed to support people using medicines are increasing. In England, two national services exist: Medicine Use Reviews (MUR) and New Medicines Service (NMS). Very few studies have been conducted seeking views of the public, rather than service users, on willingness to use these services or expectations of these services, or determined whether views align with pharmacist perceptions. Objective: To compare the perceptions of pharmacists and the general public on medicines-related services, particularly MUR and NMS services. Methods: Two parallel surveys were conducted in one area of England: one involved the general public and was administered using a street survey, and the other was a postal survey of community pharmacists. Similar questionnaires were used, seeking views of services, awareness, reasons for using services, and perceived benefits. Results: Response rates were 47.2% (1,000/2,012 approached) for the public and 40.8% (341/836) for pharmacists. Few people had experienced a discussion in a private consultation room or were aware of the two formal services, although their willingness to use them was high. Pharmacists estimated time spent on service provision as 10 minutes for MUR and 12 minutes for NMS, which aligned with acceptability to both pharmacists and the public. Pharmacists underestimated the willingness of the public to wait for an informal discussion or to make appointments for formal services. Both pharmacists and the public had high expectations that services would be beneficial in terms of increasing knowledge and understanding, but public expectations and experiences of services helping to sort out problems fell well below pharmacists’ perceptions. People who had experienced a pharmacy service had different percept