Main Article Content
Child, Adolescent, Parents, Caregivers, Professional Practice, Pharmacies, Community Pharmacy Services, Pharmacists, Medication Adherence, Surveys and Questionnaires, Cross-Sectional Studies, United Kingdom
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.
2. Pharmaceutical Services Negotiating Committee (PSNC). Advanced Services. Available at: https://psnc.org.uk/services-commissioning/advanced-services/ (accessed Sep 11, 2019).
3. Office for National Statistics. Overview of the UK population: November 2018. Available at: https://www.ons.gov.uk/peoplepopulationandcommunity/populationandmigration/po pulationestimates/articles/overviewoftheukpopulation/november2018 (accessed Sep 11, 2019).
4. Association for Young People’s Health. Key data on young people 2019: Latest information and statistics. Available at: http://ayph.org.uk/key-data-on-young-people (accessed Sep 10, 2019).
5. Can we improve adolescent adherence? Drug Ther Bull. 2016;54(1):6-9. https://doi.org/10.1136/dtb.2016.1.0375
6. World Health Organization (WHO). Adherence to Long-term Therapies. Evidence for Action. Available at: https://apps.who.int/medicinedocs/pdf/s4883e/s4883e.pdf (accessed Sep 10, 2019).
7. Santer M, Ring N, Yardley L, Geraghty AW, Wyke S. Treatment non-adherence in pediatric long-term medical conditions: systematic review and synthesis of qualitative studies of caregivers' views. BMC Pediatr. 2014;14:63. https://doi.org/10.1186/1471-2431-14-63
8. Matsui D. Current issues in pediatric medication adherence. Paediatr Drugs. 2007;9(5):283-288. https://doi.org/10.2165/00148581-200709050-00001
9. Aston J, Huynh C, Sinclair A, Wilson K, Terry D. Medication review of children on long-term medications: a review of the literature. Arch Dis Child. 2016;101(9):e2. https://doi.org/10.1136/archdischild-2016-311535.47
10. National Institute for Health and Care Excellence (NICE). Medicines Optimisation: The Safe and Effective Use of Medicines to Enable the Best Possible Outcomes. London: NICE; 2015.
11. Pharmaceutical Services Negotiating Committee (PSNC). MUR statistics. [Internet]. http://psnc.org.uk/funding-and-statistics/nhs- statistics/mur-statistics/ (accessed Apr 12, 2019).
12. World Health Organization. ICD 11. Available at: https://www.who.int/classifications/icd/en/ (accessed Feb 13, 2020)
13. Gray N, Prescott J. Community pharmacists’ engagement with young people aged 13-19 years. Int J Pharm Pract. 2013;21(S2):128.
14. Aston J, Wilson KA, Terry DRP. Children/young people taking long-term medication: a survey of community pharmacists’ experiences in England. Int J Pharm Pract. 2018;26(2):104-110. https://doi.org/10.1111/ijpp.12371
15. Public Health England (PHE). A Menu of Interventions for Productive Healthy Ageing For pharmacy teams working in different settings. Available at: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attach ment_data/file/786248/a_menu_of_interventions_for_productive_healthy_ageing.pdf (accessed Sep 10, 2019).
16. Public Health England (PHE). Pharmacy: A Way Forward for Public Health Opportunities for action through pharmacy for public health. Available at:https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attach ment_data/file/643520/Pharmacy_a_way_forward_for_public_health.pdf (accessed Sep10, 2019).
17. Horsfield E, Kelly F, Sheridan J, Stewart J, Clark T. Could community pharmacies help to improve youth health? Service availability and views of pharmacy personnel in New Zealand. Int J Public Health. 2014;59(5):789-798. https://doi.org/10.1007/s00038-014-0593-3
18. Hindi AMK, Schafheutle EI, Jacobs S. Patient and public perspectives of community pharmacies in the United Kingdom: A systematic review. Health Expect. 2018;21(2):409-428. https://doi.org/10.1111/hex.12639
19. Aimaurai S, Jumpated A, Krass I, Dhippayom T. Patient opinions on medicineuse review: exploring an expanding role of community pharmacists. Patient Prefer Adherence. 2017;11:751-760. https://doi.org/10.2147/PPA.S132054
20. Mukattash TL, Jarab AS, Abu-Farha RK, Nusair MB. A qualitative assessment of the pediatric content in pharmacy curricula adopted by pharmacy schools in Jordan. Pharm Pract (Granada). 2019;17(1):1355. https://doi.org/10.18549/PharmPract.2019.1.1355
21. Darmanin Ellul R, Cordina M, Buhagiar A, Fenech A, Mifsud J. Knowledge and sources of information about medicines among adolescents in Malta. Pharm Pract (Granada). 2008;6(4):178-186. https://doi.org/10.4321/s1886-36552008000400002
22. Latif A. Community pharmacy Medicines Use Review: current challenges. Integr Pharm Res Pract. 2018;7:83-92. https://doi.org/10.2147/IPRP.S148765
23. Simpson CR, Sheikh A. Trends in epidemiology of asthma in England: a national study of 333,294 patients. J R Soc Med. 2010;103(3):98-106. https://doi.org/10.1258/jrsm.2009.090348
24. Portlock J, Holden M, Patel S. A community pharmacy asthma MUR project in Hampshire and the Isle of Wight. Pharm J. 2009;282:109-112.
25. NHS England (NHSE). Children and Young People. Available at: https://www.england.nhs.uk/mental-health/cyp/ (accessed Sep 10. 2019).
26. Abraham O, Brothers A, Alexander DS, Carpenter DM. Pediatric medication use experience and patient counseling in community pharmacies: Perspectives of children and parents. J Am Pharm Assoc (2003). 2017;57(1):38-46. https://doi.org/10.1016/j.japh.2016.08.019
27. Boztepe H, Özdemir H, Karababa Ç, Yildız Ö. Administration of oral medication by parents at home. J Clin Nurs. 2016;25(21-22):3345-3353. https://doi.org/10.1111/jocn.13460
28. National Institute for Health and Care Excellence (NICE). Transition from children’s to adults' services for young people using health or social care services. 2016. Available at: https://www.nice.org.uk/guidance/ng43/evidence/full-guideline-pdf2360240173 (accessed Sep 10, 2019).
29. Carpenter DM, Abraham O, Alexander DS, Horowitz K. Counseling of children and adolescents in community pharmacies: results from a 14-day observational study. J Am Pharm Assoc (2003). 2016;56(3):266-269. https://doi.org/10.1016/j.japh.2016.03.001
30. Gray NJ, Shaw KL, Smith FJ Burton J, Prescott J, Roberts R, Terry D, McDonagh JE. The role of pharmacists in caring for young people with chronic illness. J Adolesc Health. 2017;60(2):219-225. https://doi.org/10.1016/j.jadohealth.2016.09.023
31. Conard LA, Fortenberry JD, Blythe MJ, Orr DP. Pharmacists' attitudes toward and practices with adolescents. Arch Pediatr Adolesc Med. 2003;157(4):361-365. https://doi.org/10.1001/archpedi.157.4.361
32. Abraham O, Alexander DS, Schleiden LJ, Carpenter DM. Identifying barriers and facilitators at affect community pharmacists' ability to engage children in medication counseling: a pilot study. J Pediatr Pharmacol Ther. 2017;22(6):412-422. https://doi.org/10.5863/1551-6776-22.6.412
33. NHS England and NHS Improvement (NHSE&I). A short summary of The Community Pharmacy Contractual Framework for 2019/20 to 2023/24: supporting delivery for the NHS Long Term Plan. Available at: https://www.england.nhs.uk/wpcontent/uploads/2019/07/short-summary-community-pharmacy-contractualframework.pdf (accessed Sep 10, 2019).