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Supporting patient access to medicines in community palliative care on-line survey of health professionals’ practice, perceived effectiveness and influencing factors

Supporting patient access to medicines in community palliative care on-line survey of health professionals’ practice, perceived effectiveness and influencing factors
Supporting patient access to medicines in community palliative care on-line survey of health professionals’ practice, perceived effectiveness and influencing factors
Background: patient access to medicines at home during the last year of life is critical for symptom control, but is thought to be problematic. Little is known about healthcare professionals’ practices in supporting timely medicines access and what influences their effectiveness. The purpose of the study was to evaluate health professionals’ medicines access practices, perceived effectiveness and influencing factors.

Methods: on-line questionnaire survey of health care professionals (General Practitioners, Community Pharmacists, community-based Clinical Nurse Specialists and Community Nurses) delivering end-of-life care in primary and community care settings in England. Quantitative data were analysed using descriptive statistics.

Results: 1327 responses were received. All health professional groups are engaged in supporting access to prescriptions, using a number of different methods. GPs remain a predominant route for patients to access new prescriptions in working hours. However, nurses and, increasingly, primary care-based pharmacists are also actively contributing. However, only 42% (160) of Clinical Nurse Specialists and 27% (27) of Community Nurses were trained as prescribers. The majority (58% 142) of prescribing nurses and pharmacists did not have access to an electronic prescribing system. Satisfaction with access to shared patient records to facilitate medicines access was low: 39% (507) were either Not At All or only Slightly satisfied. Out-of-hours specialist cover was reported by less than half (49%; 656) and many General Practitioners and pharmacists lacked confidence advising about out-of-hours services. Respondents perceived there would be a significant improvement in pain control if access to medicines was greater. Those with shared records access reported significantly lower pain estimates for their caseload patients.

Conclusions: action is required to support a greater number of nurses and pharmacists to prescribe end-of-life medicines. Solutions are also required to enable shared access to patient records across health professional groups. Coverage and awareness of out-of-hours services to access medicines needs to be improved.
Latter, Susan
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Campling, Natasha
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Birtwistle, Jacqueline
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Richardson, Alison
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Bennett, Michael
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Ewings, Sean
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Meads, David
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Santer, Miriam
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Latter, Susan
83f100a4-95ec-4f2e-99a5-186095de2f3b
Campling, Natasha
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Birtwistle, Jacqueline
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Richardson, Alison
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Bennett, Michael
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Ewings, Sean
326656df-c0f0-44a1-b64f-8fe9578ca18a
Meads, David
394bf351-3283-47a6-8bc0-61d54a960b45
Santer, Miriam
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Latter, Susan, Campling, Natasha, Birtwistle, Jacqueline, Richardson, Alison, Bennett, Michael, Ewings, Sean, Meads, David and Santer, Miriam (2020) Supporting patient access to medicines in community palliative care on-line survey of health professionals’ practice, perceived effectiveness and influencing factors. BMC Palliative Care. (In Press)

Record type: Article

Abstract

Background: patient access to medicines at home during the last year of life is critical for symptom control, but is thought to be problematic. Little is known about healthcare professionals’ practices in supporting timely medicines access and what influences their effectiveness. The purpose of the study was to evaluate health professionals’ medicines access practices, perceived effectiveness and influencing factors.

Methods: on-line questionnaire survey of health care professionals (General Practitioners, Community Pharmacists, community-based Clinical Nurse Specialists and Community Nurses) delivering end-of-life care in primary and community care settings in England. Quantitative data were analysed using descriptive statistics.

Results: 1327 responses were received. All health professional groups are engaged in supporting access to prescriptions, using a number of different methods. GPs remain a predominant route for patients to access new prescriptions in working hours. However, nurses and, increasingly, primary care-based pharmacists are also actively contributing. However, only 42% (160) of Clinical Nurse Specialists and 27% (27) of Community Nurses were trained as prescribers. The majority (58% 142) of prescribing nurses and pharmacists did not have access to an electronic prescribing system. Satisfaction with access to shared patient records to facilitate medicines access was low: 39% (507) were either Not At All or only Slightly satisfied. Out-of-hours specialist cover was reported by less than half (49%; 656) and many General Practitioners and pharmacists lacked confidence advising about out-of-hours services. Respondents perceived there would be a significant improvement in pain control if access to medicines was greater. Those with shared records access reported significantly lower pain estimates for their caseload patients.

Conclusions: action is required to support a greater number of nurses and pharmacists to prescribe end-of-life medicines. Solutions are also required to enable shared access to patient records across health professional groups. Coverage and awareness of out-of-hours services to access medicines needs to be improved.

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Supporting patient access to medicines in community palliative care on-line survey of health professionals’ practice, perceived effectiveness and influencing factors. - Accepted Manuscript
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Accepted/In Press date: 4 September 2020

Identifiers

Local EPrints ID: 444510
URI: http://eprints.soton.ac.uk/id/eprint/444510
PURE UUID: 9fbb6471-793d-45ff-980d-99755583eb94
ORCID for Susan Latter: ORCID iD orcid.org/0000-0003-0973-0512
ORCID for Natasha Campling: ORCID iD orcid.org/0000-0002-4158-7894
ORCID for Alison Richardson: ORCID iD orcid.org/0000-0003-3127-5755
ORCID for Sean Ewings: ORCID iD orcid.org/0000-0001-7214-4917
ORCID for Miriam Santer: ORCID iD orcid.org/0000-0001-7264-5260

Catalogue record

Date deposited: 22 Oct 2020 16:32
Last modified: 18 Feb 2021 17:25

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Contributors

Author: Susan Latter ORCID iD
Author: Jacqueline Birtwistle
Author: Michael Bennett
Author: Sean Ewings ORCID iD
Author: David Meads
Author: Miriam Santer ORCID iD

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