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Qualitative analysis of community pharmacists’ opinions on their involvement in reducing potentially inappropriate prescribing

  • Pharmacoepidemiology and Prescription
  • Published:
European Journal of Clinical Pharmacology Aims and scope Submit manuscript

Abstract

Purpose

Older people are at risk of potentially inappropriate prescribing (PIP) due to polypharmacy arising from multi-morbidity. Despite available explicit criteria to reduce PIP, it is highly prevalent. Whilst community pharmacists have the required knowledge to help reduce PIP, they are not currently engaged with the problem. This study explores the views of community pharmacists on their potential involvement in reducing PIP and determines the challenges to its implementation.

Methods

Semi-structured interviews with pharmacists working in community pharmacies in Ireland. The theoretical domains framework (TDF) was used to develop the topic guide and to analyse the transcripts. Domains of highest relevance for PIP reduction were identified based on their frequency or whether the participants emphasised the impact of constructs within a domain. Local ethical approval was obtained.

Results

Of 18 participants, 12 were female, median age was 30 years (IQR, 27–35) with a median of 6 years (IQR, 3–8) of experience. Seven TDF domains were identified as relevant to PIP reduction. Pharmacists were uncertain about their role in reducing PIP and reluctant to challenge physicians’ prescribing decisions. Challenges pertained to the environment, knowledge, social influences, professional role and identity.

Conclusions

Pharmacists welcomed new responsibilities in reducing PIP as part of their daily practice but expressed a need for removal of social and environmental barriers as well as, provision of relevant guidelines and education about PIP. This study provides useful insights into the target domains for overcoming barriers of pharmacist involvement in reducing PIP.

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Notes

  1. The supervising/superintendent pharmacists is the person responsible for the day-to-day management and operation of the pharmacy and must have a minimum of 3 years post-registration experience (http://www.thepsi.ie/gns/Pharmacy_Practice/practice-guidance/Guidance_for_pharmacists/Guidance_for_Supervising_Pharmacists.aspx).

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Acknowledgements

The authors would like to acknowledge all pharmacists who took part in this study for their time and interest in the study.

Author information

Authors and Affiliations

  1. Pharmaceutical Care Research Group, School of Pharmacy, Cavanagh Pharmacy Building Room UG06, University College Cork, College Road Cork, Cork, Ireland

    Christina Raae Hansen, Stephen Byrne & Laura J. Sahm

  2. Section for Social and Clinical Pharmacy, Department of Pharmacy, Faculty of Health and Medical Sciences, University of Copenhagen, Universitetsparken 2, 2100, Copenhagen Ø, Denmark

    Christina Raae Hansen

  3. Department of Medicine, School of Medicine, University College Cork, Western Gateway Building Room 2.59, Western Road, Cork, Ireland

    Denis O’Mahony

  4. Department of Geriatric Medicine, Cork University Hospital, Wilton, Cork, Ireland

    Denis O’Mahony

  5. School of Public Health, University College Cork, Western Gateway Building 4th Floor, Western Road, Cork, Ireland

    Patricia M. Kearney

  6. Pharmacy Department, Mercy University Hospital, Greenville Place Centre, Cork, Ireland

    Laura J. Sahm

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  1. Christina Raae Hansen
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  2. Stephen Byrne
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  3. Denis O’Mahony
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  4. Patricia M. Kearney
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  5. Laura J. Sahm
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Corresponding author

Correspondence to Christina Raae Hansen.

Ethics declarations

Ethical approval for this study was granted by the Clinical Research Ethics Committee of the Cork Teaching Hospitals prior to recruitment. Written informed consent was obtained from all participants included in the study.

Conflict of interest

The authors declare that they have no conflict of interest.

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Hansen, C.R., Byrne, S., O’Mahony, D. et al. Qualitative analysis of community pharmacists’ opinions on their involvement in reducing potentially inappropriate prescribing. Eur J Clin Pharmacol 75, 265–274 (2019). https://doi.org/10.1007/s00228-018-2578-2

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  • DOI: https://doi.org/10.1007/s00228-018-2578-2

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