Community Pharmacists and Medicines Optimisation in SMI v1
Research type
Research Study
Full title
What are the views of people with severe mental illness (SMI) on the role of community pharmacists in supporting them with medicines optimisation?
IRAS ID
222192
Contact name
Ian Maidment
Contact email
Duration of Study in the UK
0 years, 8 months, 28 days
Research summary
Research Summary
One in four people experience a mental health problem in the UK each year and 81 million people worldwide are affected by severe mental illnesses (SMI) such as bipolar disorder, schizophrenia and other psychoses. Compared to the general population, people with SMI die 10-25 years earlier and this is thought to be in part related to poorer physical health in this population. Suboptimal use of medicines for these conditions, including using more than one medicine for the same condition at the same time and using doses that are above the recommended limits has been reported in the literature.
This study is designed to explore the views of people with SMI on how community pharmacists might better support them with their medicines in order to improve outcomes for this potentially vulnerable and hard to reach population. Limited literature from countries other than the UK have shown that people with SMI value the services that community pharmacists provide but that they have low expectations of those services.
Potential participants will be identified via community pharmacists (across the West Midlands) on presentation of a prescription for an antipsychotic or mood stabiliser on a list provided to the community pharmacy in advance (the "prescription trigger"). The community pharmacist will then provide study-related information to the potential participant. Anyone who consents to participation in the study will be required to take part in a semi-structured interview conducted in the private consulting room in the community pharmacy.Approximately 15 people will be recruited to the study and the semi-structured interviews are expected to last approximately 30-60 minutes each.
Summary of Results
Mental disorder is common in the UK, affecting one in four people each year. It is associated with suboptimal use of medicines and poor physical health outcomes. Community pharmacists are accessible experts who are well-placed to offer services to help people optimise medicines outcomes. Studies have shown that people with severe mental illness (SMI) value the services received from these professionals but that their expectations are low. It is imperative that people with SMI are involved in development of services aimed at medicines optimisation to ensure relevance and value for this important population.
Methods: People taking regular medicines for SMI were purposefully sampled via community pharmacies. Having expressed initial expression of interest, capacitous adults were invited to participate. Qualitative interviews were conducted to ascertain participants’ views on the support received from community pharmacies in relation to their medicines. Data were digitally-recorded, transcribed verbatim and analysed using thematic analysis.
Results: Three people were interviewed between November 2017 and July 2018. Three themes were developed describing the experiences and views of the participants on the roles of community pharmacists in supporting them with medicines optimisation: ‘Empower me’, ‘See me before my medicine’ and ‘Meet my minimum expectations’. The importance of personal control over medicines taken for mental illness dominated the data, although what this meant was specific to the individual. The importance of understanding the person with SMI as an individual was another key finding. The participants described expectation of, and satisfaction with, a supply-focussed pharmacy service.
Conclusions: The findings were consistent with earlier studies in similar populations. Larger-scale work with a modified recruitment strategy is recommended to better understand the needs of this population. The challenges of recruiting people with SMI by proxy through community pharmacies are discussed and recruitment by such a method for other small-scale studies is not recommended.REC name
Yorkshire & The Humber - Bradford Leeds Research Ethics Committee
REC reference
17/YH/0232
Date of REC Opinion
7 Jul 2017
REC opinion
Favourable Opinion