Addressing inequalities in the provision of pharmaceutical services

Addressing inequalities in the provision of pharmaceutical services in Scotland: a proof of concept study of telepharmacy in rural Scotland Bond CM 1, Inch J 1, Notman F 1, on behalf of the Tele-pharmacy Research Team 1 Centre of Academic Primary Care, University of Aberdeen Baseline findings: BACKGROUND: • Demand for NHS services is increasing • Delivery of NHS services is changing • Limited access to community pharmacy in remote areas 1 • Community pharmacy services in rural areas provided by video-linkage technology, integrated within a medicines supply robot 2 Source Finding Resident focus group Satisfied with current community pharmacy service including prescription collection and delivery service. Would like easier access to pharmacy services for the older population New service would improve access and reduce GP workload. Concerns about resources, costs, maintenance, and impact on other providers Majority would use collection and delivery service (61. 5%), GSL purchase (59%), advice on prescribed medicines (53%), e. Mas(51%). 18% would not access any service or advice HCP interviews/focus groups Resident questionnaire AIM : To assess the feasibility, acceptability and scope of providing community pharmacy services via a video link and a supply robot (a tele-pharmacy robotic supply service) METHOD: Desired services: Kiosk development • Hardware • Software • Service specification • Stock Baseline data Follow up data • Resident focus group • Resident questionnaire • Professional/stakeholder interviews • Pharmacy staff • GP staff • Pharmacist focus group • Service use data • User/resident questionnaire • Patient/user interviews • Professional/ stakeholder interviews Follow-up: Service specification: • Prescription form collection and delivery • Purchase of General Sales List (GSL) medicines (NHS Grampian formulary) • Advice • The Minor Ailment Service (e. MAS) • Supply of pharmacy only (P) medicines on an individual basis • National health promotion campaigns Questionnaire Accessing services HCP Interviews 112 (29%) (6 users) 6 (66. 7%) • Respondents • mostly female (65%) (n=73) • aged 50 -69 years 37% (n=41) • 32% retired (n=36) • The majority rated their health as good to excellent • 36% lack of personal need to use service (i. e. no health compliant or had medicines at home) • 31% preferred regular pharmacy • Feedback from users (6) • All extremely satisfied/satisfied • Accessibility, convenience, efficiency and being simple to operate were highlighted as good • Bigger range of nonprescription medicines requested • Service easy to use, staff helpful • Barriers • Fear of technology • Lack of awareness of pharmacy services e. g. e. MAS • ‘Wrong’ pharmacy • Errors with phone numbers • Facilitators • Collection and delivery service more secure • Convenience of access in rural areas • Video link preferred to telephone consultation • Acceptable privacy * Services accessed: medicines and prescriptions RESULTS: Participants: Method of data collection Baseline Resident Questionnaires Baseline Resident Focus Group Baseline Healthcare Professional (HCP) Interviews Baseline NHS Grampian Pharmacist Focus Group Follow-up Resident Questionnaire Follow-up Resident Interviews Follow-up HCP Interviews Number invited 400 40 24 12 385 Number responding (%) 154 (40%) 4 (10. 0%) 9 (37. 5%) 6 (41. 6%) 112 (29%) 30 9 14 (46. 7%) 6 (66. 7%) References: 1. . Porteous T, Bond C. Novel provision of pharmacy services to a deprived area: a pharmaceutical needs assessment. International Journal of Pharmacy Practice 2003; 11(1): 47 -54. 2. King, Lotus S. Remote Pharmacy: it’s closer than you think. The Pharmaceutical Journal 2014; 293: 11 -13. Acknowledgements: The Telepharmacy Research Team David Green (Atos), M. Watson 1, J Cleland 1, D Heaney 1, C Hind (NHS Grampian), J Ferguson (NHS Grampian) F Mair (University of Glasgow), B Mc. Kinstry (University of Edinburgh) A Strath (Robert Gordon University) This research has been funded by the Chief Scientist Office, Scottish Government and an Atos Innovation Fund Award CONCLUSION: • Remotely delivering pharmacy services to a rural community via tele-kiosk is • acceptable and feasible Future implementation needs to consider • Multiple links to all nearby pharmacies/other health care providers • Clarification of printing capability e. g. labels • Interface with ADASTRA (a clinical patient management system) /N 3 link(national broadband network for the NHS)/and GP systems • Clarification of legal issues around P sales, emergency hormonal contraception supply, remote ordering and supply of pharmacy only medicines. • Capacity • Physical requirements of remote location and confidentiality