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Article

Ying Xie and Liz Breen

– The purpose of this paper is to determine how best to reduce, reuse and dispose of household waste medicines in the National Health Service (NHS) (UK).

Abstract

Purpose

The purpose of this paper is to determine how best to reduce, reuse and dispose of household waste medicines in the National Health Service (NHS) (UK).

Design/methodology/approach

Through a combination of literature review and empirical work, this research investigates the existing household waste medicines reverse logistics (RL) system and makes recommendations for improvement by benchmarking it against household waste batteries RL. The viability and feasibility of these recommendations are evaluated through in-depth interviews with healthcare professionals and end user surveys.

Findings

The batteries RL system appears to be a more structured and effective system with more active engagement from actors/stakeholders in instigating RL practices and for this very reason is an excellent comparator for waste medicines RL practices. Appropriate best practices are recommended to be incorporated into the waste medicines RL system, including recapturing product value, revised processing approaches, system cooperation and enforcement, drivers and motivations and system design and facilitation.

Research limitations/implications

This study offers academics and professionals an improved insight into the current household waste medicines RL system and provides a step towards reducing an existing gap in this under-researched area. A limitation is that only a small sample of healthcare professionals were involved in subjectively evaluating the feasibility of the recommendations, so the applicability of the recommendations needs to be tested in a wider context and the cost effectiveness of implementing the recommendations needs to be analysed.

Practical implications

Reducing, reusing and properly disposing of waste medicines contribute to economic sustainability, environmental protection and personal and community safety. The information retrieved from analysing returned medicines can be used to inform prescribing practice so as to reduce unnecessary medicine waste and meet the medicine optimisation agenda.

Originality/value

This paper advocates learning from best practices in batteries RL to improve the waste medicines RL design and execution and supports the current NHS agenda on medicine waste reduction (DoH, 2012). The recommendations made in the paper not only aim to reduce medicine waste but also to use medicines effectively, placing the emphasis on improving health outcomes.

Details

Supply Chain Management: An International Journal, vol. 19 no. 4
Type: Research Article
ISSN: 1359-8546

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Article

Andria Hanbury and Hannah Wood

This paper aims to develop a behavioural science informed communication strategy aimed at health professionals and patients promoting best practice recommendations…

Abstract

Purpose

This paper aims to develop a behavioural science informed communication strategy aimed at health professionals and patients promoting best practice recommendations regarding the use of specialist liquid medicines for elderly people with swallowing difficulties.

Design/methodology/approach

The medicine prescribing, formulation and administration related challenges and experiences of health professionals and elderly patients with swallowing difficulties were identified through a pragmatic literature search. Key findings across the papers were synthesised into themes, before being linked to domains from a behavioural science framework. Published recommendations for behaviour change techniques that can be used to target the domains were then mapped to the domains. Guidance on how to develop a communication strategy, drawing on the insight gained from the literature review and the behavioural science recommendations, and designed to stimulate change in health-care professionals’ and patients’ behaviours, was then developed.

Findings

In total, 13 themes emerged across 15 papers, including “patient and health professional roles and remits”. These themes were linked to nine domains from the framework, highlighting the range of individual, social and environmental factors influencing patients’ and health professionals’ perceptions and experiences. A summary table, mapping the domains and underpinning themes to recommended behaviour change techniques, was used to develop the subsequent communication strategy recommendations. Recommendations include using techniques such as providing social processes of encourage, pressure and support to change patients’ and health professionals’ perceptions of their roles/responsibilities in medicines prescribing and administration, delivered via, for example, an educational leaflet and/or online training.

Practical implications

The summary table and guidance can inform development of an evidence-based strategy for communicating best practice recommendations regarding the use of liquid medicines for elderly patients with swallowing difficulties, tailored to the perceptions and challenges identified.

Originality/value

The behavioural science approach is less established within the pharmaceutical industry for promotion of best practice recommendations and related products, yet it offers a framework for an evidence-based and systematic approach that goes beyond a literature review or focus group.

Details

International Journal of Pharmaceutical and Healthcare Marketing, vol. 12 no. 4
Type: Research Article
ISSN: 1750-6123

Keywords

Content available
Article

Marina Papalexi, David Bamford and Liz Breen

This study aims to explore the downstream pharmaceutical supply chain (PSC) and provides insight to the delivery process of medicines and associated operational inefficiencies.

Abstract

Purpose

This study aims to explore the downstream pharmaceutical supply chain (PSC) and provides insight to the delivery process of medicines and associated operational inefficiencies.

Design/methodology/approach

An exploratory, qualitative approach was adopted to examine PSC inefficiency within two European contexts, namely, the UK and Greece. Data was gathered through interviews and a thematic analysis conducted to analyse the data and identify challenges faced by both supply chains(SCs).

Findings

The medicines delivery system needs to be enhanced in terms of quality, visibility, speed and cost to perform effectively. The findings demonstrated that although the healthcare SCs in the two European contexts have different operational structures, the results are in concordance with each other. Financial, communication, waste and complexity issues were the major concerns.

Research limitations/implications

To the knowledge this is the first study to examine aspects of the medicines SC via a cross-case analysis in the UK and Greece and extends the body of knowledge. A broader sample of responses is warranted to further validate these findings.

Practical implications

The study outputs can inform pharmacies’ strategic to instigate targeted improvement interventions. The implications of which may be extrapolated further to other European healthcare organisations.

Originality/value

This research contributes to the academic literature by adding further theoretical insights to SC strategy development, especially those that have been characterised as highly complex. The study identifies four key areas of intervention needed within this SC (in both countries) to promote higher level efficiencies and effectiveness.

Details

Supply Chain Management: An International Journal, vol. 25 no. 6
Type: Research Article
ISSN: 1359-8546

Keywords

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Abstract

Details

Cognition and Innovation
Type: Book
ISBN: 978-1-78769-432-3

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Article

Rory Sheehan

This commentary accompanies Clare et al.’s study investigating psychotropic drug prescribing for adults with intellectual disability who were referred to specialist…

Abstract

Purpose

This commentary accompanies Clare et al.’s study investigating psychotropic drug prescribing for adults with intellectual disability who were referred to specialist community learning disability teams in the east of England. The purpose of this paper is to explore some of the background to psychotropic drug prescribing for people with intellectual disability, review important contextual factors that influence prescribing decisions, and consider how we might make the best use of psychotropic drugs in this group.

Design/methodology/approach

Narrative summary and opinion, supported by reference to recent research literature.

Findings

Psychotropic drug use for people with intellectual disability raises complex issues, not least because of the lack of research evidence that exists on the topic. Psychotropic drugs can be an important part of treatment for people with mental illness but further research is needed to support prescribing for challenging behaviour. Medication optimisation is a framework within which individual preferences and values are considered alongside the evidence base and clinical judgement in order to inform safe, effective, and collaborative management decisions.

Practical implications

Prescribing decisions should be individualised and reviewed regularly, incorporating evidence from patients and carers. Improving the use of psychotropic medication requires concerted action, adequate social support, and the provision of alternative, non-pharmacological interventions that are acceptable and effective.

Originality/value

This paper reviews some of the current concerns about the use of psychotropic drugs and opens up new avenues of discussion.

Details

Tizard Learning Disability Review, vol. 23 no. 1
Type: Research Article
ISSN: 1359-5474

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Article

David Branford, David Gerrard, Nigget Saleem, Carl Shaw and Anne Webster

The STOMP programme – stopping the over-medication of people with an intellectual disability, autism or both is a three-year programme supported by NHS England. Concern…

Abstract

Purpose

The STOMP programme – stopping the over-medication of people with an intellectual disability, autism or both is a three-year programme supported by NHS England. Concern about the overuse of antipsychotic drugs has been a constant theme since the 1970s. However, despite a multitude of guidelines the practice continues. The report into the events at Winterbourne View not only raised concerns about the overuse of antipsychotic drugs but of antidepressants. Part 1 presented the historical background to the use of psychotropic drugs for people with an intellectual disability, autism or both. The purpose of this paper (Part 2) is to present the approach adopted to reduce over-medication (the “Call to Action”) and the progress so far at the half way stage.

Design/methodology/approach

The “Call to Action” methodology is described in a Manchester University report – mobilising and organising for large-scale change in healthcare “The Right Prescription: A Call to Action on the use of antipsychotic drugs for people with dementia”. Their research suggested that a social mobilising and organising approach to change operates could provide a mechanism for bringing about change where other approaches had failed.

Findings

The adoption of the “Call to Action” methodology has resulted in widespread acknowledgement across intellectual disability practice that overuse of psychotropic medication and poor review was resulting in over-medication. Many individual local programmes are underway (some are described in this paper) however to what extent the overall use of psychotropic drugs has changed is yet to be evaluated.

Originality/value

STOMP is part of an English national agenda – transforming care. The government and leading organisations across the health and care system are committed to transforming care for people with intellectual disabilities autism or both who have a mental illness or whose behaviour challenges services. This paper describes a new approach to stopping the over-medication of people with an intellectual disability, autism or both.

Details

Advances in Mental Health and Intellectual Disabilities, vol. 13 no. 1
Type: Research Article
ISSN: 2044-1282

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Article

Alpana Mair, Eleftheria Antoniadou, Anne Hendry and Branko Gabrovec

Polypharmacy, the concurrent use of multiple medicines by one individual, is a common and growing challenge driven by an ageing population and the growing number of people…

Abstract

Purpose

Polypharmacy, the concurrent use of multiple medicines by one individual, is a common and growing challenge driven by an ageing population and the growing number of people living longer with chronic conditions. Up to 11% of unplanned hospital admissions in the UK are attributable to, mostly avoidable, harm from medicines. However, this topic is not yet central to integrated practice. This paper reviews the challenge that polypharmacy presents to the health and care system and offers lessons for integrated policy and practice.

Design/methodology/approach

Two commonly encountered scenarios illustrate the relevance of addressing inappropriate polypharmacy to integrated practice. An overview of the literature on polypharmacy and frailty, including two recent large studies of policy and practice in Europe, identifies lessons for practitioners, managers, policy makers and commissioners.

Findings

Comprehensive change strategies should extend beyond pharmacist led deprescribing initiatives. An inter-professional and systems thinking approach is required, so all members of the integrated team can play their part in realising the value of holistic prescribing, appropriate polypharmacy and shared decision making.

Practical implications

Awareness and education about polypharmacy should be embedded in inter-professional training for all practitioners who care for people with multimorbidity or frailty.

Originality/value

This paper will help policy makers, commissioners, managers and practitioners understand the value of addressing polypharmacy within their integrated services. Best practice national guidance developed in Scotland illustrates how to target resources so those at greatest risk of harm from polypharmacy can benefit from effective pharmaceutical care as part of holistic integrated care.

Details

Journal of Integrated Care, vol. 29 no. 2
Type: Research Article
ISSN: 1476-9018

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Article

Yose Rizal

This paper aims to find in-depth information related the activities of “clean and healthy behavior” in household regulations, starting from assessment, planning…

Abstract

Purpose

This paper aims to find in-depth information related the activities of “clean and healthy behavior” in household regulations, starting from assessment, planning, mobilization, implementation monitoring and assessment.

Design/methodology/approach

Data analysis was used for quantitative and qualitative approaches (mixing method). The qualitative approach was used to understand the individual phenomena in terms of finding, obtaining and describing the community behavior, which is related to health problems. The data obtained through the approach were then analyzed using interactive model.

Findings

In principle, this research exactly determines the responses of officers and the community to the process of “clean and healthy living behavior” activities. In general, the health facility used first is self-treatment, before seeking medical treatment or non-drug treatment. It proves that humans are always experimenting. From the research result, there are respondents who do not use medical treatment at 16 per cent; and the remaining 84 per cent are using medical treatment, despite being preceded by self-treatment (S) and non-medical treatment (N).

Originality/value

Currently, there have not been many studies related to the implementation of clean and healthy behavior although the information about it is very important to know. The managers of the “clean and healthy behavior” program need to know such information.

Details

Journal of Global Responsibility, vol. 9 no. 3
Type: Research Article
ISSN: 2041-2568

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Article

Ian Hamilton, Rose Pringle and Stephen Hemingway

The purpose of this paper is: first, to consider the reported problems in sexual function caused by psychotropic medication. Second, the complex undertaking of completing…

Abstract

Purpose

The purpose of this paper is: first, to consider the reported problems in sexual function caused by psychotropic medication. Second, the complex undertaking of completing an assessment of sexual functioning. Third, the role of the pharmaceutical industry is explored. Finally, implications for future research and practice are suggested.

Design/methodology/approach

As a commentary this paper draws on the available literature to synthesise what is already known about the relationship between psychoactive substances and sexual functioning.

Findings

The limited literature and lack of research attention given to psychotropic induced sexual dysfunction limits our collective understanding of how many people are affected and in what way.

Research limitations/implications

A greater focus on psychotropic induced sexual dysfunction is needed for people with a dual diagnosis. There has been an over reliance on single case studies and self-reporting. Large scale epidemiological investigation would help understand the extent and nature of the problem more fully. The demographic shift particularly in relation to an ageing population should be considered as psychotropic substances effect individuals in different ways as they grow older.

Practical implications

There is scope for workers to engage more fully in a conversation with clients about their experience of using psychotropic substances and how this has impacted their sexual functioning. The literature suggests that clients want to talk about this issue but staff are unwilling or unable to discuss the topic.

Originality/value

To the authors’ knowledge this is the first paper that draws on the available literature to explore the known and likely implications of psychotropic induced sexual dysfunction for this client group.

Details

Advances in Dual Diagnosis, vol. 8 no. 4
Type: Research Article
ISSN: 1757-0972

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Article

Jakob Demant, Silje Anderdal Bakken and Alexandra Hall

Internet use has changed the mechanics of drug dealing. Although this has spurred some initial academic interest in how markets and their users have been changing, the…

Abstract

Purpose

Internet use has changed the mechanics of drug dealing. Although this has spurred some initial academic interest in how markets and their users have been changing, the issue is still under-researched. The purpose of this paper is to understand how the organisation of the distribution of prescription drugs and other illegal drugs overlap in these online markets by analysing data gathered from observation of the Swedish Facebook drug market and its participants.

Design/methodology/approach

Data were gathered during three months of digital ethnography conducted among Swedish Facebook posters supplemented by 25 interviews with sellers (20) and buyers (5). Screenshots and interview data were coded by carrying out an NVivo-based content analysis. The analysis is based on descriptive statistics of drug types, co-occurrence with other drugs, group size and the demographic characteristics of sellers. Additionally, the interviewees’ descriptions of the marketplace and their drug dealing or buying activities were included in the analysis.

Findings

In total, 57 Swedish Facebook groups that sold illegal substances were located. The groups rarely specialised in specific drug types, but were convened around demographic factors, such as specific cities and locales. The sales of prescription drugs were part of the overall activity of groups selling other illegal drugs, but they were more often sold in separate Facebook posts, possibly by specialist sellers. Swedish Facebook sales primarily concerned alprazolam, tramadol, pregabalin and clonazepam, and were sold by both professional and amateur sellers.

Originality/value

This study reports findings from a Nordic comparative study on social media drug dealing, representing the first in-depth study of digitally mediated prescription drug dealing outside of cryptomarkets.

Details

Drugs and Alcohol Today, vol. 20 no. 1
Type: Research Article
ISSN: 1745-9265

Keywords

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