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Supply of unlicensed medicines to children: semi-structured interviews with carers
Nicola Rachel Husain1,2, J Graham Davies1, Stephen Tomlin2
1Institute of Pharmaceutical Science, King's College London, London, UK.
Insights
Parents faced significant challenges obtaining their child's unlicensed medicines post-hospital discharge, often requiring their intervention and causing distress. Improved communication and support for healthcare professionals are crucial for smoother medicine supply.
Area of Science:
- Pediatric pharmacology
- Healthcare systems research
- Patient experience studies
Background:
- The transition of pediatric patients requiring unlicensed medicines from hospital to home care presents unique supply chain challenges.
- Parents and carers often navigate complex systems to secure these essential medications for their children.
Purpose of the Study:
- To investigate the experiences of parents and carers concerning the procurement of unlicensed medicines for children after hospital discharge.
- To identify barriers and facilitators in the supply process of these critical medications.
Main Methods:
- Qualitative thematic analysis of semi-structured interviews with 15 parents and carers.
- Interviews were conducted at least four weeks post-discharge to capture ongoing experiences.
Main Results:
- Frequent difficulties were reported in obtaining unlicensed medicines, including general practitioner (GP) refusal or incorrect prescribing, and community pharmacy sourcing issues.
- Medicines often lacked clear administration instructions, leading to delays and requiring parental intervention.
- These challenges frequently resulted in parental anxiety, frustration, and dissatisfaction.
Conclusions:
- Enhanced communication among healthcare professionals and carers is essential for improving medicine supply during care transitions.
- General practitioners and community pharmacists require greater support and guidance for safely prescribing and supplying unlicensed medicines.
- Informing parents and carers about the process can foster understanding, empowerment, and stronger professional relationships.
Objectives:
To explore the experiences of parents and carers relating to the supply of unlicensed medicines for their child after discharge from hospital.
Methods:
Semi-structured interviews were conducted with 15 parents and carers of children who were newly prescribed an unlicensed medicine. Interviews were conducted at least 4 weeks after the child's discharge from hospital. Qualitative thematic analysis of the data was carried out.
Results:
Problems were frequently encountered by parents when attempting to obtain further supplies of their child's unlicensed medicine. Problems included general practitioners (GPs) refusing to prescribe the medicine, GPs prescribing a dose or formulation that differed to what had been prescribed previously, pharmacists who were unable to source a suitable medicine, medicines that were not labelled with administration instructions and delays in obtaining the medicine. Action or intervention by the parent was often required to overcome the problems faced. The necessity of these actions or interventions, and the implication of not succeeding, frequently caused parents anxiety, frustration and dissatisfaction.
Conclusions:
Strategies for improving the process of medicine supply during the transition between secondary and primary care are necessary and must involve greater communication among healthcare professionals and carers. GPs and community pharmacists should have access to greater support and guidance to facilitate the safe prescribing and supply of unlicensed medicines. Parents and carers should be informed about the process to ensure understanding, create empowerment and to build relationships between them and the professionals responsible for the care of their child.
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