Pharmacy World & Science

, Volume 29, Issue 5, pp 517–525 | Cite as

Assessment of a United States pharmaceutical care model for nursing homes in the United Kingdom

  • Susan M. Patterson
  • Carmel M. HughesEmail author
  • Kate L. Lapane
Research Article



To assess the suitability of an American model of pharmaceutical care for nursing home residents (The Fleetwood model) for application in nursing homes in the United Kingdom.


Pharmacists (those from a hospital setting or involved in prescribing support), general practitioners, nursing home managers and advocates for older people were invited to participate in semi-structured interviews or focus groups. The American Fleetwood model was explained to all participants who were asked for their views and opinions on how such a model could be adapted for use in the UK setting. All interviews and focus groups were tape-recorded, transcribed verbatim and analysed using the framework method.

Main outcome measure

An adapted model of pharmaceutical care for use in UK nursing homes.


There was general concern about prescribing in nursing homes, particularly in relation to psychoactive drugs. All participants were supportive of the proposed model of care and endorsed the greater involvement of pharmacists. However, participants also recognised that unlike pharmacists in the US nursing home setting for which the Fleetwood model had been developed, pharmacists implementing this approach in the UK would face major challenges in relation to access to records (medical and medication), prescribers and residents.


The findings highlighted the key elements of access which will need to be considered if this model of pharmaceutical care is to be applied to nursing home residents in the UK.

Impact of findings on practice

The model has been revised to take account of the challenges relating to access and will be tested in a randomised controlled trial.


Nursing homes Prescribing Pharmaceutical care Qualitative research United Kingdom 


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The authors wish to thank all of the participants who volunteered for this study. Susan Patterson is currently being supported by a Doctoral Fellowship from the Research and Development Office, Northern Ireland; Carmel Hughes is currently being supported by a Cochrane Fellowship from the Research and Development Office, Northern Ireland. The American Fleetwood project was supported in part by a grant from the Commonwealth Fund and a grant from the Retirement Research Foundation

Potential conflict of interest: none


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Copyright information

© Springer Science+Business Media B.V. 2007

Authors and Affiliations

  • Susan M. Patterson
    • 1
  • Carmel M. Hughes
    • 1
    Email author
  • Kate L. Lapane
    • 2
  1. 1.Clinical and Practice Research Group, School of PharmacyQueen’s University BelfastBelfastUK
  2. 2.Department of Community Health, Brown Medical SchoolBrown UniversityProvidenceUSA

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