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International Journal of Clinical Pharmacy

, Volume 38, Issue 5, pp 1241–1249 | Cite as

A focus group based study of the perspectives of the Maltese population and healthcare professionals on medication wastage

  • Lorna Marie WestEmail author
  • Lesley Diack
  • Maria Cordina
  • Derek Stewart
Research Article
  • 190 Downloads

Abstract

Background The World Health Organization states that globally more than half of all medication is inappropriately prescribed, dispensed or sold with a need to implement wastage reduction strategies. Developing processes which include behaviour change theories, such as the Theoretical Domains Framework (TDF), significantly impacts the positive implementation of evidence into healthcare practice. Objective To describe and understand the beliefs and behaviours regarding medication wastage of the Maltese public and healthcare professionals (HCPs) and to explore potential solutions. Setting: Malta. Method Five 90 min audio recorded focus groups (2 public and 3 HCPs) were conducted with a purposive sample who responded to a previous survey study and were willing to participate in focus groups in Malta. The guide was based upon the TDF with interview questions derived from findings of the questionnaire phase. Focus groups were audio recorded and transcribed verbatim. Analysis was carried using the framework approach. Main outcome measure Beliefs and behaviours regarding medication wastage and potential solutions to reduce medication wastage. Results A total of eleven pharmacists, six doctors and six members of the public consented to participate. Focus groups conducted with HCPs and the general public identified the following four key themes aligned with the TDF domains to address proposed solutions to minimise medication wastage: (1) practitioner effects; (2) patients effects; (3) political effects; (4) societal effects. Conclusion This study has employed a theoretical framework to obtain a better understanding of facilitators which require attention as part of strategic development.

Keywords

Awareness Behaviour Focus groups Healthcare professionals Malta Medication wastage 

Notes

Acknowledgments

The authors acknowledge those who participated in the focus groups.

Funding

The research work carried out was fully funded by the Malta Government Scholarship Scheme.

Conflicts of interest

The authors declare no conflict of interest. This study formed part of the author’s submission for PhD. The scholarship had no influence on study design, conduction, analysis, interpretation or writing of this article.

References

  1. 1.
    World Health Organization. Challenges in expanding access to essential medicines. 2004. http://apps.who.int/medicinedocs/en/d/Js5571e/2.html; 29 Apr 2016.
  2. 2.
    West LM, Diack L, Cordina M, Stewart D. A systematic review of the literature on ‘medication wastage’: causative factors and effect of interventions. Int J Clin Pharm. 2014;36(5):873–81.CrossRefPubMedGoogle Scholar
  3. 3.
    Medical Research Council. Developing and evaluating complex interventions: new guidance. 2008. http://www.mrc.ac.uk/complexinterventionsguidance; 2 Nov 2014.
  4. 4.
    Malta Tourism Authority. Tourism in Malta. 2013. http://www.mta.com.mt/loadfile.ashx?id=69b07385-93a7-4b05-89cb-db6a27fb95d3. 29 Apr 2016.
  5. 5.
  6. 6.
    West LM, Diack L, Cordina M, Stewart D. A cross-sectional survey of the Maltese general public on medication wastage. Int J Clin Pharm. 2016;. doi: 10.1007/s11096-015-0233-x.Google Scholar
  7. 7.
    Cane J, O’Connor D, Michie S. Validation of the theoretical domains framework for use in behaviour change and implementation research. Implement Sci. 2012;7(37). doi:  10.1186/1748-5908-7-37.
  8. 8.
    Squires JE, Suh KN, Linklater S, Bruce N, Gartke K, Graham ID, et al. Improving physician hand hygiene compliance using behavioural theories: a study protocol. Implement Sci. 2013;8(16). doi:  10.1186/1748-5908-8-16.
  9. 9.
    Duncan EM, Francis JJ, Johnston M, Davey P, Maxwell S, McKay GA, et al. Learning curves, taking instructions, and patient safety: using a theoretical domains framework in an interview study to investigate prescribing errors among trainee doctors. Implement Sci. 2012;7(86). doi:  10.1186/1748-5908-7-86.
  10. 10.
    Bussières AE, Patey AM, Francis J, Sales AE, Grimshaw JM. Identifying factors likely to influence compliance with diagnostic imaging guideline recommendations for spine disorders among chiropractors in North America: a focus group study using the Theoretical Domains Framework. Implement Sci. 2012;7(82). doi:  10.1186/1748-5908-7-82.
  11. 11.
    Bradley E, Curry LA, Devers KJ. Qualitative data analysis for health services research: developing taxonomy, themes, and theory. Health Serv Res. 2007;42(4):1758–72.CrossRefPubMedPubMedCentralGoogle Scholar
  12. 12.
    Phillips CJ, Marshall AP, Chaves NJ, Jankelowitz SK, Lin IB, Loy CT, et al. Experiences of using the Theoretical Domains Framework across diverse clinical environments: a qualitative study. J Multidiscip Healthc. 2015;8:139–46.PubMedPubMedCentralGoogle Scholar
  13. 13.
    Richardson K, Kenny RA, Bennett K. The effect of free health care on polypharmacy: a comparison of propensity score methods and multivariable regression to account for confounding. Pharmacoepidemiol Drug Saf. 2014;23(6):656–65.CrossRefPubMedGoogle Scholar
  14. 14.
    European Commission. Investing in health. 2013. http://ec.europa.eu/health/strategy/docs/swd_investing_in_health.pdf. 29 Apr 2016.
  15. 15.
    European Association of Hospital Pharmacists. Common position between patients’, consumers, and healthcare professionals’ organisations involved in the activities of the European Medicines Agency on: supply shortages of medicines, 2013. http://www.geneticalliance.org.uk/docs/final_common_position_supply_shortages_signatures.pdf. 29 Apr 2016.
  16. 16.
    Dill S, Ahn J. Drug shortages in developed countries—reasons, therapeutic consequences, and handling. Eur J Clin Pharmacol. 2014;70(12):1405–12.CrossRefPubMedGoogle Scholar
  17. 17.
    Charatan F. Prescription drug shortages plague US. BMJ. 2001;322(7279):130.CrossRefPubMedPubMedCentralGoogle Scholar
  18. 18.
    Gray A, Manasse HR. Shortages of medicines: a complex global challenge. Bull WHO. 2012;90:158.PubMedPubMedCentralGoogle Scholar
  19. 19.
    Kardas P, Lewek P, Matyjaszczyk M. Determinants of patient adherence: a review of systematic reviews. Front Pharmacol. 2013;4(91). doi:  10.3389/fphar.2013.00091.
  20. 20.
    Check E. Task force set up to combat threat of political interference. Nature. 2003;426(6964):218.PubMedGoogle Scholar
  21. 21.
    Baum NM, Gollust SE, Goold SD, Jacobson PD. Ethical issues in public health practice in Michigan. Am J Public Health. 2009;99(2):369–74.CrossRefPubMedPubMedCentralGoogle Scholar
  22. 22.
    Rest KM, Halpern MH. Politics and the erosion of federal scientific capacity: restoring scientific integrity to public health science. Am J Public Health. 2007;97(11):1939–44.CrossRefPubMedPubMedCentralGoogle Scholar
  23. 23.
    Pham HH, Ginsburg PB, Verdier JM. Medicare governance and provider payment policy. Health Aff. 2009;28(5):1382–94.CrossRefGoogle Scholar
  24. 24.
    Michie S, van Stralen MM, West R. The behaviour change wheel: a new method for characterising and designing behaviour change interventions. Implement Sci. 2011;6(42). doi:  10.1186/1748-5908-6-42.
  25. 25.
    Goff SL, Kleppel R, Lindenauer PK, Rothberg MB. Hospital workers’ perceptions of waste: a qualitative study involving photo-elicitation. BMJ Qual Saf. 2013;22(10):826–35.CrossRefPubMedPubMedCentralGoogle Scholar

Copyright information

© Springer International Publishing 2016

Authors and Affiliations

  • Lorna Marie West
    • 1
    Email author
  • Lesley Diack
    • 1
  • Maria Cordina
    • 2
  • Derek Stewart
    • 1
  1. 1.Faculty of Health and Social Care, School of Pharmacy and Life SciencesRobert Gordon UniversityAberdeenUK
  2. 2.Department of Clinical Pharmacology and Therapeutics, Faculty of Medicine and SurgeryUniversity of MaltaMsidaMalta

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