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Williams M, Jordan A, Scott J, Jones MD. A systematic review examining the effectiveness of medicines information services for patients and the general public. INTERNATIONAL JOURNAL OF PHARMACY PRACTICE 2019; 28:26-40. [PMID: 31512292 DOI: 10.1111/ijpp.12571] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Revised: 07/09/2019] [Accepted: 07/11/2019] [Indexed: 11/28/2022]
Abstract
OBJECTIVES Hospital-based patient medicines helpline services (PMHS) and medicines information services for the general public (MISGP) are available in many countries to support people with their medicines. Our aim was to examine the available evidence regarding the effectiveness of PMHS and MISGP. METHODS Searches were conducted using Medline, EMBASE, CINAHL, Scopus and Web of Science, on 11 August 2018. Forward and backward citation searches were conducted, grey literature was searched, and study quality/risk of bias was assessed. Findings were synthesised in a narrative synthesis. Where appropriate, weighted means were calculated. KEY FINDINGS Thirty-two studies were identified for inclusion (17 published articles, 15 conference abstracts). Eighteen studies were conducted within the United Kingdom. Mean quality assessment was moderate (51%), and risk of bias was high (63%). PMHS and MISGP are both typically perceived as positive (e.g. 94% and 91% of participants were satisfied with using a PMHS and MISGP, respectively). For PMHS, the advice received is reported to be usually followed (94%, and 66% for MISGP). For both services, users report several positive outcomes (e.g. problems resolved/avoided, feeling reassured and improved health). PMHS may also be effective for correcting medicines-related errors (up to 39% of calls may concern such errors) and for potentially avoiding medicines-related harm (48% of enquiries concerned situations that were judged to have the potential to harm patients). CONCLUSIONS Findings suggest that both PMHS and MISGP may be beneficial sources of medicines-related support. However, the moderate quality and high risk of bias of studies highlight that more high-quality research is needed.
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Affiliation(s)
- Matt Williams
- Department of Pharmacy & Pharmacology, University of Bath, Bath, UK
| | - Abbie Jordan
- Department of Psychology, University of Bath, Bath, UK
| | - Jenny Scott
- Department of Pharmacy & Pharmacology, University of Bath, Bath, UK
| | - Matthew D Jones
- Department of Pharmacy & Pharmacology, University of Bath, Bath, UK
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Stephens A, Brodribb W, McGuire T, Deckx L. Breastfeeding questions to medicines call centres from the Australian public and health professionals. Aust J Prim Health 2018; 24:409-416. [PMID: 30086825 DOI: 10.1071/py18010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Accepted: 04/24/2018] [Indexed: 01/04/2023]
Abstract
There is considerable uncertainty regarding medication use during breastfeeding. This study compared lactation-related questions about medicines from consumers and health professionals to identify knowledge gaps. A retrospective, mixed-methods study of lactation-related call data extracted from two Australian medicines call centre databases: National Prescribing Service (NPS) Medicines Line (ML) for the general public and Therapeutic Advice and Information Service (TAIS) for health professionals, was conducted. Of the 5662 lactation-related calls by consumers to ML, most were from women enquiring about themselves (95%). The 2219 lactation-related calls from health professionals to TAIS were largely from GPs (46%), community pharmacists (35%) and nurses (12%). Consumers commonly enquired about medicines freely accessible or over-the-counter, including non-steroidal anti-inflammatory products (9.3%), paracetamol (6.9%), ibuprofen (4.8%) and codeine (4.2%). Health professionals' questions involved prescription medicines such as antidepressants (16.9%), with queries on sertraline (3.7%), levonorgestrel (2.7%) and domperidone (2.4%) most common. Question themes were similar for both cohorts, focusing mainly around medication safety, risk minimisation and milk supply. Understanding the compelling and common themes driving medicines help-seeking related to breastfeeding is key to addressing information gaps and improving overall medication use during breastfeeding.
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Affiliation(s)
- Amelia Stephens
- Primary Care Clinical Unit, Faculty of Medicine, The University of Queensland, Health Sciences Building 16/910, Royal Brisbane & Women's Hospital, Brisbane, Qld 4029, Australia
| | - Wendy Brodribb
- Primary Care Clinical Unit, Faculty of Medicine, The University of Queensland, Health Sciences Building 16/910, Royal Brisbane & Women's Hospital, Brisbane, Qld 4029, Australia
| | - Treasure McGuire
- Mater Pharmacy Services, Mater Health Services, Brisbane, Qld 4101, Australia
| | - Laura Deckx
- Primary Care Clinical Unit, Faculty of Medicine, The University of Queensland, Health Sciences Building 16/910, Royal Brisbane & Women's Hospital, Brisbane, Qld 4029, Australia
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Babac A, Frank M, Pauer F, Litzkendorf S, Rosenfeldt D, Lührs V, Biehl L, Hartz T, Storf H, Schauer F, Wagner TOF, Graf von der Schulenburg JM. Telephone health services in the field of rare diseases: a qualitative interview study examining the needs of patients, relatives, and health care professionals in Germany. BMC Health Serv Res 2018; 18:99. [PMID: 29426339 PMCID: PMC5807836 DOI: 10.1186/s12913-018-2872-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2016] [Accepted: 01/22/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Rare diseases are, by definition, very serious and chronic diseases with a high negative impact on quality of life. Approximately 350 million people worldwide live with rare diseases. The resulting high disease burden triggers health information search, but helpful, high-quality, and up-to-date information is often hard to find. Therefore, the improvement of health information provision has been integrated in many national plans for rare diseases, discussing the telephone as one access option. In this context, this study examines the need for a telephone service offering information for people affected by rare diseases, their relatives, and physicians. METHODS In total, 107 individuals participated in a qualitative interview study conducted in Germany. Sixty-eight individuals suffering from a rare disease or related to somebody with rare diseases and 39 health care professionals took part. Individual interviews were conducted using a standardized semi-structured questionnaire. Interviews were analysed using the qualitative content analysis, triangulating patients, relatives, and health care professionals. The fulfilment of qualitative data processing standards has been controlled for. RESULTS Out of 68 patients and relatives and 39 physicians, 52 and 18, respectively, advocated for the establishment of a rare diseases telephone service. Interviewees expected a helpline to include expert staffing, personal contact, good availability, low technical barriers, medical and psychosocial topics of counselling, guidance in reducing information chaos, and referrals. Health care professionals highlighted the importance of medical topics of counselling-in particular, differential diagnostics-and referrals. CONCLUSIONS Therefore, the need for a national rare diseases helpline was confirmed in this study. Due to limited financial resources, existing offers should be adapted in a stepwise procedure in accordance with the identified attributes.
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Affiliation(s)
- Ana Babac
- CHERH - Centre for Health Economics Research Hannover, Leibniz University Hannover, Otto-Brenner-Straße 1, 30159 Hannover, Germany
| | - Martin Frank
- CHERH - Centre for Health Economics Research Hannover, Leibniz University Hannover, Otto-Brenner-Straße 1, 30159 Hannover, Germany
| | - Frédéric Pauer
- CHERH - Centre for Health Economics Research Hannover, Leibniz University Hannover, Otto-Brenner-Straße 1, 30159 Hannover, Germany
| | - Svenja Litzkendorf
- CHERH - Centre for Health Economics Research Hannover, Leibniz University Hannover, Otto-Brenner-Straße 1, 30159 Hannover, Germany
| | - Daniel Rosenfeldt
- CHERH - Centre for Health Economics Research Hannover, Leibniz University Hannover, Otto-Brenner-Straße 1, 30159 Hannover, Germany
| | - Verena Lührs
- ZQ - Centre for Quality and Management in Healthcare, Medical Association of Lower Saxony, Berliner Allee 20, 30175 Hannover, Germany
| | - Lisa Biehl
- ACHSE – Alliance for Chronic Rare Diseases, DRK-Clinics Berlin, Drontheimer Straße 39, 13359 Berlin, Germany
| | - Tobias Hartz
- IMBEI - Institute for Medical Biometry, Epidemiology and Informatics, Obere Zahlbacher Str. 69, 55131 Mainz, Germany
| | - Holger Storf
- IMBEI - Institute for Medical Biometry, Epidemiology and Informatics, Obere Zahlbacher Str. 69, 55131 Mainz, Germany
| | - Franziska Schauer
- Department of Dermatology, Freiburg Center for Rare Diseases, University Medical Center, University of Freiburg, Hauptstraße 7, 79104 Freiburg, Germany
| | - Thomas O. F. Wagner
- University Centre for Thorax Oncology, University Clinic of the Johann Wolfgang-Goethe University, Theodor-Stern-Kai 7, 60559 Frankfurt am Main, Germany
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Jahnsen JA, Widnes SF, Schjøtt J. Analysis of questions about use of drugs in breastfeeding to Norwegian drug information centres. Int Breastfeed J 2018; 13:1. [PMID: 29339968 PMCID: PMC5759832 DOI: 10.1186/s13006-017-0143-8] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2017] [Accepted: 12/18/2017] [Indexed: 01/16/2023] Open
Abstract
Background Health professionals may advise women to either stop breastfeeding or drug treatment due to restrictive advice in drug monographs. Regional medicines information and pharmacovigilance centres in Norway (RELIS) provide free and industry-independent answers to questions about drugs and breastfeeding documented in a full-text, searchable database (RELIS database). We used the RELIS database to describe which health care practitioners sought information about medication safety in lactation, most common drugs involved, advice provided and which resources were used to provide the advice. Methods A random selection of 100 question-answer pairs (QAPs) from the RELIS database indexed with “BREASTFEEDING” in the period from January 2011 to December 2015 was analysed. Inclusion criteria were queries from health professionals about drugs. Questions about herbal supplements and other exposures not classified as drugs were excluded. The QAPs were manually analysed for compatibility of one or several drugs with breastfeeding, health care profession and workplace of enquirer in addition to advice and search strategy used. Results In the 100 QAPs there were enquires about 152 drugs. Seventy-four questions concerned a single drug, but the number of drugs evaluated varied between 1 and 16. Fifty-nine questions were from physicians, 34 from nurses or midwives, two from pharmacists and two from other health professionals. Questions from physicians contained 93 drug evaluations (61%), nurses or midwives 47 (31%) and pharmacists seven (5%). The most frequent categories of drugs were antidepressants, antiepileptics and immunosuppressants. The most asked about drugs were lamotrigine, codeine, quetiapine and escitalopram. Fifty-nine percent of the drugs were deemed safe while breastfeeding, 16% if precautions were taken and 12% not recommended. Thirty-nine percent of the drug evaluations used an advanced literature search strategy, and this was significantly (p < 0.05) more likely when the enquirer was a physician. Conclusions This analysis of questions to Norwegian medicines information centres about medicine use in breastfeeding indicates the need for communication about safety of drugs affecting the nervous system, primarily to medical doctors and midwives. In the majority of cases the medicine information centre can reassure about the safety of breastfeeding while taking a drug. Electronic supplementary material The online version of this article (10.1186/s13006-017-0143-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Jan Anker Jahnsen
- Regional Medicines Information and Pharmacovigilance Centre (RELIS Vest), Haukeland University Hospital, Bergen, Norway
| | - Sofia Frost Widnes
- Regional Medicines Information and Pharmacovigilance Centre (RELIS Vest), Haukeland University Hospital, Bergen, Norway
| | - Jan Schjøtt
- Regional Medicines Information and Pharmacovigilance Centre (RELIS Vest), Haukeland University Hospital, Bergen, Norway.,Section of Clinical Pharmacology, Laboratory of Clinical Biochemistry, Haukeland University Hospital, Bergen, Norway.,Department of Clinical Science, Faculty of Medicine and Dentistry, University of Bergen, Bergen, Norway
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Davanzo R, Bua J, De Cunto A, Farina ML, De Ponti F, Clavenna A, Mandrella S, Sagone A, Clementi M. Advising Mothers on the Use of Medications during Breastfeeding: A Need for a Positive Attitude. J Hum Lact 2016; 32:15-9. [PMID: 26173811 DOI: 10.1177/0890334415595513] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2015] [Accepted: 06/19/2015] [Indexed: 11/15/2022]
Abstract
The use of medications by the nursing mother is a common reason for interrupting breastfeeding. Few drugs have been demonstrated to be absolutely contraindicated during breastfeeding. Excessive caution may lead health professionals to unnecessarily advise to interrupt breastfeeding, without assessing the latest evidence or considering the risk-benefit ratio of taking a medication versus terminating breastfeeding. To foster an appropriate approach toward the use of medications in breastfeeding women, the Italian Society of Perinatal Medicine created the following policy statement.
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Affiliation(s)
- Riccardo Davanzo
- Department of Perinatal Medicine, Institute for Maternal and Child Health-IRCCS "Burlo Garofolo," Trieste, Italy
| | - Jenny Bua
- Department of Perinatal Medicine, Institute for Maternal and Child Health-IRCCS "Burlo Garofolo," Trieste, Italy
| | - Angela De Cunto
- Department of Perinatal Medicine, Institute for Maternal and Child Health-IRCCS "Burlo Garofolo," Trieste, Italy
| | | | - Fabrizio De Ponti
- Pharmacology Unit, Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Antonio Clavenna
- IRCCS-Istituto di Ricerche Farmacologiche "Mario Negri," Milan, Italy
| | | | | | - Maurizio Clementi
- Teratology Information Service-Clinical Genetics Unit, Department of Women's and Children's Health, University of Padua, Padua, Italy
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Thomson G, Crossland N. Callers' attitudes and experiences of UK breastfeeding helpline support. Int Breastfeed J 2013; 8:3. [PMID: 23628104 PMCID: PMC3651704 DOI: 10.1186/1746-4358-8-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2012] [Accepted: 04/19/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Breastfeeding peer support, is considered to be a key intervention for increasing breastfeeding duration rates. Whilst a number of national organisations provide telephone based breastfeeding peer support, to date there have been no published evaluations into callers' experiences and attitudes of this support. In this study we report on the descriptive and qualitative insights provided by 908 callers as part of an evaluation of UK-based breastfeeding helpline(s). METHODS A structured telephone interview, incorporating Likert scale responses and open-ended questions was undertaken with 908 callers over May to August, 2011 to explore callers' experiences of the help and support received via the breastfeeding helpline(s). RESULTS Overall satisfaction with the helpline was high, with the vast majority of callers' recalling positive experiences of the help and support received. Thematic analysis was undertaken on all qualitative and descriptive data recorded during the evaluation, contextualised within the main areas addressed within the interview schedule in terms of 'contact with the helplines'; 'experiences of the helpline service', 'perceived effectiveness of support provision' and 'impact on caller wellbeing'. CONCLUSION Callers valued the opportunity for accessible, targeted, non-judgmental and convenient support. Whilst the telephone support did not necessarily influence women's breastfeeding decisions, the support they received left them feeling reassured, confident and more determined to continue breastfeeding. We recommend extending the helpline service to ensure support can be accessed when needed, and ongoing training and support for volunteers. Further advertising and promotion of the service within wider demographic groups is warranted.
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Affiliation(s)
- Gill Thomson
- Maternal & Infant Nutrition and Nurture Unit (MAINN), School of Health, University of Central Lancashire, Preston, PR1 2HE, UK
| | - Nicola Crossland
- Maternal & Infant Nutrition and Nurture Unit (MAINN), School of Health, University of Central Lancashire, Preston, PR1 2HE, UK
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Thomson G, Crossland N, Dykes F, Sutton CJ. UK Breastfeeding Helpline support: An investigation of influences upon satisfaction. BMC Pregnancy Childbirth 2012; 12:150. [PMID: 23234293 PMCID: PMC3534517 DOI: 10.1186/1471-2393-12-150] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2012] [Accepted: 11/28/2012] [Indexed: 11/17/2022] Open
Abstract
Background Helpline services have become an increasingly popular mode of providing community access to information and expert information and advice in the health and welfare sector. This paper reports on data collected from 908 callers to UK-based breastfeeding helplines. Methods A mixed methods design was adopted utilising a structured interview schedule to elicit callers experiences of the help and support received. In this paper we report on a series of multiple regression models undertaken to elicit the variables associated with callers’ ‘overall satisfaction’ with the helpline service. Three models were constructed; 1) caller demographic/call characteristics; 2) attitudes and effectiveness of service characteristics and 3) impact of support on caller wellbeing. Results Overall, 74.6% of callers were very satisfied, and 19.8% were satisfied with the help and support received by the helpline service. The caller demographic/call characteristics found to have a significant relationship with overall satisfaction related to the ease of getting through to the helpline and whether the woman had previously breastfed. Service characteristics associated with overall satisfaction related to whether the information received was helpful and whether the support helped to resolve their issues. The extent to which the volunteer was perceived to have enough time, whether the support had encouraged them to continue breastfeeding, met the caller’s expectations and/or provided the support the caller needed were also significantly associated. Caller outcomes contributing significantly to overall satisfaction concerned callers feeling less stressed, more confident, reassured and determined to continue breastfeeding following the call. Consideration of the effect sizes indicated that key factors associated with overall satisfaction related to: volunteers having sufficient time to deal with the callers’ issues; the information being perceived as helpful; the volunteers providing the support the callers needed; and for callers to feel reassured following the call. Conclusion Overall, these results highlight the value of the breastfeeding helpline(s) in terms of providing rapid, targeted, realistic, practical, and responsive support that provides affirmation and encouragement. The benefits include confidence building and callers feeling reassured and motivated to continue breastfeeding. Care needs to be taken to ensure that helpline support is easily accessible to ensure that callers and their families can access support when needed. This may require consideration of extension to a 24 hour service.
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Affiliation(s)
- Gill Thomson
- Maternal and Infant Nutrition and Nurture Unit (MAINN), School of Health, University of Central Lancashire, Preston, PR1 2HE, England.
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