What effect does medicine advice provided by UK Medicines Information pharmacists have on prescriber practice and patient care: a qualitative primary care study

Rationale, aims and objectives UK Medicines Information (UKMI) is pharmacist-led service funded by the National Health Service providing evidence-based advice about medicines to health care professionals. Service evaluations have repeatedly shown high user satisfaction but few studies have assessed how this advice influences the care patients receive. Furthermore, no study has assessed how prescribers actually use this information in shaping their decision making. The aim was to explore how UKMI advice influences prescriber decision making and patient care. Methods Doctors and dentists (referred to as prescribers) working in primary care in England and Wales who received reactive medicines advice from a medicines information centre were contacted by telephone to determine how they used the advice provided. Forty semi-structured interviews were analysed and coded using constant comparative content analysis. Results Five key themes were identified that affected prescriber decision making, these were: prescriber action, patient outcome, medicines information advice, risk management and time factors. Prescribers acted directly on the advice provided enabling them to provide the right care for their patients. Advice had a positive effect on how they viewed a medication problem and empowered them to make decisions that appeared to confer greater confidence in managing patient problems. A favourable patient outcome was described by over half of the prescribers, for example, the advice enabled them to provide patient reassurance, avoid a potential allergic reaction, stabilize the patient's condition or stop treatment. Conclusions Medicines information advice empowered prescribers in helping them to make decisions about medicines that shaped patient car