Addressing inequalities in the provision of pharmaceutical services in Scotland: a proof of concept study of tele-pharmacy in rural Scotland.

The problem

Many any remote areas have limited access to community pharmacy services such as: advice on healthcare related issues, purchasing over-the-counter medicines, medicine advice, or the enhanced pharmacy services in the new Community Pharmacy (Scotland) contract. Recent advances in technology have seen a change in service delivery? eg tele-medicine1. Use of such technology allows provision of health services in remote settings, which begins to address inequality of care in rural areas. We propose using video-linkage technology, integrated within a medicines supply robot, to provide community pharmacy services in a rural area currently without a registered community pharmacy.This abstract describes one part of a larger study (using mixed methodology) which aims to assess the feasibility, acceptability and scope of providing community pharmacy services via a video link and a supply robot. Preliminary findings from baseline focus groups are reported here.This study was approved by the North of Scotland Research Ethics Committee.

The approach

Practising pharmacists were identified, utilising the local pharmacy contractors' list and purposefully sampled to include urban, rural and suburban pharmacies and a mix of independents, large and small multiples. Four community pharmacists and a Grampian health board pharmacist attended.Forty-eight local residents, purposefully sampled from the electoral role to avoid gender bias, received written invitations to participate. Six agreed to attend and four took part.Topic guides were developed based on the literature2 and agreed by the research team. Core areas explored in the resident focus group included: current use of pharmacies, perceived need for a tele-pharmacy service and facilitators/barriers to using such a service. For the pharmacist's focus group areas explored were: views regarding remote supervision, perceived acceptability of the tele-pharmacy service, facilitators/barriers, and personal involvement in the service.Focus groups for local residents and pharmacist stakeholders, who provided written consent, were conducted, digitally recorded, transcribed and analysed using an agreed thematic framework. Transcripts and thematic analysis were validated within the research team.

Findings

Provisional findings suggest residents' satisfaction with the current pharmacy service provision, particularly specifying the delivery of prescriptions to the remote site. They recognised the benefits of the proposed service for the elderly and those with limited transport access. Participants highlighted the need for the Minor Ailment Service to be included, but had reservations regarding confidentiality with others services e.g. Emergency Hormonal Contraception and Nicotine Replacement Therapy.Pharmacists acknowledged the benefits of providing pharmacy services for rural communities. They highlighted resource implications and confidentiality as barriers to this proposed service provision.

Consequences

Findings

from this study will inform any future initiatives to introduce similar tele-pharmacy services in Scotland enabling the public to manage their own health and wellbeing by providing health care to remote and rural communities.

Credits

• Christine Bond
• Frances Notman
• Jackie Inch