Background Most oral contraception options require a doctor’s prescription in Australia; however, there are many models of direct pharmacy access that have been successfully implemented internationally. Despite these advancements, the most preferable OTC model for consumers is yet to be explored in the international literature, and no prior studies have determined the potential benefits of implementation in Australia. The aim of this study was to explore women’s perspectives and preferences for models of direct pharmacy access to oral contraceptive pills (OCPs). Methods Women participants (n = 20) aged 18–44 residing in Australia were recruited via posts on a community Facebook page and participated in semi-structured telephone interviews. Interview questions were guided by Andersen’s Behavioural Model of Health Service Use. Data were coded and thematically analysed in NVivo 12, using an inductive process to develop themes. Results Participants’ perspectives and preferences in relation to direct pharmacy OCP access were characterised by: (1) the importance of autonomy, accessibility and decreasing stigma; (2) confidence and trust in pharmacists; (3) health and safety concerns regarding OTC access; and (4) the need for varying OTC models to cater for both experienced and first-time users. Conclusion Women’s perspectives and preferences regarding direct pharmacy OCP access can be used to inform potential pharmacy practice advancements in Australia. While direct pharmacy OCP access is at the nexus of heated political debate in Australia, the potential benefits of being able to access OCPs directly from a pharmacist are evidently salient to women. Australian women’s preferred OTC availability models were identified.
Background: A lack of clear guidelines for medication cessation has contributed to the proliferation of polypharmacy. Hospitalisation provides a unique opportunity for initiating deprescribing. Deprescribing interventions are usually pharmacist-or multidisciplinary team-led and are typically safe and beneficial for patients. However, few studies have explored interventions that are implementable by clinicians at the bedside. Aim: To explore the efficacy and feasibility of a clinician-led deprescribing intervention on an acute general medicine ward. Method: A multifaceted intervention was implemented comprising (a) education sessions on deprescribing and (b) a deprescribing alert in the bedside folders of patients with hyperpolypharmacy (>10 medications). Using a historical cohort study design, data from the intervention cohort were compared to a historical control group. A subset of the intervention cohort was surveyed after discharge regarding attitudes toward deprescribing. Results: We recruited 1333 patients and had complete data for 1169 (n intervention = 888, n control = 281). The prevalence of hyperpolypharmacy decreased from 28% to 26% in the intervention cohort, but this reduction was not statistically significant (net change = À1, interquartile range [IQR] = À2-0; p = 0.26). There was similarly no statistically significant change in medication numbers due to the intervention across other subgroups. Most patients agreed they were taking too many medications and supported deprescribing. Conclusions: Despite observing no statistically significant effect of the intervention, we demonstrated the feasibility of introducing clinician-led deprescribing interventions in resource-poor, busy inpatient units. Simple, innovative deprescribing interventions in hospital settings, along with the measurement of long-term patient outcomes and medication adverse effects, should be investigated further in large inpatient cohorts.
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