Introducing alcohol as a drug in medicine reviews with pharmacists: Findings from a co‐design workshop with patients

Abstract

Introduction Alcohol poses a range of potential problems to people taking medications, but health professionals are usually not comfortable talking about drinking with patients. The Medicines and Alcohol Consultation aims to increase the capacity of pharmacists to conduct person‐centred reviews in which alcohol is regarded as another drug to be discussed alongside medications. This paper explores sensitivities in discussing alcohol and views on the legitimacy of the Medicines and Alcohol Consultation intervention concept at a pharmacy‐user intervention co‐design workshop. Methods A co‐design workshop was held with 14 people recruited from UK community pharmacies who regularly drank alcohol and took medications for long‐term conditions. This formed one element of a broader, iterative, intervention co‐production process. Workshop discussions were audio‐recorded and analysed thematically. Results The basic intervention concept resonated well, though not entirely unproblematically. Participants were interested in receiving information on how medications interact with alcohol and how this might affect their own conditions, with which to make their own informed choices. Linking alcohol use to medicines gave legitimacy to pharmacists to raise alcohol in medicines reviews. Sensitivity in talking about alcohol was linked to vulnerability to negative judgement. Discussion and Conclusions Changing the framing of alcohol in medicines reviews, away from being regarded as a ‘lifestyle issue’ to being considered a drug directly linked to medicines use, safety and effectiveness, was welcomed by participants in this study.

Addressing complex pharmacy consultations: methods used to develop a person-centred intervention to highlight alcohol within pharmacist reviews of medications

“…The co-design workshops were intended to examine the content of Version 1, with one large patient workshop (including one carer/caregiver), co-facilitated by patient advisory group leads, particularly useful for examining how consultations might begin, and the idea of alcohol as a drug that is appropriate for medications review discussions [ 46 ].…”

Using qualitative process evaluation in the development of a complex intervention to advance person-centred practice by pharmacists: The Medicines and Alcohol Consultation (MAC)

“…The first phase of the five-year research programme ‘Community pharmacy: Highlighting Alcohol use in Medication Appointments’ (CHAMP-1) used qualitative participatory methods to gather patient and pharmacist perspectives on acceptability and suitability of the proposed Medicines and Alcohol Consultation (MAC) intervention for use within routine practice in established pharmaceutical services ( Madden, et al, 2020 ; Morris, et al, 2019 ; Madden, Morris et al, 2020 ; Madden et al, 2021 ). This formed part of a 15 month intervention development process to prepare the intervention for study in a RCT.…”

“…The piloted version of MAC frames alcohol as a drug consumed alongside other drugs and therefore within the CP's sphere of expertise. This moves way from the more familiar framing of alcohol as a ‘lifestyle’ issue to one directly linked to medicines use, safety and effectiveness - and the conditions for which medications are prescribed ( Madden et al., 2021 ).…”