Pharmacists’ perspectives on the value of reason for use information

Abstract

Background: The indication for a particular medication, or its reason for use (RFU), is important information for prescribers, pharmacists and patients but is not often communicated in writing from prescribers to pharmacists. Adding RFU to a prescription and a medication label would ensure that pharmacists are confident that they are providing high-quality, accurate patient care. This study aims to describe the perspectives of pharmacists on how receiving RFU from prescribers would affect their practice and how pharmacists putting this information on prescriptions would affect patients. Methods: Semi-structured qualitative interviews were conducted with 20 pharmacists in Southwestern Ontario. Thematic analysis was used to analyze the interview transcripts, leading to 4 major themes. Results: Pharmacists expressed that RFU should be formatted to ensure that it is of clinical utility via the use of written text and noted that either medical or lay (also known as plain) language would be appropriate for use. Pharmacists indicated that patient privacy should be considered when writing RFU on labels and that patient preference with respect to the addition of RFU should dictate its inclusion on a medication label. Pharmacist access to RFU was universally acknowledged to improve patient safety by providing pharmacists with more information to determine whether the given medication was indicated. Conclusions: This study provides further information about the impact that having access to RFU would have on pharmacy practice and can be used to advocate for the inclusion of RFU information with prescriptions to improve patient outcomes. Can Pharm J (Ott) 2020;153:xx-xx.

Prescribers’ perspectives on including reason for use information on prescriptions and medication labels: a qualitative thematic analysis

“…The few prescribers who currently add RFU to prescriptions tended to do so in limited circumstances, which seemed to be a palatable option for most prescribers. Prescribers' speculation that pharmacists currently determine RFU by asking the patient, or by guessing is in agreement interviews that we conducted separately with pharmacists, and many participants empathized with the difficulty their pharmacy colleagues have in determining why a given medication was prescribed [25]. As evidenced by Prescriber 16, simply informing prescribers of the value of adding RFU to medications has the potential to encourage its routine addition on medication labels.…”

“…Listing RFU on medication bottles could help patients have a greater understanding of their medications, potentially mitigating some risks of selfmedication [35]. Notably, these benefits may be lessened by the adoption of paperless ePrescribing [25,36,37]. Additionally, there is a potential to add RFU to discharge prescriptions post-hospital stay, to assist with medication reconciliation [38].…”

“…Throughout the interviews, the prescribers highlighted a number of cases where adding RFU would be particularly beneficial. If adding RFU is to be implemented in routine practice, phasing in its use beginning with select populations or medications may help to highlight the value of this practice to prescribers, help clarify expectations for the parties involved, and provide valuable information to pharmacists [25]. Adding RFU for medications being used for short-term use (eg, antibiotics) as stated by Prescriber 4 can facilitate medication reconciliation and deprescribing, encouraging medication lists to be up-todate [18,41].…”

“…Medications indicated for neurological and psychiatric illnesses have been found to be prescribed off-label frequently [42]. While RFU would be particularly valuable for off-label psychotropic medications, concerns about patient privacy were others to see the medication's RFU could pose challenges relating to embarrassment for patients [25]. Future work will focus on developing guidelines for when RFU should be added to prescriptions and medication labels, and consulting with communities who live with sensitive illnesses to determine what they would see as best practice for sharing the RFU for their medications on prescriptions and medication labels.…”

Incorporating ‘reason for use’ into the prescribing process of medication: a survey on the opinion of patients in Flanders, Belgium

“…The current research on including 'the reason for use' was recently and comprehensively reviewed by Mercer et al [16] using that specific phrasing and therefore, in this manuscript, the term 'reason for use' is utilized unless a direct reference to another study is made. Some data is available about the opinions of physicians and pharmacists regarding this possible extra aspect of the prescription [17][18][19]. Pharmacists are undoubtedly the long-time leading enthusiasts as they perceive this extra information a prerequisite for providing better pharmaceutical care.…”