Unlicensed "Special" Medicines: Understanding the Community Pharmacist Perspective

Integr Pharm Res Pract. 2020 Aug 13:9:93-104. doi: 10.2147/IPRP.S263970. eCollection 2020.

Abstract

Objective: Community pharmacy staff are responsible for obtaining and supplying unlicensed "special" medicines to patients in primary care. Less well-defined parameters for safe and effective use of unlicensed compared to licensed medicines, along with issues around maintaining consistency between care settings or among manufacturers, have been associated with increased risks. This study aimed to explore the views and experiences of community pharmacy staff on accessing and supplying unlicensed "special" medicines to patients in Wales and the perceived impact of challenges faced on patient care.

Methods: A qualitative, phenomenological approach was employed, involving semi-structured interviews with pharmacists and pharmacy technicians working at one small chain of community pharmacies in Wales. The interview schedule focused on the personal experiences and perceptions of the participants on the processes involved in accessing and supplying unlicensed "special" medicines from a community pharmacy. Interviews were audio-recorded and transcribed verbatim.

Results: A total of six participants completed the interview. Three main themes were constructed from inductive thematic analysis of the transcribed interviews: requirement for additional patient responsibilities; influences on the confidence felt by pharmacy staff when accessing and supplying unlicensed "special" medicines; and continuity of supply.

Conclusion: This study gives a preliminary insight into the views and experiences of community pharmacy staff in Wales when accessing and supplying unlicensed "special" medicines. Further research is required to see if these views and experiences are representative of community pharmacy staff across the country.

Keywords: community pharmacy; compounding; medicines supply; off-label; specials; transfer of care; transmural care; unlicensed medicines; “special” medicines.

Grants and funding

This research is funded by a Knowledge Economy Skills Scholarship (KESS), supported by European Social Funds (ESF) through the Welsh Government. KESS is a pan-Wales higher level skills initiative led by Bangor University on behalf of the HE sector in Wales. It is partly funded by the Welsh Government’s ESF convergence programme for West Wales and the Valleys. We also thank KESS partner company Mayberry Pharmacy and St Mary’s Pharmaceuticals.