The online version of this article (doi:10.1007/s11096-017-0541-4) contains supplementary material, which is available to authorized users.
Background Mental and physical health problems are common in people with substance misuse problems and medications are often required in their management. Given the extent of prescribing for service users who attend specialist addiction services, it is important to consider how prescribers in this setting assess the appropriateness of service users’ prescribed medications. Objective To explore prescribers’ views and experiences of assessing the appropriateness of medications prescribed for service users coming in for treatment as well as the differences between prescribers. Setting A specialist addiction service in the North of England. Method A phenomenological approach was adopted. Semi-structured interviews were conducted with four nurse prescribers and eight doctors. Data were analysed using thematic framework analysis. Main outcome measure Prescribers’ views and experiences of assessing the appropriateness of prescribed medications. Results Assessment of the appropriateness of prescribed medications involved reviewing medications, assessing risk, history-taking, involvement of service users, and comparing guideline adherence and ‘successful’ prescribing. Doctors and nurse prescribers assessed the appropriateness of medications they considered to be within their competency. Doctors provided support to nurse prescribers and general practitioners (GPs) when dealing with issues around prescribing. Conclusion Assessment of the appropriateness of prescribed medications is complex. The recent reduction in medical expertise in specialist addiction services may negatively impact on the clinical management of service users. It appears that there is a need for further training of nurse prescribers and GPs so they can provide optimal care to service users.
Oluyase AO, Raistrick D, Abbasi Y, Dale V, Lloyd C. A study of the psychotropic prescriptions of people attending an addiction service in England. Adv Dual Diagn. 2013;6(2):54–65. CrossRef
Hughes E. Guidelines for working with mental health-substance use. In: Cooper DB, editor. Developing services in mental health-substance use. London: Radcliffe Publishing Ltd; 2011.
Boscarino JA, Kirchner HL, Pitcavage JM, Nadipelli VR, Ronquest NA, Fitzpatrick MH, et al. Factors associated with opioid overdose: a 10-year retrospective study of patients in a large integrated health care system. Subst Abuse Rehabil. 2016;77:131–41. CrossRef
Department of Health. Review of prescribing, supply and administration of medicines: final report (Crown II). London: Department of Health; 1999.
National Treatment Agency for Substance Misuse. Models of care for alcohol misusers (MoCAM). London: National Treatment Agency for Substance Misuse; 2006.
Miles MB, Huberman AM. Qualitative data analysis: a sourcebook of new methods. Beverly Hills: Sage Publications; 1994.
Silverman D. Doing qualitative research: a practical handbook. London: Sage Publications; 2013.
Public Health England. Non-medical prescribing in the management of substance misuse. London: Public Health England; 2014. http://www.nta.nhs.uk/uploads/nmp-in-the-management-of-substance-misuse.pdf. Accessed 23 Jul 2015.
Public Health England. The role of addiction specialist doctors in recovery orientated treatment systems. A resource for commissioners, providers and clinicians. London: Public Health England; 2014. http://www.nta.nhs.uk/uploads/the-role-of-addiction-specialist-doctors.pdf. Accessed 23 Jul 2015.
Virgo N, Bennett G, Higgins D, Bennett I, Thomas P. The prevalence and characteristics of co-occurring serious mental illness (SMI) and substance abuse or dependence in the patients of adult mental health and addictions services in eastern Dorset. J Ment Health. 2001;10(2):175–88. CrossRef
Strathdee G, Manning V, Best D, Keaney F, Bhui K, Witton J, et al. Dual diagnosis in a primary care group (PCG), (100,000) population locality: a step-by-step epidemiological needs assessment and design of a training and service response model. Drugs Educ Prev Policy. 2005;12(1):119–23.
Delgadillo J, Godfrey C, Gilbody S, Scott P. Depression, anxiety and comorbid substance use: association patterns in outpatient addictions treatment. Ment Health Subst Use. 2013;6(1):59–75. CrossRef
Walsh K, Copello A. Severe and enduring mental health problems within an established substance misuse treatment partnership. Psychiatr Bull. 2014;38(5):216–9. CrossRef
Bezreh T, Laws MB, Taubin T, Rifkin DE, Wilson IB. Challenges to physician-patient communication about medication use: a window into the skeptical patient’s world. Patient Prefer Adherence. 2012;6:11–8. PubMed
Action on Addiction. The management of pain in people with a past or current history of addiction. London: Action on Addiction; 2013. http://www.actiononaddiction.org.uk/Documents/The-Management-of-Pain-in-People-with-a-Past-or-Cu.aspx. Accessed 23 Jul 2015.
Farquhar CM, Kofa EW, Slutsky JR. Clinicians’ attitudes to clinical practice guidelines: a systematic review. Med J Aust. 2002;177(9):502–6. PubMed
Ali SI, Ajmal SR. When is off-label prescribing appropriate? Curr Psychiatr. 2012;11(7):23–7.
- Prescribers’ views and experiences of assessing the appropriateness of prescribed medications in a specialist addiction service
Adejoke Obirenjeyi Oluyase
- Springer International Publishing
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