Background: The Minor Ailment Service (MAS) in Scottish community pharmacy allows eligible people to gain improved access to care by providing free treatment for self-limiting conditions. Objective: To determine the perceptions and experiences of individuals using MAS and to quantify the potential impact on usage of other healthcare services. Methods: A cross-sectional survey was conducted of patients accessing MAS across Scotland during June and July 2018. Questionnaire items included reasons for choosing treatment through MAS, which other services they may have accessed had MAS not been available, experiences of consultation, overall satisfaction, and perceived effectiveness of treatment. Those accessing MAS were given a study pack including an information sheet, pre-piloted questionnaire, and pre-paid return envelope. Participants had the option to consent to an optional one-week follow up questionnaire that focused on perceived effectiveness of treatment after seven days and any further access to healthcare services such as general practice, emergency departments or repeat pharmacy visits. Results: There were 1,121 respondents to the initial questionnaire. Most reported ‘convenient Location' as the main reason for their access to community pharmacy (n=748; 67.1%). If MAS had not been available, 59% (n=655) of participants reported that they would have accessed general practice for treatment of their minor ailment. Experience of consultations was also rated highly with all ten outcome measures scoring ‘Excellent' overall. Satisfaction was reported positively with most participants reporting full satisfaction with the overall experience (n=960; 87.2%). At one-week follow up, 327 participants responded, over 85% (n=281) did not require further access to care to treat their minor ailment and 99.7% (n=326) said they would use MAS again. Conclusions: Positive perceptions and experiences of those using MAS demonstrate a highly regarded service in terms of satisfaction and experience of consultation. The capacity for MAS to impact on the use of higher-cost healthcare services is evidenced through the number of participants who reported these services as a point of access to care should community pharmacy not be available. This national evaluation demonstrates MAS to be a positively experienced service and outlines the factors determining access for treatment of minor ailments.

Abstract Background: There is an acknowledged lack of robust and rigorous research focusing on the perspectives of those prescribing direct acting oral anticoagulants (DOACs) for non-valvular atrial fibrillation (AF). Objective: The objective was to describe prescribers' experiences of using DOACs in the management of non-valvular AF, including perceptions of benefits and limitations. Methods: A cross-sectional survey of prescribers in a remote and rural area of Scotland. Among other items, the questionnaire invited free-text description of positive and negative experiences of DOACs, and benefits and limitations. Responses were independently analysed by two researchers using a summative content analysis approach. This involved counting and comparison, via keywords and content, followed by interpretation and coding of the underlying context into themes. Results: One hundred and fifty-four responses were received, 120 (77.9%) from physicians, 18 (11.7%) from nurse prescribers and 10 (6.4%) from pharmacist prescribers (6 unidentified professions). Not having to monitor INR was the most cited benefit, particularly for prescribers and patients in remote and rural settings, followed by potentially improved patient adherence. These benefits were reflected in respondents' descriptions of positive experiences and patient feedback. The main limitations were the lack of reversal agents, cost and inability to monitor anticoagulation status. Many described their experiences of adverse effects of DOACs including fatal and non-fatal bleeding, and upper gastrointestinal disturbances. Conclusions: While prescribers have positive experiences and perceive benefits of DOACs, issues such as adverse effects and inability to monitor anticoagulation status merit further monitoring and investigation. These issues are particularly relevant given the trajectory of increased prescribing of DOACs.

Appropriate prescribing remains an important priority in all medical areas of practice. Objective: The objective of this study was to apply a Medication Appropriateness Index (MAI) to identify issues of inappropriate prescribing amongst patients admitted from the Emergency Department (ED). Method: This study was carried out at Malta's general hospital on 125 patients following a two-week pilot period on 10 patients. Patients aged 18 years and over and on medication therapy were included. Medication treatment for inappropriateness was assessed by using the MAI. Under-prescribing was also screened for Results: Treatment charts of 125 patients, including 697 medications, were assessed using a MAI. Overall, 115 (92%) patients had one or more medications with one or more MAI criteria rated as inappropriate, giving a total of 384 (55.1%) medications prescribed inappropriately. The mean SD MAI score per drug was 1.78 (SD=2.19). The most common medication classes with appropriateness problems were biguanides (100%), anti-arrhythmics (100%) and anti-platelets (96.8%). The most common problems involved incorrect directions (26%) and incorrect dosages (18.5%). There were 36 omitted medications with untreated indications. Conclusion: There is considerable inappropriate prescribing which could have significant negative effects regarding patient care.

La prescripción adecuada es una prioridad importante en todas las áreas de la práctica médica. Objetivo: El objetivo de este estudio fue aplicar el Medication Appropriateness Index (MAI) para identificar problemas de prescripción de medicación inadecuada entre los pacientes admitidos en un servicio de urgencias (ED). Método: Este estudio se realizó en el Hospital General de Malta sobre 125 pacientes después de un periodo piloto de dos semanas sobre 10 pacientes. Se incluyeron pacientes de 18 o más años con medicación. La inadecuación del tratamiento se evaluó usando el MAI. También se evaluó la sub-prescripción. Resultados: Los perfiles de medicación de los 125 pacientes, que incluían 697 medicamentos, se evaluaron con el MAI. En general, 115 pacientes (92%) tenían uno o más medicamentos con uno o más de los criterios del MAI evaluados como inadecuados, dando un total de 384 (55,1%) medicamentos prescritos inadecuadamente. La media (SD) de puntuación del MAI por medicamento fue de 1,78 (SD=2,19). Los grupos terapéuticos más comúnmente asociados a problemas de inadecuación eran las biguanidas (100%), anti-arritmicos (100%) y antiagregantes (96,8%). Los problemas más comunes incluían indicaciones incorrectas (26%) y dosis incorrectas (18,5%). Hubo 36 medicaciones omitidas con indicaciones no tratadas. Conclusión: Hay una considerable prescripción de medicación inadecuada que podría tener significativos efectos negativos en los cuidados del paciente.

This paper presents a process of mining research & development abstract databases to profile current status and to project potential developments for target technologies, The process is called "technology opportunities analysis." This article steps through the process using a sample data set of abstracts from the INSPEC database on the topic o "knowledge discovery and data mining." The paper offers a set of specific indicators suitable for mining such databases to understand innovation prospects. In illustrating the uses of such indicators, it offers some insights into the status of knowledge discovery research*.