Background: The increasing burden of chronic disease is recognised globally. Within the English National Health\r\nService, patients with chronic disease comprise of half of all consultations in primary care, and 70% of inpatient bed\r\ndays. The cost of prescribing long-term medications for those with physical chronic diseases is rising and there is a\r\ndrive to reduce medicine wastage and costs. While current policies in England are focused on the latter, there has\r\nbeen little previous research on patient experience of ordering and obtaining regular medication for their chronic\r\ndisease. This paper presents findings from England of a qualitative study and survey of patients and their carersââ?¬â?¢\r\nexperiences of community and primary care based services for physical chronic diseases. Although not the primary\r\nfocus of the study, the results highlighted particular issues around service delivery of repeat prescriptions.\r\nMethods: We conducted 21 qualitative in-depth interviews with 30 patients and family carersââ?¬â?¢ in two Primary Care\r\nTrusts in England. Participants were receiving community based care for diabetes, respiratory, neurological or\r\ncomplex co-morbidities, and ranged in age from 39ââ?¬â??92 years old. We used a broadly inductive approach to enable\r\nthemes around patient experience to emerge from the data.\r\nResults: While the study sought to gain an overview of patient experience, the findings suggested that the\r\nprocesses associated with ordering and obtaining regular medication ââ?¬â?? the repeat prescription, was most frequently\r\ndescribed as a recurring hassle of managing a long-term condition. Issues for patients and carers included multiple\r\njourneys to the surgery and pharmacy, lack of synchrony and dissatisfaction with the length of prescriptions.\r\nConclusion: Much literature exists around medication waste and cost, which led to encouragement from the NHS\r\nin England to reduce dosage units to a 28-day supply. While there has been an acknowledgement that longer\r\nsupplies may be suitable for people with stable chronic conditions, it appears that there is limited evidence on the\r\nimpact of shorter length prescriptions on patient and carer experience, adherence and health outcomes. Recent\r\npolicy documents within England also fail to address possible links between patient experience, adherence and\r\nflaws within repeat prescription service delivery.
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