Medication breaks in ADHD

Ibrahim, K. & Donyai, P. What stops practitioners discussing medication breaks in children and adolescents with ADHD? Identifying barriers through theory-driven qualitative research. ADHD Atten Def Hyp Disord (2018). https://doi.org/10.1007/s12402-018-0258-9

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Treatment guidelines for attention deficit hyperactivity disorder (ADHD) in children recommend ‘drug holidays’ to assess the continual need for medication. Drug holidays are interruptions in treatment which allows parents and clinicians to monitor children. Recent research from the department, conducted under the supervision of Dr. Parastou Donyai, explored barriers which prevent clinicians from initiating planned ‘drug holidays’. Components of the Capability-Opportunity-Motivation (COM-B) model was used to analyse interview transcripts with clinicians. Knowledge and skills of general practitioner doctors as well as time contraints could be some of the barriers reported by this study. The full article can be accessed here, https://doi.org/10.1007/s12402-018-0258-9.

Should pharmacists be allowed to reuse medicines?

“If somebody leaves the pharmacy with their own medication and we can’t trust the integrity of the product in their hands, why would that medicine be OK for them [but not for someone else],” asks Donyai.”

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A recent article in The Pharmaceutical Journal recently questioned whether pharmacists should be allowed to reuse medicines and included comments by Dr. Donyai. Previous research by the department has shown that the public would be willing to reuse medications that are returned to pharmacies if their concerns are appropriately addressed¹.

Visit The Pharmaceutical Journal to read more about the feasibility of allowing medicines reuse. (The Pharmaceutical JournalDOI: 10.1211/PJ.2018.20205091)

¹Alhamad H, Patel N & Donyai P. Beliefs and intentions towards reusing medicines in the future: a large‐scale, cross‐sectional study of patients in the UK. Int J Pharm Pract 2018; 26 (suppl 1):12. doi: 10.1111/ijpp.12442).

Information design and architecture: combating drug-resistant infection

Dr. Rosemary Lim is a co-investigator on an exciting antimicrobial resisitance project funded by the Arts and Humanities Research Concil entitiled, ‘Information Design and Architecture in Persuaive Pharmacy space: combating AMR (IDAPPS)’.

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A design competition was recently held where groups of designers comprising of architects, information designers, pharmacists and others worked together to produce five great ideas for talking about drug-resistant infections. More information about the project and the winning designs can be found here https://amrpharmacy.org/five-ideas-for-talking-about-drug-resistant-infections/

Research collaboration

Dr. Rosemary Lim was recently awarded the certicate for new Research Collaborators with Berkshire Healthcare NHS Foundation Trust for 2017/18 in recognition of her study which explored medication use in people with Alzheimers.

The aim of the study, entitled ‘How do people with Alzheimer’s Disease and their family carers, view and manage medicine-taking?’, was to explore and explain medication non-adherence and the results have also been presented at Alzheimer’s Association International Conference 2017 in London.

Dr. Donyai’s expert comments are in the news!

A study published this month in the BMJ reports an association between the use of certain anticholinergic drugs and the risk of dementia in the future. Dr Parastou Donyai, Associate Professor of Social and Cognitive Pharmacy, provided her expert comment on this study to the Science Media Centre and said,

“This paper ties in well with current advice for doctors to be careful when using drugs with anticholinergic effects in older people, those who are frail and others with numerous health conditions. The warning to not use anticholinergic drugs in Parkinson’s disease is also important. But the headline claim that some drugs, especially antidepressants, can cause dementia up to 20 years later should be looked at closely. This type of study imagines that patients actually take their drugs as they were prescribed for them. But we know from other research that people with long-term health conditions really only take their medication as prescribed around half of the time – the other half, people either take more or less of their medication or not at all. This issue of ‘non-adherence’ is common in people with heart conditions, stomach problems and mental health illnesses including depression and we want to be careful not to add to the problem. So my first comment is to remember that the paper really looked at the ‘prescribing’ of drugs rather than the ‘taking’ of these medications. This brings me to my second comment which is that anyone worried about taking their antidepressant as a result of this paper should speak to their doctor or pharmacist first and not suddenly stop their medication.”

Results from the study along with Dr. Parastou’s comments have also been reported in the BBC and The Guardian.

BBC: https://www.bbc.co.uk/news/health-43881209

The Guardian: https://www.theguardian.com/society/2018/apr/25/some-antidepressants-linked-to-dementia-risk

Link to study: https://doi.org/10.1136/bmj.k1315