Madden Mary, Morris Stephanie, Ogden Margaret, Lewis David, Stewart Duncan, O'Carroll Ronan E, McCambridge Jim
Department of Health Sciences, University of York, York, UK.
Department of Psychology, University of Stirling, Stirling, UK.
Drug Alcohol Rev. 2021 Sep;40(6):1028-1036. doi: 10.1111/dar.13255. Epub 2021 Mar 1.
Alcohol poses a range of potential problems to people taking medications, but health professionals are usually not comfortable talking about drinking with patients. The Medicines and Alcohol Consultation aims to increase the capacity of pharmacists to conduct person-centred reviews in which alcohol is regarded as another drug to be discussed alongside medications. This paper explores sensitivities in discussing alcohol and views on the legitimacy of the Medicines and Alcohol Consultation intervention concept at a pharmacy-user intervention co-design workshop.
A co-design workshop was held with 14 people recruited from UK community pharmacies who regularly drank alcohol and took medications for long-term conditions. This formed one element of a broader, iterative, intervention co-production process. Workshop discussions were audio-recorded and analysed thematically.
The basic intervention concept resonated well, though not entirely unproblematically. Participants were interested in receiving information on how medications interact with alcohol and how this might affect their own conditions, with which to make their own informed choices. Linking alcohol use to medicines gave legitimacy to pharmacists to raise alcohol in medicines reviews. Sensitivity in talking about alcohol was linked to vulnerability to negative judgement.
Changing the framing of alcohol in medicines reviews, away from being regarded as a 'lifestyle issue' to being considered a drug directly linked to medicines use, safety and effectiveness, was welcomed by participants in this study.
酒精给正在服药的人带来一系列潜在问题，但医疗专业人员通常不太愿意与患者谈论饮酒问题。药物与酒精咨询旨在提高药剂师进行以患者为中心的评估的能力，在这种评估中，酒精被视为另一种与药物一同讨论的药物。本文在一个药房用户干预共同设计研讨会上探讨了讨论酒精时的敏感性以及对药物与酒精咨询干预概念合理性的看法。
与从英国社区药房招募的14名经常饮酒且因长期疾病服药的人员举办了一次共同设计研讨会。这是更广泛的迭代干预共同生产过程的一个组成部分。研讨会讨论进行了录音并进行主题分析。
基本干预概念反响良好，尽管并非完全没有问题。参与者有兴趣获取关于药物如何与酒精相互作用以及这可能如何影响他们自身病情的信息，以便做出明智的个人选择。将饮酒与药物联系起来使药剂师在药物评估中提及酒精具有了合理性。谈论酒精时的敏感性与易受负面评判有关。
本研究的参与者欢迎在药物评估中改变对酒精的界定，从将其视为“生活方式问题”转变为视为与药物使用、安全性和有效性直接相关的药物。
