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Introducing alcohol as a drug in medicine reviews with pharmacists: findings from a co-design workshop with patients

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Madden, Mary, Morris, Stephanie, Ogden, Margaret, Lewis, David, Stewart, Duncan, O'Carroll, Ronan and McCambridge, Jim (2021) Introducing alcohol as a drug in medicine reviews with pharmacists: findings from a co-design workshop with patients. Drug and Alcohol Review, 40 (6). pp. 1028-1036. ISSN 0959-5236

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Abstract

Introduction:
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.

Methods:
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.

Results:
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.

Discussion and conclusions:
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.

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