Reducing medicines waste in the community

There is increasing concern at the amount and cost of prescribed medicines that are unused or wasted and then have to be disposed of. Previous studies have used health promotion and Dispose Unwanted Medicines Properly campaigns targeted at the patient to describe and quantify the annual cost of waste. The reasons patients return unused drugs to pharmacies have also been explored. The paper focuses on patient explanations for not needing medication; categorized as: over-collection in the past, self-management strategies, changes in medical condition, other changes in patient circumstances, or the repeat medicines policy at the surgery. The aim of the original study was to make a measurable change in prescribed medicines with a reduction in medicines wastage, whilst at the same time achieving improved standards of pharmaceutical care. Information on patient needs and behaviour came from consultation in the pharmacy monitoring forms and interview. The study was based on two medical practices in the West Midlands, UK, comparing an outer city and an inner city population. The participants were general practitioners, pharmacists and 350 repeat prescription patients. Prescriptions were issued for two three-month periods. The outcome was that 23.8% of the prescribed items were not dispensed, at a value of £13.1K, 58% of the medications that would be expected to be regularly supplied were collected. The study suggests that closer professional management at the point of dispensing and an understanding of patient experiences can help reduce the amount of unwanted medication collected by patients.

Visualisation of quality information for geospatial and remote sensing data:providing the GIS community with the decision support tools for geospatial dataset quality evaluation

The evaluation of geospatial data quality and trustworthiness presents a major challenge to geospatial data users when making a dataset selection decision. The research presented here therefore focused on defining and developing a GEO label – a decision support mechanism to assist data users in efficient and effective geospatial dataset selection on the basis of quality, trustworthiness and fitness for use. This thesis thus presents six phases of research and development conducted to: (a) identify the informational aspects upon which users rely when assessing geospatial dataset quality and trustworthiness; (2) elicit initial user views on the GEO label role in supporting dataset comparison and selection; (3) evaluate prototype label visualisations; (4) develop a Web service to support GEO label generation; (5) develop a prototype GEO label-based dataset discovery and intercomparison decision support tool; and (6) evaluate the prototype tool in a controlled human-subject study. The results of the studies revealed, and subsequently confirmed, eight geospatial data informational aspects that were considered important by users when evaluating geospatial dataset quality and trustworthiness, namely: producer information, producer comments, lineage information, compliance with standards, quantitative quality information, user feedback, expert reviews, and citations information. Following an iterative user-centred design (UCD) approach, it was established that the GEO label should visually summarise availability and allow interrogation of these key informational aspects. A Web service was developed to support generation of dynamic GEO label representations and integrated into a number of real-world GIS applications. The service was also utilised in the development of the GEO LINC tool – a GEO label-based dataset discovery and intercomparison decision support tool. The results of the final evaluation study indicated that (a) the GEO label effectively communicates the availability of dataset quality and trustworthiness information and (b) GEO LINC successfully facilitates ‘at a glance’ dataset intercomparison and fitness for purpose-based dataset selection.