title: Access to medicines in remote and rural areas: a survey of residents in the Scottish Highlands & Western Isles.
abstract: OBJECTIVE
  Sparsely populated areas are potentially predisposed to health inequalities due to limited access to services. This study aimed to explore and describe issues of access to medicines and related advice experienced by residents of the Scottish Highlands and Western Isles.
  
  
  METHODS
  Cross-sectional cohort study.
  
  
  METHODS
  Anonymized questionnaires were mailed to a random sample of 6000 residents aged ≥18 years identified from the electoral register. The questionnaire contained items on: access to medicines; interactions with health care services; and perceptions of the services. Results were analysed using descriptive, inferential and spatial statistics.
  
  
  RESULTS
  Adjusted response rate was 49.5% (2913/5889). Almost two thirds (63.4%, 1847) were prescribed medicines regularly, 88.5% (1634) of whom considered the source convenient. Pharmacy (73.8%, 1364) or dispensing GP (24.0%, 443) were the most accessed sources. Prescription medicine advice was mainly obtained from the GP (55.7%, 1029). Respondents ≥80 years old were significantly (P < 0.0001) more likely to live alone (45.3%, 92) compared with those <80 (15.8%, 424). Almost a fifth (16.5%, 31) of those >80 years living alone disagreed that they obtained prescribed medicines from a convenient source. The majority of respondents who felt they did not have a convenient medicines source, regardless of urban/rural classification, lived within five miles of a pharmacy or GP practice.
  
  
  CONCLUSIONS
  Respondents accessed medicines and advice from a variety of sources. While most considered their access to medicines convenient, there were issues for those over 80 years and living alone. Perceived convenience would not appear to be solely based on geographical proximity to supply source. This requires further exploration given that these individuals are likely to have long-term conditions and be prescribed medicines on a chronic basis.
authors.affiliation: Highland Clinical Research Facility, Centre for Health Science, Old Perth Road, Inverness, UK; NHS Highland, Assynt House, Beechwood Park, Inverness, UK. Electronic address: gordon.rushworth@nhs.net.
authors.forename: G F
authors.initials: GF
authors.lastname: Rushworth
authors.affiliation: School of Pharmacy and Life Sciences, Robert Gordon University, Riverside East, Garthdee Road, Aberdeen, UK.
authors.forename: L
authors.initials: L
authors.lastname: Diack
authors.affiliation: NHS Highland, Assynt House, Beechwood Park, Inverness, UK.
authors.forename: A
authors.initials: A
authors.lastname: MacRobbie
authors.affiliation: Centre for Rural Health, University of the Highlands and Islands, Centre for Health Science, Old Perth Road, Inverness, UK.
authors.forename: S-A
authors.initials: SA
authors.lastname: Munoz
authors.affiliation: NHS Highland, Assynt House, Beechwood Park, Inverness, UK.
authors.forename: S
authors.initials: S
authors.lastname: Pfleger
authors.affiliation: School of Pharmacy and Life Sciences, Robert Gordon University, Riverside East, Garthdee Road, Aberdeen, UK.
authors.forename: D
authors.initials: D
authors.lastname: Stewart
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001294:Attitude to Health; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005260:Female; D019538:Health Care Surveys; D006297:Health Services Accessibility; D006801:Humans; D008297:Male; D008875:Middle Aged; D055553:Prescription Drugs / Q000600:supply & distribution*; D012424:Rural Population / Q000706:statistics & numerical data; D012606:Scotland
chemical_list: D055553:Prescription Drugs
keywords: Access; Convenience; Non-prescription drugs; Prescription drugs; Rural health services