title: Pharmacists' perceptions and communication of risk for alertness impairing medications.
abstract: A core role of the pharmacist is to ensure safe and effective medication use. Therapeutic classes that impair alertness (e.g. sedatives or hypnotics) can pose safety concerns for the consumer when undertaking activities requiring psychomotor vigilance (e.g. driving).
  
  
  
  To explore pharmacists' perceptions and communication strategy of the risks related to alertness impairing medications in clinical practice.
  
  
  
  In-depth semi-structured interviews explored community pharmacists' perceptions of medication-related risks, current medication provision and the feasibility of new practice tools. Interviews were digitally recorded, transcribed verbatim and analysed using Framework Analysis to identify emergent themes. A Psychometric Risk Perception Questionnaire was also used to evaluate pharmacists' perceptions across 7 common psychotropic drug classes.
  
  
  
  Synthesis of the qualitative dataset of 30 pharmacist interviews revealed three key themes: 'Safety and Consequences of AIMs', 'Factors that Influence Risk Communication' and 'Refining Risk Communication'. Participating pharmacists were generally aware of the therapeutic classes associated with medication-related risks but were concerned about patients' level of understanding. Counselling approaches were largely dictated by perceived patient interest/experience with a medication. Concerns were centred on inter-individual pharmacokinetic differences, which could make the precise risk assignment difficult. Pharmacists also highlighted workflow limitations and the need to bring patients' attention to these resources during the clinical interaction to maximise impact.
  
  
  
  Medication-related risk communication is a complex clinical phenomenon dictated by patients' prior experiences and the pharmacists' practice environment. Extending the evidence base in this therapeutic area and refining clinical resources are key steps towards optimising patient medication safety.
authors.affiliation: Faculty of Pharmacy, University of Sydney, Sydney, New South Wales, Australia.
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Jomaa
authors.affiliation: Faculty of Pharmacy, Uppsala University, Uppsala, Sweden.
authors.forename: Mariam
authors.initials: M
authors.lastname: Odisho
authors.affiliation: Faculty of Pharmacy, University of Sydney, Sydney, New South Wales, Australia; Sleep and Circadian Group, Woolcock Institute of Medical Research, Glebe, New South Wales, Australia.
authors.forename: Janet M Y
authors.initials: JMY
authors.lastname: Cheung
authors.affiliation: Sleep and Circadian Group, Woolcock Institute of Medical Research, Glebe, New South Wales, Australia; Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia.
authors.forename: Keith
authors.initials: K
authors.lastname: Wong
authors.affiliation: Northumbria Centre for Sleep Research, Newcastle-upon-Tyne, United Kingdom.
authors.forename: Jason G
authors.initials: JG
authors.lastname: Ellis
authors.affiliation: The Centre for Accident Research and Road Safety, Brisbane, Queensland, Australia.
authors.forename: Tanya
authors.initials: T
authors.lastname: Smyth
authors.affiliation: Faculty of Pharmacy, University of Sydney, Sydney, New South Wales, Australia; Sleep and Circadian Group, Woolcock Institute of Medical Research, Glebe, New South Wales, Australia. Electronic address: bandana.saini@sydney.edu.au.
authors.forename: Bandana
authors.initials: B
authors.lastname: Saini
mesh_terms: D001291:Attitude of Health Personnel; D003142:Communication; D003157:Community Pharmacy Services / Q000458:organization & administration*; D064420:Drug-Related Side Effects and Adverse Reactions / Q000517:prevention & control; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage / Q000009:adverse effects; D007407:Interviews as Topic; D008297:Male; D010353:Patient Education as Topic / Q000379:methods*; D010465:Perception; D010595:Pharmacists / Q000458:organization & administration / Q000523:psychology*; D024382:Professional Role; D011594:Psychometrics; D012306:Risk; D011795:Surveys and Questionnaires
chemical_list: D006993:Hypnotics and Sedatives
keywords: Consumer; Medication safety; Risk communication; Sedatives