A cross-sectional survey of the access of older people in the Scottish Highlands to general medical practices, community pharmacies and prescription medicines.
Access to medicines and healthcare is more problematic in remote and rural areas.



To quantify issues of access to general practitioners (GPs), community pharmacies and prescribed medicines in older people resident in the Scottish Highlands.



Anonymized questionnaires were mailed to a random sample of 2000 older people (≥60 years) resident in the Scottish Highlands. Questionnaire items were: access and convenience to GP and pharmacy services (10 items); prescribed medicines (13 items); attitudinal statements based on the Theoretical Domains Framework (12 items); quality of life (SF8, 8 items); and demographics (12 items). Results were analysed using descriptive, inferential and spatial statistics, and principal component analysis (PCA) of attitudinal items.



With a response rate of 54.2%, the majority reported convenient access to GPs (89.1%) and community pharmacies (84.3%). Older age respondents (p < 0.0001) were more likely to state that their access to GP services was not convenient and those in rural areas to community pharmacies (p < 0.01). For access to prescribed medicines, those in poorer health (p < 0.001) and taking five or more regular prescribed medicines (p = 0.002) were more likely to state access not convenient. PCA identified three components of beliefs of capabilities, emotions and memory. Those with poorer health had more negative scores for all (p < 0.001). Those reporting issues of access to prescribed medicines had more negative scores for beliefs of capabilities (p < 0.001) while those of older age, living alone, and taking five or more regular prescribed medicines (all p < 0.001) had more negative scores for emotions.



While the majority of respondents have convenient access to their GP practice, pharmacy and prescribed medicines, there is a need for further review of the pharmaceutical care of those of older age with poorer health, living alone in the more remote and rural areas and taking five or more prescribed medicines.
Highland Pharmacy Education and Research Centre, Centre for Health Science, Old Perth Road, Inverness, IV2 3JH, UK. Electronic address: gordon.rushworth@nhs.net.
Gordon F
GF
Rushworth
School of Pharmacy and Life Sciences, Robert Gordon University, The Sir Ian Wood Building, Garthdee Road, Aberdeen, AB10 7GJ, UK. Electronic address: s.cunningham@rgu.ac.uk.
Scott
S
Cunningham
NHS Highland, Assynt House, Beechwood Park, Inverness, IV2 3BW, UK. Electronic address: sharon.pfleger@nhs.net.
Sharon
S
Pfleger
Centre for Rural Health, University of the Highlands and Islands, Centre for Health Science, Old Perth Road, Inverness, IV2 3JH, UK. Electronic address: Jenny.Hall@uhi.ac.uk.
Jenny
J
Hall
School of Pharmacy and Life Sciences, Robert Gordon University, The Sir Ian Wood Building, Garthdee Road, Aberdeen, AB10 7GJ, UK. Electronic address: d.stewart@rgu.ac.uk.
Derek
D
Stewart
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D003157:Community Pharmacy Services / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D005260:Female; D058005:General Practitioners / Q000706:statistics & numerical data*; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D019338:Polypharmacy; D055553:Prescription Drugs / Q000008:administration & dosage / Q000600:supply & distribution*; D025341:Principal Component Analysis; D011788:Quality of Life; D012424:Rural Population; D012606:Scotland; D011795:Surveys and Questionnaires
D055553:Prescription Drugs
Access; Convenience; Prescription drugs; Questionnaire; Rural health services