Use this URL to cite or link to this record in EThOS:
Title: Accessing P class medicines from General Practitioners or Community Pharmacists : investigating user choice, substitution and relative costs between the two routes
Author: Myles, Susan
Awarding Body: University of Edinburgh
Current Institution: University of Edinburgh
Date of Award: 2006
Availability of Full Text:
Access from EThOS:
Full text unavailable from EThOS. Please try the link below.
Access from Institution:
Aim: To assess the extent to which increased availability of P class medicines facilitates substitution between general practice and community pharmacy and the costs accruing to stakeholders as a result. Participants: 1185 users recruited in 15 community pharmacies in Lothian while obtaining a P medicine, either on prescription or over-the-counter. Results: Substitution: the majority of users buying P medicines from a community pharmacy successfully substituted this in place of obtaining them on prescription from a general practitioner. However, one in seven of these users subsequently visited a general practitioner also. User Profiles: Healthy, more affluent users were significantly more and less affluent, iller users significantly less likely to attempt to substitute. Costs: Substitution generated savings for society overall, with all stakeholders benefiting, on average. Resource savings swing heavily towards the health sector. Users were only marginally better off, on average. Time and resource costs were significantly higher among those in less favourable economic circumstances, who perceived themselves not to be in good health, or who were frequent users of primary care. Cost minimisation analysis indicates promoting increased self-medication using P medicines accessed from community pharmacies, as opposed to from general practitioners, enhances technical and allocative efficiency within the primary care sector. Conclusion: Policies increasing availability of P medicines has improved access for many users and is consonant with encouraging enhanced, graduated access to first-contact services. However, it promotes differential access that is systematically related to the socio-economic status of users. Already disadvantaged people are further disadvantaged. Conversely, inverse care is emergent.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available