Patients using antifungals following laryngectomy : a qualitative study of community pharmacists in the North of England

Todd, A; Husband, A; Hurren, A; Kler, S; Ling, J

Abstract

Objective: To explore community pharmacists’ understanding and opinions in relation to prevention of fungal colonisation of voice prostheses amongst laryngectomy patients. Method: Semi-structured interviews were conducted on a purposive sample of 12 community pharmacists from the North of England. Interviews were undertaken until data saturation was reached and responses were transcribed verbatim and analysed using a thematic approach. Key findings: Six themes emerged from the data analysis. These were: terminology confusion about laryngectomy, stoma and voice prostheses; smoking as a risk factor for the development of laryngeal cancer; using nystatin to prevent biofilm formation; counselling information related to nystatin; prescription intervention and additional education in relation to laryngectomy. The theme of counselling information related to nystatin use and additional education was a key finding: our data show that when dispensing nystatin to patients with a voice prosthesis, community pharmacists would either give no advice related to medication use or would give incorrect advice that may lead to premature prosthesis failure amongst this patient group. Conclusion: This study highlights that community pharmacists lack understanding in relation to laryngectomy and are unaware of the off-label doses and administration methods of the drugs (specifically nystatin) used to prevent fungal colonisation on voice prostheses. Additional information sources – possibly obtained through the local Speech and Language Therapy Department – in the form of an educational leaflet would be perceived as a valuable resource to support community pharmacists who are required to manage these patients in the community.

Citation

Todd, A., Husband, A., Hurren, A., Kler, S., & Ling, J. (2014). Patients using antifungals following laryngectomy : a qualitative study of community pharmacists in the North of England. International Journal of Pharmacy Practice, 22(3), 193-199. https://doi.org/10.1111/ijpp.12071

• Journal Article Type: Article
• Publication Date: Jun 1, 2014
• Deposit Date: Jul 26, 2013
• Publicly Available Date: Sep 6, 2013
• Journal: International Journal of Pharmacy Practice
• Print ISSN: 0961-7671
• Electronic ISSN: 2042-7174
• Publisher: Oxford University Press
• Peer Reviewed: Peer Reviewed
• Volume: 22
• Issue: 3
• Pages: 193-199
• DOI: https://doi.org/10.1111/ijpp.12071
• Keywords: Head and neck cancer, Community pharmacists, Laryngectomy, Off-label prescribing, Voice prosthesis.
• Public URL: https://durham-repository.worktribe.com/output/1449588