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United Kingdom Clinical Pharmacy Association

This year’s spring symposium of the UKCPA was held in Leeds on May 18–20 and marked the association’s 20th anniversary. Cost implications of reducing benzodiazepine prescribing through intervention by a health professional and benefits of training pharmacists to write discharge prescriptions were among the topics presented

Education reduces benzodiazepine prescribing costs
Benefits from training pharmacists to write discharge prescriptions
UKCPA news

Education reduces benzodiazepine prescribing costs

Educating patients about the problems associated with long-term benzodiazepine usage reduced prescribing costs, according to julie morgan, teacher practitioner at the University of Bradford. Intervention was also likely to reduce drug-related morbidiy, which in turn could generate further cost savings.

A study was undertaken to determine the economic implications of sending a letter to patients prescribed long-term benzodiazapines, with the aim of reducing benzodiazepine use. The letter explained the problems associated with long-term benzodiazepine use and was signed by each patient’s general practitioner.

Using data from two general practices, the researchers identified 325 patients who had been prescribed benzodiazepines for at least a year and sent a copy of the letter to 242 of them.

Presenting the Pharmacia pharmacoeconomics award 2001 lecture, Dr Morgan said that the duration of benzodiazepine use among these patients ranged from one to 36 years (mean duration 19 years) and the users were aged between 29 and 95 years. As seen in other studies, the largest proportion were elderly and female. The average number of defined daily dosages prescribed per patient per year was 337 and the majority of patients had been prescribed one benzodiazepine, with 7 per cent being prescribed two.

The researchers found that after receiving the letter, 5 per cent of patients discontinued taking benzodiazepines, 10 per cent had either the drug or its strength changed to help reduce usage and 13 per cent reduced usage by 50 per cent or more.

An overall cost reduction in benzodiazepine prescribing of £1.20 per patient was seen in the year following intervention. The cost of implementing the intervention, which included paying for pharmacist, GP and administration staff time as well, as the cost of postage, was estimated at £5.54 per patient. The net result of the intervention was a cost of £4.34 per patient. Mrs Morgan said that the cost for each patient discontinuing use was £86.80 and that this could be “justified given the morbidity associated with benzodiazepine use”.

She further commented that the success rate of reducing benzodiazepine prescribing costs could be improved by repeat intervention, perhaps on an annual basis.

Involving community pharmacists more would reduce general practitioner reconsultation rates and result in further beneficial cost savings.

Benefits from training pharmacists to write discharge prescriptions

Pharmacists felt more competent at writing discharge prescriptions after being trained do so, according to anne tyrrell, deputy chief pharmacist, St George’s Healthcare NHS Trust, London.

Traditionally, discharge prescriptions had been written by junior medical staff. However, in-house data at St George’s had shown that pharmacists made fewer errors when transcribing discharge prescriptions. Also, pharmacists monitoring and screening discharge prescriptions in hospitals did not help overcome problems such as delayed generation by other medical staff and further delay if the prescriber needed to be contacted.

Ms Tyrrell had been involved in developing a training programme to ensure that pharmacists were competent in writing discharge prescriptions safely and accurately.

Giving the Wyeth education and training award 2001 lecture, she said that five out of eight of the pharmacists involved in the training programme completed the programme at first attempt and were deemed competent to write discharge prescriptions. The remaining three completed the programme with further training. However, all completed the programme within a two to three week period. None of the pharmacists made an error relating to clinical judgment.

The results of the study suggested that such a system could be implemented within a pharmacy department. In order to validate the programme further, trained pharmacists would need to be compared with junior medical staff for quality and accuracy of transcribing. More pharmacists would also need to be assessed.

Ms Tyrrell suggested that the training format should be a core competency for clinical pharmacists. The wide range of experience among pharmacists meant that competency could not be assumed.

UKCPA news

A “Unichem community pharmacy award” was launched at the spring symposium. The retrospective award is aimed at community pharmacists involved in improving the care of patients in the community. It will be presented for the first time at next year’s spring symposium. Further detaills will be forwarded to UKCPA members this summer.

A UKCPA website was also launched. The website (www.ukcpa.org) was expected to go live on June 1.

Philip Howard has taken over the position of UKCPA chairman from Pat Murray.