Practice research awards presented
Patricia Morgan, from Nevill Hall Hospital, Abergavenny,
won the UKPPG award for best pharmacist practice research presentation,
for her study into the advantages of "near patient" testing in a pharmacist-nurse
led lithium clinic.
This study looked at patients' knowledge of lithium
and the impact of pharmacist involvement during the introduction of the
ion specific electrode (ISE) lithium testing system into three clinics
in North Gwent. With this facility, blood lithium levels are available
immediately, and reports can be sent to the GP on the same day. Patients'
knowledge of lithium was assessed using a questionnaire, examining issues
such as side effects, signs of toxicity, what to avoid during therapy,
and the need for monitoring. Other factors examined were the interventions
facilitated by a pharmacist's presence in the clinic, patients' satisfaction
with the clinic, and GPs' and psychiatrists' views.
The preliminary data presented involved 44 patients
in the ISE clinics, compared with 12 in a nurse-led clinic as controls.
Some of the interventions made by the pharmacist at the clinic included
dealing promptly with lithium toxicity and side effects, preventing concordance
problems, and providing general support and guidance to the patients.
Unexpected results occurred: lithium knowledge testing led to counselling
sessions with patients; dosing adjustment became easier; lowering doses
to the minimum effective dose helped with side effects; and attendance
at the clinic rose over the study period. Drug interactions could be investigated
too: co-prescribing of non-steroidal anti-inflammatory drugs was found
to be a bigger problem with older patients.
Salwa Morcos (Kent and Canterbury Hospital) won
the Astra Zeneca travel award for her descriptive study of discrepancies
in prescribing between primary and secondary care sectors of mental health
services. Discrepancies were found to exist at each stage of information
transfer, particularly between pre-admission primary care records and
hospital admission data, and between the discharge letter and subsequent
primary care prescriptions. Around 20 per cent of these were judged to
have a high likelihood of causing patient harm. Her recommendations included
a more holistic approach to patient care, with GPs contacted within 24
hours of a patient's admission for a full drug history.
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