The Pharmaceutical Journal
Vol 269 No 7206 p61
13 July 2002

Shared care winner

Referral to pharmacist-led diabetes clinic improves glycaemic control

Pharmacist shared care diabetes programme

Labib Tadros, MRPharmS (clinical specialist pharmacist), Margaret Ledger-Scott, MRPharmS (chief pharmacist), Edward Barnes, FRCP (consultant endocrinologist), Darlington Memorial Hospital. Basil Penney, MD (general practitioner), Ahmed Faut, MD (general practitioner), Roger James, MD (general practitioner), Susan McIlhinney, MD (general practitioner)

A scheme that allows general practitioners to refer patients with type 2 diabetes back to a pharmacist-led outpatient clinic after discharge is the winner of the shared care category.

The scheme, developed at South Durham Health Care Trust, was set up in response to problems experienced when patients were discharged from the pharmacist-led clinic. Traditionally patients are seen by their GP every three months, and the specialist practice nurse and consultant endocrinologist once a year.

Patients in whom complications arise or glycaemic control is lost can be referred back to the clinic where the pharmacist will review them, make appropriate changes to their medicines according to laboratory results, and offer advice and education.

The scheme was assessed during a 12-month study in which the shared care and traditional models were compared. Fifty patients were allocated to the shared care model and 47 to the traditional model. HbA1c was used as an indicator of the level of glycaemic control achieved. Target HbA1c was maintained for all patients in the shared care group but deteriorated in the traditional care group. In addition, there were no hospital admissions for patients in the shared care group, whereas in the traditional model 12 patients were admitted with diabetes related complications.

Dr Labib Tadros, who presented the project, said that the next step will be to involve community pharmacists in the scheme.

Shared care finalist

Pharmacist works with staff in a young offenders institution to set up a smoking cessation programme

Smoking cessation programme for Scottish prisons

Pamela Shearin, MRPharmS (contract manager), Kirstie Hepburn, MRPharmS (dispensary manager), Moss Pharmacy, Sandra Hands (head of health care), James McAteer (practitioner nurse), HMYOI Polmont, Lyndon Braddick, MRPharmS (deputy head of health care and pharmacy advisor) Scottish Prison Service

A project in Scotland has shown that smoking cessation programmes can be run successfully within prisons and young offenders institutions. The need to provide smoking cessation services in a young offenders institution was identified and in response Moss pharmacists, along with nursing and operational staff, developed a comprehensive smoking cessation programme that included the supply of nicotine replacement therapy, group support sessions, individual counselling and encouragement to use a quitter's diary.

Four of the 11 young offenders who took part in the scheme stopped smoking completely and all other participants dramatically reduced their intake. All eight participants who completed an evaluation form valued the contribution of the pharmacist and would recommend the clinic to other smokers.

Kirstie Hepburn explained that the group has successfully obtained funding in order to develop the programme with a view to rolling it out to other establishments within the Scottish Prison Service.