The Pharmaceutical Journal
Vol 269 No 7218 p500
5 October 2002

This article
Reprint
Photocopy

UniChem convention 2002 summary

Pharmacy Alliance schemes show how pharmacists can get involved in medicines management

Conference participants heard from two pharmacists who had taken part in UniChem's Pharmacy Alliance medicines management schemes.

Chris Martin, managing director of St Davids Pharmacy, described a bone health programme undertaken in Wales earlier this year. "The greatest benefit of [the] programme is that it really does increase the professional image of the pharmacy in the community and most importantly the patient's and general practitioner's perception of our role," he said.

As part of the programme, for which pharmacies received funding from the National Assembley for Wales, the following standards were set:

• At least 80 per cent of participating patients should achieve the recommended daily calcium intake (over 700mg in adults)

• Patients should receive advice and have an understanding of bone health, including healthy lifestyle factors

• Patients should be referred to their GP if identified as being at high-risk

Questionnaires were used by trained pharmacy staff to assess bone health knowledge, approximate calcium intake and risk of developing osteoporosis. In Mr Martin's pharmacy all these first questionnaires were undertaken by support staff and then he made the necessary interventions to provide patients with healthy lifestyle advice and, where necessary, the sale of a calcium supplement and a GP referral.

Mr Martin told the conference that patient knowledge increased by 20 per cent, daily calcium intake increased by over 20 per cent and that GPs believed that the referrals were appropriate in most cases.

"It has been a win-win situation. More calcium supplement sales, more prescriptions, more team working, more professional satisfaction, happy patients and a fee for each intervention," he said.

Paul Benson, an independent pharmacist in Manchester, explained how hypertensive patients could also benefit from interventions by community pharmacists in collaboration with their GPs. "Around 40 per cent [of hypertensive patients] will not comply with their prescribed medicines," he said.

The programme involved 20 pharmacies across the United Kingdom and ran from January 2001 until July 2002. After attending a training workshop, pharmacists recruited 119 eligible patients into the scheme who were required to complete two short questionnaires. These were designed to identify patient needs and address any misunderstandings. The patients blood pressure was then measured. Specific targeted advice was given based on the responses from the questionnaires. This process was repeated over a period of 12 months with patients being recalled via follow-up phone calls, letters or appointments.

"The majority of problems identified involved patients having a poor understanding of their condition and its treatment." In 90 per cent of cases, pharmacists were able to help by providing verbal and written advice, he added.

"Time management could have been difficult ... so, to effectively manage the process, a member of staff was dedicated to recruit patients, manage the documentation and arrange appointments which usually took place in the afternoon. This enabled the pharmacist to concentrate on the provision of advice to the patients," Mr Benson explained.

Interventions made when patients were referred to their GP included initiating an ACE-inhibitor, optimising an ACE-inhibitor dose, stopping Zyban treatment, stopping amlodipine in favour of alternative therapy because of persistent headache, initiation of a loop diuretic due to oedema, and reducing bendroflumethiazide from 5mg to 2.5mg. "Clearly, these are all simple but important interventions that could otherwise have been missed if they hadn't been identified by the pharmacist," said Mr Benson.