The Pharmaceutical Journal
Vol 271 No 7256 p18
5 July 2003

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Medicines support scheme for patients with diabetes wins award

The winners of the Pharmaceutical Care Awards 2002 were presented with their awards at a dinner held at the Savoy Hotel in London on 27 June. The awards, organised by The Journal and sponsored by GlaxoSmithKline, were presented by Professor Martin Kendall. Finalists presented their work at a conference held in the afternoon before the dinner

Community pharmacy diabetes medicines support service

Ziba Rajaei-Dehkordi, MRPharmS (service development manager, Pharmacy Alliance), Caroline Hollingshead, MRPharmS (service development pharmacist, Pharmacy Alliance), Shailen Rao, MRPharmS (pharmaceutical adviser, Hillingdon PCT), Rob Horne, MRPharmS (professor of psychology in health care and director, centre for health care research, University of Brighton), Donna Herkes (service development technician, Pharmacy Alliance), Michael Holden, MRPharmS (service development pharmacist, Pharmacy Alliance)

A diabetes medicines support service run through four pharmacies within Hillingdon Primary Care Trust was the winner of the award in the innovation in community pharmacy category. The service involves joint working between a range of health care professionals, including practice nurses and dietitians, who recognise pharmacists as medicines specialists and refer patients to them. The pharmacist then checks that the patient's diabetes monitoring parameters (eg, blood glucose, HbA1c, blood pressure and cholesterol) are in line with PCT targets and advises on medicines and the benefits of a healthy lifestyle.

The project is ongoing, but interim results show that for the 83 patients recruited, pharmacists made 141 consultations and identified 265 problems. Pharmacists referred 11 per cent of these patients to their general practitioner, mainly if monitoring parameters were uncontrolled or if drug regimens needed to be reviewed. The consultation allowed pharmacists to spend time with patients and the concerns or mis-informed beliefs that patients had about their diabetes medicines were significantly reduced by the pharmacists' interventions. Ziba Rajaei-Dehkordi, Pharmacy Alliance, said that because of the pilot's initial success, the PCT has allowed the service to be continued and expanded, with four more pharmacists to join the team later in the year.

FINALIST: Improving adherence by calling patients

"Hello, it's the pharmacist calling" — how telephoning patients improves adherence

Nick Barber, MRPharmS (professor of the practice of pharmacy, school of pharmacy, University of London), Sarah Clifford (research fellow, school of pharmacy, University of London), Elaine Hartley, MRPharmS (professional services executive, Moss Pharmacy), Helen Smurthwaite, MRPharmS (ethical development manager, Moss Pharmacy), Glen Savage, MRPharmS (pharmacists training officer, Moss Pharmacy), Rob Horne, MRPharmS (professor of psychology in health care and director, centre for health care research, University of Brighton), Rachel Elliot, MRPharmS (senior lecturer, school of pharmacy and pharmaceutical sciences, University of Manchester)

A project in which pharmacists telephoned patients two weeks after they had started new medication for a chronic condition, to provide advice and information on any medicine-related problems, revealed non-adherence in eight per cent of patients at four weeks compared with 16 per cent in the control group (n=492, P=0.03).

This patient-centred service was prompted by an earlier study, which showed that non-adherence quickly develops at the start of taking a new medicine. Patients were recruited from across England (through Moss Pharmacies) based on National Health Service priorities — apart from being prescribed a new medicine for a chronic condition, patients also had to be aged over 75 years or suffering from stroke, heart disease, diabetes or rheumatoid arthritis.

Helen Smurthwaite, one of the two specially trained pharmacists who telephoned patients, said that the best thing about the service was getting to spend quality time talking to patients. "I spoke to one man who had been prescribed statins for years but had never taken them," she said. This patient was persuaded to tell his doctor and at follow up he had started to take his statins.

The authors of the project say that pharmacist-led telephone services are a viable option for implementation of current National Health Service strategies. In this case, each telephone call took an average of 12 minutes (range 1 to 56 minutes).