Medicines management guide to follow renal NSF
Guidance on medicines management issues related to the treatment of people with renal disease is to be published next month, according to a spokesman for the Department of Health. The guidance will form part of the National
Service Framework for Renal Services, which was launched last week
by Health Secretary John Reid.
Renal targets for 2014
The standards set by the framework, which need
to be delivered by the NHS by 2014, are: Access
to information All patients with chronic kidney disease
are to have access to information that enables them to make
informed decisions.
Preparation and choice All patients approaching established
renal failure are to be prepared for dialysis early enough
so that disease progression is minimised and choice of treatment
is maximised.
Access surgery All patients with established renal failure
are to have timely elective surgery for dialysis access.
Dialysis Appropriate dialysis designed around the needs of
patients is to be delivered.
Transplantation All patients likely to benefit from a kidney
transplant are to receive a high quality service that supports
them in managing their transplant. |
The NSF sets out five standards that must be delivered by the NHS by
2014 (see Panel). It also describes markers of good practice, including
medicine-related markers, that will be used as performance indicators.
Andrea Devaney, specialist principal pharmacist, renal transplantation
for Oxford Radcliffe NHS Trust, is a member of the NSF expert reference
group. She told The Journal that the renal NSF was a departure from earlier,
target-driven NSFs, such as those for older people and coronary heart
disease. “This NSF focuses on patients’ needs and how to
meet those needs at a local level. Specific clinical targets are no longer
being driven by Whitehall,” she said.
Mrs Devaney added that there were opportunities for pharmacists within
the renal NSF. “For example, pharmacists are key to ensuring patients
with renal disease are dosed appropriately and safely. Patients must
be fully informed about their medicines too. Some pharmacists are already
involved in medication review clinics for renal and transplant
patients, and supplementary prescribing will augment this role.”
Furthermore, pharmacists will have an important role in the management
of renal patients taking several medicines. “Most patients who
have entered the renal pathway are
on complicated polypharmacy regimens. Pharmacists can help patients manage
these regimens and hence optimise compliance.”
She explained that the guidance on renal specific medicines management
will include some examples of good practice. “The document, which
is soon to be published, will give pharmacists and other health care
workers practical advice on renal medicines management issues eg, anaemia
management, calcium and phosphate management, immunosuppression and others.
It will also include contact details for the services described.”
The first part of the renal NSF is published on the Department of Health’s website.
The second part of the renal NSF will cover prevention of renal disease
and care at the end of life.
The National Institute for Clinical Excellence is also due to issue guidance
on the use of immunosuppressive agents in April. |
The
Pharmaceutical Journal