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Letters to the Editor
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CSM
Equal access to information
From Miss K. E. Aveyard, MRPharmS
I write on behalf of the Yorkshire Pharmacists in Psychiatry Group with
regard to the recent Committee on Safety of Medicines warning “Atypical
antipsychotic drugs and stroke” issued on 9 March.
This is the latest in a long line of alerts and drug withdrawals that
have had a significant impact on mental health service users and workers
in recent years.
Immediately following the publication of this alert pharmacists working
in mental health settings were inundated with requests for advice, explanations
and reassurance.
Quite apart from the fact that the content of this alert and the accompanying
advice may lead to the inappropriate discontinuation of the two drugs
in question and the introduction of unsuitable alternatives, potentially
worsening the quality of life in some cases for those with dementia,
the impact on mental health services has not been addressed. In many
parts of Britain, pharmacists, who are on the front line when it comes
to medicines advice and information, have been working on local statements
and policies in response, often at the expense of clinical services.
It is difficult to respond in a timely manner to these alerts without
prior knowledge. It takes time to digest and assess the accompanying
information and the impact it may have on local services and the quality
of life of those taking the implicated drugs.
Statements accompanied this most recent alert: one from the Royal College
of General Practitioners (representing the Royal College of Psychiatrists,
the RCGP, the British Geriatrics Society and the Alzheimer’s Society)
and another from the Alzheimer’s Society itself. Although we acknowledge
the need for contributions from these groups, involvement from pharmacy
in this advice appears to be lacking. Where was the statement from a
pharmacy organisation? The United Kingdom Psychiatric Pharmacists’ Group
and the College of Mental Health Pharmacists have members who are experts
in drug treatments in mental health; surely a statement from them should
have been solicited.
A statement from one of these groups in time for the release of this
alert would have saved incredible amounts of pharmacists’ time,
uncertainty by doctors and others providing mental health services, and
anxiety and distress to service users and carers.
The profession is not shown in a good light when not able to respond
to information in a timely fashion. It seems to us that the ones in most
need of the information are among the last to hear; the media know, drug
companies appear to know, service user groups know.
Regarding access to information, all we ask is equality.
K. E. Aveyard
Medicines Management Pharmacist
South West Yorkshire Mental Health NHS Trust
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Gordon W. Duff, chairman, Committee on Safety of Medicines, replies:
The CSM advice was issued after careful consideration of all available
data, the possible clinical implications and advice from an expert
working group. The high absolute risk of stroke associated with these
products
was considered to outweigh any benefits in treatment of behavioural
symptoms of dementia.
The CSM was aware of the impact the advice would have on mental
health services, and considered it vital that treatment guidelines
were available to coincide
with the timing of the announcement. The comprehensive guidelines were
brought together over a short period and were co-ordinated by the
Department of Health
and the Royal College of Psychiatrists and I am aware that two senior pharmacists,
one from a primary care trust and one from a mental health trust, were
involved in the process.
The Medicines and Healthcare products Regulatory Agency co-ordinates the
communication of drug safety information and makes every effort to inform
pharmacists and prescribers
in advance of any announcement in the media. Embargoed information is routinely
sent to interested patient groups and professional bodies, including the
Royal Pharmaceutical Society, in advance of any public announcement, to
enable them
to respond to enquiries. It is helpful that attention has been drawn to
the important role of the United Kingdom Psychiatric Pharmacists Group
and the College of Mental
Health Pharmacists. We will in future ensure that these organisations are
provided with advanced warning of relevant announcements.
We fully appreciate the need for pharmacists to receive timely information
to allow them to respond appropriately to new drug safety information and
will continue
to work to improve links with the relevant professional bodies to facilitate
communication of urgent issues. |
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The
Pharmaceutical Journal