First pharmacist prescription written in primary care
Last week, a pharmacist in Scotland became the first to write a prescription for use in primary care.
Fiona Reid is a primary care pharmacist for cardiovascular disease at
Newbyres Medical Group in Gorebridge, Midlothian. She also runs clinics
at nearby Newbattle Medical Practice in Mayfield. “My first prescription
was for a statin for primary prevention of cardiovascular disease for
a woman with both diabetes and obesity. The statin was initiated according
to the new British Hypertension Society guidelines,” she said.
Mrs Reid already runs clinics in the following clinical areas: hypertension,
primary and secondary prevention of CHD, heart failure and angina. She
is now prescribing for all new patients referred to these clinics. Existing
patients who need medicine changes, for example to comply with new guidelines,
will also have clinical management plans drawn up and Mrs Reid will prescribe
for them. “My clinical management plans are very broad, listing
drugs by the class, although I prescribe according to the Lothian joint
formulary,” she said.
Patients already attending the clinics who do not require medication
changes will continue to be managed using repeat prescriptions signed
by the GPs. “My prescription pad is for handwritten prescriptions
so at the moment it does not make sense for me to write repeat prescriptions,” Mrs
Reid commented. “I have been told that computer-generated prescriptions
will be possible once a sufficient number of pharmacists have become
supplementary prescribers,” she added.
Future expansion plans exist. “I would like to provide more clinics
and at other practices. To enable this I hope to bring in a community
pharmacist on a sessional basis to run some of the existing clinics to
allow me to set up new clinics,” Mrs Reid explains.
In England, similar developments are expected next week. Lorna Davies,
medicines management pharmacist at Greater Derby Primary Care Trust and
practice pharmacist at Derwent Valley Medical Practice, Derby, plans
to write her first prescription at a clinic scheduled for 7 May. Miss
Davies undertook her supplementary prescribing training at Keele University.
A spokeswoman for Astron, the company processing requests for prescription
pads in England, confirmed that the first order for prescriptions it
has received is from Miss Davies and that she will receive the pads this
week.
Miss Davies will be running clinics for patients with hypertension. Patients
will either be called into the clinic for a review and then ongoing management,
or will be referred following diagnosis. “The clinical management
plans are fairly broad and cover management of hypertension, cholesterol
lowering and use of aspirin. We have put the plans onto the computer
system and I can upload them onto a patient’s record for the doctor
to agree,” she explains. “I have been given the clinical
freedom to prescribe any drug for these patients within local guidelines.”
Miss Davies adds: “The sticking point of being a practice pharmacist
was that I could only flag up problems for GPs, I could not do any more.
Now, being a supplementary prescriber means that I can manage a patient’s
care properly.” |
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