The Pharmaceutical Journal
Vol 272 No 7298 p559
8 May 2004

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DoH: Supplementary prescribing (more)

Prescribing reaches community pharmacy

Campbell Shimmins of Woodside Pharmacy, Doune, Perthshire, is the first community pharmacist to write a supplementary prescription. “The prescription was for digoxin for a patient with ischaemic heart disease,” Mr Shimmins explained. “She had been stabilised on digoxin in hospital and had just been discharged. Last week she came into the pharmacy with signs of digoxin toxicity — she was in a confused state and was nauseous. So, after talking to her GP, I wrote a supplementary prescription for a reduced dose of digoxin.”

The patient had already been ear-marked for supplementary prescribing during a review Mr Shimmins had recently carried out as part of the pharmaceutical care model scheme for the frail elderly which operates in Scotland (PJ, 25 October 2003, p575). “So I had already developed a pharmaceutical care plan for her,” he said. This included a clinical management plan to allow supplementary prescribing. All Mr Shimmins had to do was contact her GP to get the go-ahead to implement the clinical management plan.

Mr Shimmins plans to prescribe for other patients with cardiovascular conditions. He will continue to run clinics and carry out reviews in order to identify patients taking complex regimens who need monitoring. “I see supplementary prescribing as a tool that fits in with reviews under the pharmaceutical care model scheme,” he explained. In addition, a local nurse-led ischaemic heart disease clinic refers patients with complex medication needs to him.

Access to patients’ information has not been a problem because he already goes to the surgery once a week to use patients’ notes as part of the frail elderly model scheme. The surgery also sends relevant monitoring results to him electronically via the NHSnet.