The Pharmaceutical Journal
Vol 275 No 7364 p246
27 August 2005

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Berkshire pharmacists provide new service for patients diagnosed with coeliac disease

Community pharmacists in Bracknell, Berkshire, are providing a service for patients diagnosed with coeliac disease following a successful pilot project run by Bracknell Forest Primary Care Trust.

The pilot project compared the standard GP model of care with a model where the GP and pharmacist share responsibility and with a pharmacist-only model. The project revealed that both patients and health care professionals preferred the service provided entirely by pharmacists.

Prescribing for coeliac patients was identified as an area of concern by the local medical committee and new prescribing guidelines for gluten-free products were introduced. Marjorie Mitchell, a pharmaceutical adviser at Bracknell Forest PCT, told The Journal: “Patients were not receiving the best products. Some were having a lot of biscuits but not much flour or bread.” She added: “It was difficult for the GPs to keep up to date with the gluten-free products available.”

Ten pharmacists are now accredited to provide the service, which is gradually expanding as more patients are referred via their GPs.

Pharmacists provide an initial consultation to assess patients’ dietary requirements and suggest appropriate amounts of gluten-free products, which patients can collect from the pharmacy each month. Following this pharmacists conduct six-monthly reviews to reassess patients and make sure their requirements are being met. GPs are kept informed about patients’ assessments.

The PCT pays each pharmacist to provide the service: £5 per initial consultation, £4 per six-monthly review and £3 for administration costs. It also pays for the food products supplied. Mrs Mitchell says that this arrangement will be reviewed when the specifications for enhanced services are published.

“For many of the patients [gluten-free food] was the only prescription they had. The pharmacist-led service saves time for the GPs and provides a better service for the patients,” she added.

The accredited pharmacists undertook training led by the PCT, in conjunction with Coeliac UK. Mrs Mitchell expects that more pharmacists will undertake the training this autumn.