Integrated care needed in substance misuse
Pharmacists will be able to reduce methadone doses, if that is what
patients want |
Model schemes for integrated care in substance misuse — in which pharmacists should play a key role — are recommended by a report published this week.
The report describes the current role of pharmacy in substance misuse
services and sets out how this should be developed in pilots in order
to meet the aims of “The
right medicine”, Scotland’s
pharmacy strategy. The report was produced for the Scottish Executive
by a joint working group of the National Pharmaceutical Forum and the
Scottish Medical and Scientific Advisory Committee.
The integrated care pilots should be based on the principles of the pharmaceutical
care model schemes, it explains. The exact nature of the pilots and the
mechanism by which they will be set up is still to be decided by the
Scottish Executive. However, Lyndon Braddick, chairman of the joint working
group, told The Journal that the aim is to improve communication through
an agreement similar to the clinical management plan used in supplementary
prescribing.
“The agreement would involve the pharmacist, prescriber, patient
and anyone else involved such as care workers. It would be the basis
for planning
treatment and communicating changes to treatment,” he explained. “For
example, if the pharmacist, while supervising the patient’s daily
methadone, found that the patient wanted to reduce the dose, the agreement
could allow the pharmacist to do this immediately.” He added that
the work is based on the four-way agreement (PJ, 21 April 2001,
p547 PDF (130K)) but also incorporates supplementary prescribing.
Other recommendations include establishing formal links between pharmacists
and other agencies, and having pharmacists represented on drug action
teams. It also calls for all NHS boards to have access to the advice
of a specialist pharmacist in substance misuse.
Angela Timoney, chairman of the Royal Pharmaceutical Society’s
Scottish Executive, commented: “This comprehensive report sends
a powerful message to NHS boards and other health professionals about
the greater role that pharmacists could play in substance misuse. Many
pharmacists are already involved and do a very professional job but have
the skills and expertise to do more.”
Drug related deaths rise Drug-related deaths
in Scotland were slightly higher in 2004 than in 2003. Figures published
this week by the Registrar General for Scotland show there were 356
drug-related deaths in 2004, with heroin/morphine involved in 63
per cent, diazepam in 32 per cent and methadone in 22 per cent (some
of the deaths involved more than one drug).
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The
Pharmaceutical Journal
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