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Letters to the Editor
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Medicines use reviews
Killing two birds with one stone
From Dr S. Rudland and
Ms R. K. Parmer, MRPharmS
Within our practice we are aware of documentation coming back from local
pharmacists relating to medicines use reviews carried out with our patients.
These have contained helpful comments about compliance and prescribing.
These comments often need acting on, which creates additional work for
the GP team.
Conversely, there are occasions when the advice is not helpful, through
no fault of the pharmacist, because they do not have the whole patient
record at their disposal or a full understanding regarding the decision-making
that went into the prescribing in the first place.
We pondered over how to address this problem and realised there was one
possible solution for the two problems.
At StowHealth we run a long-term medical conditions (LTMC) clinic where
we draw on a multidisciplinary team to see patients with multiple conditions
once or twice a year rather than bringing them back separately for each
of their conditions.
Patients with high blood pressure, asthma, chronic obstructive pulmonary
disease, coronary heart disease, left ventricular dysfunction, a history
of stroke and also those with diabetes are called to our LTMC clinic. They
will initially see a health care assistant who will do blood tests and
an initial preliminary measurement. The patient’s blood tests will
be reviewed by their own registered doctor who will electronically tag
their record with any recommendations.
When the patient then returns to the clinic about two weeks after the initial
contact they are seen by one of our practice nurses working in conjunction
with a doctor. This, we thought, would be the ideal time to review prescribing.
So the solution to the two problems was to invite a local pharmacist from
Boots The Chemists to come and work with the LTMC team so that patients
could see the pharmacist at the time of their visit to the practice.
The pharmacist is able to access the doctor and our medical records while
conducting medicines use reviews. This team work makes it easier for the
pharmacist to give effective and appropriate advice, and creates an opportunity
to action the advice straight away.
This pilot project has been well received by our patients and it certainly
provides us with an opportunity to have a sense of working more closely
with our local pharmacist. We plan to assess the success of the project
formally by sampling patients’ views and hope to make a comparison
with the more usual medicines review setup where access to the patient’s
GP record and access to the patient’s GP is not so readily available.
Simon Rudland
Executive Partner
StowHealth
Roshan Kaur Parmer
Pharmacist
Boots The Chemists,
Stowmarket, Suffolk |
The
Pharmaceutical Journal