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Wendy Davies' CV
BPharm, MRPharmS, DipClinPharm
September 2002 to present Principal pharmacist for mental health
and community services for Cardiff and Vale NHS Trust, with responsibility
for developing pharmacy services to the mental health units across
Cardiff and the Vale
1989–2002 Clinical mental health pharmacist in Oxford
1988–89 Mental health pharmacist in Berkshire
1975–88 Worked in community pharmacy (managing a number of
shops), acute hospital pharmacy and as a staff pharmacist at a
mental health hospital in Chester
Teaching Has also been involved in teaching at the University of
Reading, Welsh School of Pharmacy, and at the University of Bath
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My career
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A career as a mental health pharmacist may not seem “sexy” at
first glance but, in my experience, it can be exciting, challenging and
rewarding because you can make a significant difference to people’s
lives.
At least one in three adults will suffer a mild to moderate depressive
illness at some stage in their lives, so any pharmacist who has contact
with patients will be faced with mental illness and should be aware of
the special issues involved.
Pharmaceutical input into mental health services is a mixed bag. It can
range from a sole pharmacist with no specialist training in a district
general hospital to a department of a psychiatric hospital, where a team
of pharmacists and technicians provide the service.
A good mental health
pharmacist will be caring, understanding and empathic with a good knowledge
of psychopharmacology.
My interest in neuropharmacology was sparked at Cardiff University, where
I was taught by Paul Spencer and subsequently started a PhD in his laboratory.
A post came up when I was living in Chester and I loved it from the start.
I generally meet patients for the first time on admission to hospital.
At that point I do a drug review and provide the information patients
need to make informed choices, depending on the patient’s mental
state.
At the 300-bed Whitchurch psychiatric hospital in Cardiff, the pharmacist’s
major contribution to patient care often takes place at the weekly multidisciplinary
team ward round or meeting, attended by consultants, junior medical staff,
hospital nursing staff, community psychiatric nurses, social workers,
occupational therapists, pharmacists and, in some cases, psychologists.
This
is where we make decisions about patient care. The pharmacist ensures
patients are getting the correct medicines for their mental health problems
and also checks and advises on non-psychiatric medicines.
Pharmacist input is also important when a patient’s condition has
improved and he or she is close to discharge. The pharmacist talks to
carers about medicines and will try to liaise with GPs and community
pharmacists about concordance and compliance, where appropriate. Pharmacists
have a role at every stage of the patient journey, whether patients are
being cared for in an acute setting or the community.
We have set up two clozapine clinics, one at an outpatient clinic and
one at a day hospital. The pharmacist will be there one day a week.
Doctor, nurse and pharmacist work together. While nursing staff take
physical measurements, such as weight, blood pressure, blood glucose
and cholesterol, the doctor assesses the patient’s mental state
and the pharmacist assesses and advises on medicines and their side effects.
In some clinics pharmacists see patients alone after they have seen the
doctor; in others doctor and pharmacist see the patient together.
Pharmacists are involved in lithium clinics and depot injection clinics
at the hospital and in the community. We do not have any here at present,
but they are run in other areas.
Another important role pharmacists have is providing information to patients
on medication and how it treats their illness. This can be done by the
establishment of a medication education group where patients can come
together to talk about their drug therapy or by talking to patients on
a one-to-one basis.
This can be challenging for the pharmacist, who will
often face lengthy complaints about the side effects of drugs. But it
is important for patients to have this forum as it helps them to understand
their medicines better.
At Cardiff we have a dedicated medicine information
room in the department. It has a number of computers with access to the
trust’s intranet, and other online information sources, including
Medline, Embase, Ovid, the British National Formulary, Micromedex and
the UK Medicines Information website.
Psychiatric pharmacists are often involved in teaching nurses, medical
students and pharmacists at undergraduate level, where we talk about
the presentation of illness and pharmacological treatments, and at ward
level and postgraduate level.
One of the most rewarding aspects of the job for me is my involvement
in carer groups. Carers are often given little information when relatives
or friends are admitted to an acute psychiatric unit. Information may
not be available or they may be too distressed to absorb it.
But it is
satisfying to talk to the parents of a young man who has just been
given a diagnosis of schizophrenia and to explain what the drugs are
for, how
they work, what the side effects are likely to be and how to minimise
them.
A good knowledge of psychopharmacology is essential to practise and
teach psychiatric pharmacy. This is an area that seems not to be well
catered
for on undergraduate courses, but there are many postgraduate courses
(see Panel below).
People are becoming more aware of mental health issues and it is receiving
a much higher political profile. There is a good postgraduate academic
structure to train specialist mental health pharmacists, leading to
a certificate in psychiatric therapeutics, then a diploma in psychiatric
pharmacy and membership of the College of Mental Health Pharmacist.
Supplementary prescribing and independent prescribing offer unprecedented
opportunities for pharmacists. The doctor will recommend an antipsychotic
and the pharmacist in consultation with the patient will decide which
to prescribe. |
The
Pharmaceutical Journal