Winners of the pharmaceutical care awards are announced
Andrew Lowey (on the right) receiving the winners award in the innovation
in hospital care category from Professor Martin Kendall, University
of Birmingham |
A pharmacist-led hypertension and cardiac risk clinic for patients with diabetes at Harrogate District Hospital won the “innovation in hospital pharmacy” category of the 2003 Pharmaceutical Care Awards.
Andrew Lowey (clinical
pharmacist, Harrogate District Hospital), who presented the work at the
awards ceremony at the Royal Pharmaceutical
Society’s headquarters, explained that patients are referred to the
clinic by a consultant
endocrinologist or a specialist diabetic nurse. Once baseline blood pressure
and lipids have been established, pharmacists use an evidence-based algorithm
to adjust antihypertensive
medicines. Consideration is also given to introducing a statin or aspirin.
Pharmacists educate the patients about any changes made to their medicines
and other aspects of their disease. The aim is to reduce blood pressure
and lipid levels to within target ranges, and thereby reduce the risk of
complications.
Each patient attends on a four-weekly basis. After 12 weeks of treatment
(three visits) patients have mean reductions in blood pressure of 12mmHg
and in serum cholesterol of 0.5mmol/L. Since the clinic was set up set
up in May 2002, 80 patients have been treated and, of those discharged,
66 per cent have reached their target blood pressure (140/80mmHg).
Commenting on their success in reducing blood pressure, including in a
patient who
previously had blood pressure above the target range for nine years, Andrew
Lowey said that “it is the intensive nature of the care that is key
to results.” Mr Lowey also pointed out that the clinic represented
an “ideal opportunity for pharmacists to become involved in evidence-based
medicine”. There are plans to extend the model to pharmacist-led
stroke/transient ischaemic attack and congestive cardiac failure clinics.
A project from pharmacists at Barts and the London NHS Trust to expand
the pharmacists’ role in monitoring high-risk drugs was the other
hopsital finalist.
Presenting the work, Sasha Beresford (principal pharmacist, complex medicines
clinic, Barts) explained that discharging patients with inflammatory bowel
conditions on certain high risk drugs (such as
azathioprine, sulfasalazine and mycophenolate) into the
community can cause problems unless the process is safely
managed. Pharmacists at Barts and the London educate newly-diagnosed patients
about the importance of blood monitoring and monitor the drug treatment
of follow-up patients, ensuring a safe discharge process. Their approach
also includes improving communication with general practitioners by drawing
up guidelines and by sending out standardised referral letters promptly.
Presenting the work, Sasha Beresford said that pharmacists had become an “integral
part of the outpatient multidisciplinary team.”
The awards are sponsored by GlaxoSmithKline. |
