Hospital pharmacist prescribers win awards for patient care
Two projects in which hospital pharmacists have used supplementary prescribing
skills to deliver marked improvements in patient care have won Pharmaceutical
Care Awards for 2005.
Left to right (front): winners Margaret Ledger-Scott,
Labib Tadros and Christine Oates, with Niall Dickson, chairman
of The King’s Fund, and Stephen Ross, GSK’s vice-president,
specialist business units (back)
|
Labib Tadros, specialist pharmacist at the County
Durham and Darlington Acute Hospitals NHS Trust, and his team won one
of the awards for a clinic
Dr Tadros provides in a local general practitioners’ surgery for
patients with uncontrolled type 2 diabetes, who would otherwise be referred
to a hospital consultant for treatment. Patients are selected for the
clinic on the basis that they have glycosylated haemoglobin levels of
more than 10 per cent, cholesterol levels of more than 5.5mmol/L and
a systolic blood pressure of more than 160mm/Hg, with no other complications.
Of 50 such patients identified, 42 agreed to attend the clinic.
The clinic is held once a week at the GP practice, with an average of
six patients per clinic. Dr Tadros establishes a clinical management
plan for each patient, evaluates their drug therapy and gives advice
on issues such as the self-monitoring of blood glucose levels.
Once the clinic had been in place for 12 months, patients’ mean
glycosylated haemoglobin levels had reduced from 10.8 to 7.4 per cent,
mean cholesterol levels from 7.9 to 4.1mmol/L and mean systolic blood
pressure from 184 to 133mm/Hg. The number of pharmaceutical interventions
made increased from 84 to 144. There was also a 28 per cent saving in
diabetes-protected time in primary care and an 18 per cent saving in
secondary care.
When interviewed by the GP surgery’s practice manager, all the
patients believed that their quality of life had improved and were keen
to continue attending the clinic. The clinic is to be extended into two
more GP practices in the area.
Winner Sandra Melville with (left to right) Digby Emson, chairman
of the
Company Chemists’ Association, Niall Dickson and Stephen Ross |
Sandra Melville, oncology pharmacist at
Lorn and Islands District General Hospital, and her team also won an
award for the services they provides
to patients in Argyll who have lung, colorectal, breast or ovarian cancers.
As a supplementary prescriber, Mrs Melville is able to prescribe medicines
to deal with side effects (eg, antiemetics) and adjust chemotherapy doses
to reduce toxicity or optimise efficiency, in accordance with a patient’s
clinical management plan. Previously, such drugs had to be prescribed
and dose-adjustments made by an oncologist during twice-monthly visits
to Argyll, a remote area of Scotland, from his base in Glasgow. Between
visits, prescribing was carried out using telephone and facsimile communications
with the oncologist or one of the junior doctors, the latter of whom
might never have met the patient involved.
The number of occasions on which patients’ therapy has been delayed
while waiting for changes to be made to their prescription has reduced
from 34 (five of which involved unnecessary overnight stays in hospital)
to three (none of which involved an overnight stay). The number of medicines
prescribed by junior doctors (per six-month period) has fallen from 43
to three, and the number of pharmaceutical interventions made has increased
from 45 to 72.
The Pharmaceutical Care Awards for 2005 were sponsored by GlaxoSmithKline,
The Company Chemist’s Association and The Pharmaceutical Journal. |
Hospital Pharmacist