Transcript Document
Lessons from the Field: Supplementary Prescribing in a Hospital-Based Heart Failure Service Helen Williams Pharmacy Team Leader – Cardiac Services, King’s College Hospital My Credentials! Qualified as a pharmacist in 1994 Worked in cardiology since 1995 – OP clinics since 1997 – Working in HF clinics since July 03 Trained as a SP from Sept 03 – Jan 04 Qualified in June 04 Prescribing in HF since October 04 Overview of the HF Service (1) Traditional Management of HF Patients seen at intervals by cardiology team Interim management (dose titration etc) by: – ?GP / hospital Failure to achieve therapeutic targets Lack of structured support for patients Recurrent readmissions / poor symptom control / high mortality / poor compliance Overview of Service (2) Multi-Disciplinary Team Approach at King’s HF Nurse Consultant (new post) / Specialist Pharmacist-led with input from cardiologists as required Diagnosis confirmed on first visit by cardiologist Further management delegated to nurse and pharmacist Intensive clinic supervision until symptoms controlled, drug therapy optimised, then 3 to 6 monthly review as necessary Additional medical input available if required Clinic Roles Nurse Consultant: Pharmacist: Initial assessment / class Tests and investigations Physical examination Educating patients on HF pathology Lifestyle advice Social Issues / Psychology Dealing with carers Coordinating clinic visits Tele-clinics Drug histories Medication review Optimising dosing Tailoring drug therapy Monitoring response Dealing with adverse effects Encouraging compliance Provision of patient information and GP letters Using Supplementary Prescribing Patients diagnosed by independent prescriber Responsibility for follow-up delegated to both SPs (nurse and pharmacist) Clinical management plan signed and agreed for all patients referred – On-going assessment and examination, further investigations, changes to drug therapy, psychosocial adjustment, liaison with primary care Referral back to IP if any change in diagnosis, complications or annual review due – On-going MDT review as required Clinical Management Plan (CMP) Needs to be broad enough to allow SPs to practice efficiently For heart failure it might include: – – – – – – – Symptom control Optimising outcomes Hypertension management IHD: secondary prevention IHD: anti-anginal therapy AF management (Obesity, sexual dysfunction etc., etc., etc.) Regularly reviewed in line with clinical data and local agreement Problems……. Management of Co-morbidities – Rheumatoid arthritis – NSAIDs can effect HF management: should pain control be in CMP? Restrictions of the CMP – What if patients develop gout? • Is this a new diagnosis? Or an adverse effect? Other Problems……. Pharmacists ordering and analysing – 24 hour tapes, 24hour ABPM, ECGs – Angiography, 2D and 3D Echos, CXrays, – U&Es, FBCs, inflammatory markers, etc Non-pharmacological issues – – – – Underlying pathology, role of revascularisation Lifestyle advice Travel Devices HF Clinic – Preliminary Audit 275 patients registered with the clinic (2003–2005) 143 patients offered and agreed to Supp Rx’s – No patient has refused management by Supp Rx’s 284 items prescribed over the first 8 months – 168 by nurse consultant – 116 by clinical pharmacist – 60% of items were classic “heart failure” drugs • Ramipril, carvedilol, bisoprolol, spironolactone, candesartan – Off-CMP prescribing has resulted in additions to CMP • Laxatives • Vitamins and minerals • LMWH for thromboprophylaxis Benefits of Supplementary Rx MDT working – better skill mix Holistic approach to care Consistency in approach Tailored dosing regimens Addressing compliance issues Dealing with adverse effects Achieving drug dose targets more quickly Patient satisfaction (not formally assessed) Working with an Independent Prescriber Must have confidence in each other as clinicians – prior rapport helpful IP must be an expert in clinical field IP must be available to support SPs Works best where arrangement is flexible – Managed by both SPs and IP depending on clinical needs of individual patients The Challenges Developing CMPs, managing paperwork The consultation process (for pharmacists) – Undertaking physical examination – Dealing with sensitive issues • Prognosis, Palliative care, Sexual dysfunction • Cultural differences / attitudes – Seeing the bigger clinical picture The prescribing process (for nurses) Other issues – getting support within Trusts, budgets, resources clinic space, competition between professions The Future…. Independent prescribing……. = more freedom to act = able to prescribe off-CMP if appropriate (i.e. continuation therapy) = less delay for patients awaiting Drs assessment / ratification of plan = reduced paperwork (CMPs individualised from a standard template) = greater responsibility on individual Rxer