Rosemary Plum Prescriptive Solutions Ltd SIMPLE Respiratory 2015

Transcription

1 + A SERVICE FOR COMMUNITY PHARMACY Rosemary Plum Prescriptive Solutions Ltd

2 + n Why Pharmacy? High patient footfall 450 diagnosed asthma patients Walk-in service Medicines skills and expertise Structured review

3 + Clare Gerada MBE Clare Gerada MBE Chair of the Royal College of GPs

4 + A STRUCTURED FRAMEWORK INCORPORATING DELIVERING n Asthma and COPD patient review by the doctor or practice nurse n Pharmacy Medicines Use Review n good respiratory care n support for patients in the management of their condition

5 + What is it?

6 + STOP SMOKING

7 + STOP SMOKING S Single most important change a patient can make Encourage & support giving up Refer to NHS stop smoking service

8 + inhaler Technique

9 + INHALER TECHNIQUE I Regular review Provide good advice Best choice of inhaler? MDI - Up to 70% mistakes DPI around 50% have difficulties

10 + MONITORING Assess control & severity Validated assessment tools CAT ACT MRC

11 + PHARMACOTHERAPY Understanding of treatment Reason and importance Potential side effects Medication adherence Rescue packs (oral corticosteroids/antibiotics)

12 + LIFESTYLE Healthy, active lifestyle Hydration and nutrition Advise about alcohol intake Annual vaccinations

13 + EDUCATION Patient belief & understanding Quality of Life Level of Risk Care Plan is followed Regular discussion Consistent messages

14 + EDUCATION & TRAINING Competency based, assessed training Dr Anna Murphy Consultant Respiratory Pharmacist University Hospitals Leicester NHS Trust

15 + Inhaler Technique Training ü Inhaler Device Toolkit ü 7 Steps Respiratory Consultation Skills reminder cards ü 7 steps Inhaler Device Technique reminder cards ü SIMPLE education handbook

16 + Pharmacy Service Toolkit

17 + PATIENT RESOURCES Personalised management plan SmartPhone App

18

19

20 + Web-based Platform

21 + Web-based Platform

22 + Modular Training Programme GP Practice Teams 1. Stop Smoking - Inhaler Technique training 2. Monitoring - Annual Review - Pharmacotherapy 3. Lifestyle - Pulmonary Rehabilitation - Education & Care Plans 4. Diagnostics - Red Flags - Consultation

23 + n Community Pharmacies LPC Federated Pharmacy Providers n GP Practices COMMISSIONER SUPPORT n Training events Work n Public awareness campaigns and promotion n Acute services for discharge programmes n Independent evaluation and data analysis

24 + PROJECT TEAM Dr Anna Murphy Consultant Respiratory Pharmacist & Clinical Lead for SIMPLE Framework (NHS) Rosemary Plum Project Management, Media Development & Engagement Mukesh Lad, BPharm, MRPharmS, MGPharmC Clinical Director of Community Pharmacy Research Support Respiratory specialist pharmacists Medicine Management pharmacists Consultant respiratory physicians GPs and practice nurses Community pharmacists

25 + SIMPLE OUTCOMES n GP workload and the burden of unscheduled primary care attendance n Hospital admissions and healthcare costs by better co-ordination of care n The variation in the care of respiratory patients with asthma across the healthcare community n Medication costs REDUCE n Potential risks associated with inappropriate use of high-dose inhaled corticosteroids n n n n n n n IMPROVE Health-related quality of life and overall patient management Medication adherence, usage and inhaler technique scores Clinical and cost effectiveness of respiratory prescribing Understanding by patients and carers to help self-manage their condition Number of patients receiving an assessment Quality and productivity Capability and capacity in primary care

26 SIMPLE Asthma + Feasibility Study pharmacies within Leicester City NHS 125 patients reviewed over a 6 month period Defined as an Evaluation by NHS Ethics Integrated with GP practice service

27 + SUMMARY Only 39% of patients had well-controlled asthma at the start of the intervention n Patient s Asthma Control improved significantly following the SIMPLE Intervention (baseline to final visit) n 72% increase in 36 patients n 6% no change (3 patients) n The mean improvement was 2.82 Full evaluation data set available

28 + n Leicestershire and Rutland -12 months ending December 2014 n 250 patients SIMPLE COPD Currently being evaluated n Used online platform to collect1,500 fields of data for each patient n Baseline, 3 month and 6 month intervention. n Smaller cohort of patients also being reviewed at 12 months

29 + PR & MEDIA Pharmaceutical Care Awards 2012 Clinical Leaders Network 2012 PJ Online

30 + REFERENCES n Department of Health. Outcomes Strategy for COPD and Asthma. July n Asthma UK. Where do we stand? Asthma in the UK today. Asthma UK (2004) Murphy, AC et al. n The relationship between clinical outcomes and medication adherence in difficult-to-control asthma. Thorax 2012;67: n Asthma UK. The Asthma Divide: inequalities in emergency care for asthma. April n NHS Atlas and NHS Right Care (Problems of the Respiratory System, Atlas of Variation: 2011 version). n Asthma UK. Wish you were here report. n The British Thoracic Society / Scottish Intercollegiate Guideline Network. British Guideline on the management of asthma. Thorax 2011.

31 Thank You