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Medicines management is the  pharmacist's role in the future?

Medicines management is the  pharmacist's role in the future?. Richard Cattell Director, South West Medicines Information and Training. Medicines Management and Pharmacists. The people The evidence The organisations imperative Being a Consultant. Medicines Management : the definition.

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Medicines management is the  pharmacist's role in the future?

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  1. Medicines management is the  pharmacist's role in the future? Richard Cattell Director, South West Medicines Information and Training

  2. Medicines Management and Pharmacists • The people • The evidence • The organisations imperative • Being a Consultant

  3. Medicines Management : the definition • There is no universal definition • Synonym or umbrella term? • Definition of medicines management • Appropriateness of prescribing, • Monitoring of effect • Assurance of quality (supply) • Assurance of process (administration) (in all areas of patient care)

  4. Medicines Management and Pharmacists • The people • The evidence • The organisations imperative • Being a Consultant

  5. The people • The Pharmacist • Most thorough grounding in • Pharmacology / therapeutics • Formulation and dosage form design • Pharmacokinetics/dynamics • Competency driven roles • Pre-registration Performance Standards • Knowledge and Skills Framework • Supplementary Prescribing • ‘London’ Competency Framework

  6. Medicines Management and Pharmacists • The people • The evidence • The organisations imperative • Being a Consultant

  7. The evidence for the value of a pharmacist • Pharmacists attending a post-take ward round • 3 year study including 24,000 patients • 1.84 contributions to care per patient • 50% related to therapeutic choice • Supply and patient education Pharm J 2003; 271: 22-24 (Bednall et al)

  8. The evidence for the value of a pharmacist • Pharmacists working in Pre-Admission Clinics • 398 consultations in Oxford Transplant Centre • 456 clinically significant contributions to patient care (1.14 per pt) • IJPP 2004; 12: R27 Prouse & Scott

  9. The evidence for the value of a pharmacist • Primary care clinics for patients with hypertension • After 5 months…… Pharm World & Sci 2005; 27 (3): 1573-9

  10. The evidence for the value of a pharmacist • Pharmacists working general practices reviewing patient medicines • 1188 patients • Clinical pharmacist review leads to smaller rises in number of prescribed drugs, cost of prescribed drugs • No evidence of increased use of health service • BMJ 2001; 323: 1-5 Zermansky et al

  11. The evidence for the value of a pharmacist As clinical pharmacist staffing levels increased from the tenth percentile (0.34/100 occupied beds) to the ninetieth percentile (3.23/100 occupied beds), hospital deaths declined from 113/1000 to 64/1000 admissions (43% decline). Pharmacotherapy 21(2):129-141, 2001 CABond et al

  12. The evidence for the value of a pharmacist • Three hospital pharmacy variables were associated with reduced length of stay in 1024 hospitals: • drug protocol management • pharmacist participation on medical rounds • number of clinical pharmacists/occupied bed Pharmacotherapy 21(2):129-141, 2001 CABond et al

  13. Medicines Management and Pharmacists • The people • The evidence • The organisations imperative • Being a Consultant

  14. The Organisations Imperative • National Service Frameworks • Diabetes • Diagnosis and management of diabetics in community pharmacies • Long term and Elderly Care • Medicines Review for all patients on 3 or 4 or more medicines carried out by competent practitioner (pharmacist)

  15. The Organisations Imperative • Choosing Health through Pharmacy • Pharmacist led Diabetes clinics • Cardiac Rehabilitation • Improving Medication Safety • Audit Commission ‘Spoonful of Sugar’

  16. Medicines Management and Pharmacists • The people • The evidence • The organisations imperative • Being a Consultant

  17. Being a Consultant Pharmacist • The post • Developing the posts • The person • The competency framework • Agenda for Change • Transitional arrangements

  18. Being a Consultant Pharmacist • An experienced well trained and competent practitioner • Champion for medicines management throughout the specialty and organisation • Role model for junior pharmacists

  19. Being a Consultant Pharmacist • Challenge to current practice • Competency demonstrated

  20. So…Medicines Management & the Pharmacists future • Pharmacists are best placed to oversee medicines management • Evidence abounds as to the benefit brought such an approach • The NHS requires of its pharmacists more involvement in medicines management • The consultant pharmacist role provide a focus for medicines management activity

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