assessing the benefits that community pharmacies can have ... · pdf filebackground the local...

BackgroundThe local Clinical Commissioning Group (CCG) has funded an innovative one-year pilot project to assess the value of providing specialist paediatricpharmacist and physiotherapist support direct to families and health careprofessionals (GPs, community pharmacists, practice nurses etc.) regardingasthma in the primary care setting. Community pharmacies are the oneservice that all asthmatic children come in contact with in order to pick uptheir medications and so it was decided to encourage staff to provideinterventions at the point of collection

Objectives1. Publicise the scheme and the available training to all community

pharmacies within the Liverpool CCG area2. Train interested pharmacy teams in correct inhaler techniques to be used

in paediatric population3. Provide key points to cover in a Medicines Use Review (MUR) for

pharmacists interested in the scheme4. Provide ‘back to basics’ leaflets on all key asthma medications commonly

used in childhood asthma to be given out with all prescriptions toimprove education amongst parents and patients

Method• 22 large chain, small chain and independent community pharmacy

branches were included in the pilot (out of 152 within CCG area) with atotal of 31 pharmacists and 67 assistants trained to provide the service.

• Teams were asked to provide inhaler technique counselling on handingout every prescription for an inhaler in under 18’s with/without the childbeing present

• If pharmacist felt comfortable that the patient was able to give consentand engage with them they were to perform an MUR following key pointsin booklet provided

• For both activities the teams were asked to perform the standardisedasthma control test (box 1) before any intervention followed by theparent/patient completing online version 4 weeks later. Results fed backelectronically to asthma team

Results

• 41% (n=55) of patients completed the 4 week post intervention online asthma control test• Average increase in score was 7 (30%)

Discussion• Feedback from pharmacists was generally positive on the service and did not greatly add to current work load• Improvements in asthma control test score were seen from a variety of services (MURs, NMS and inhaler technique counselling)• Longest intervention recorded was 10 minutes• Main complaint from staff was there was no financial benefit to them (despite them being able to make £28 and £20-28 for MUR and NMS performed)• Not all pharmacists were happy with consenting and engaging with children• Some patient’s missed out on MUR as they were too young to engage with pharmacist themselves (current rules state the patient not guardian/carer

must consent and engage with pharmacist).Conclusion

It is clear that interventions performed by the community pharmacy teams can help improve symptom control in asthmatic children. In particular ensuringpatients are using their medications correctly appears to be key to symptom control. Encouraging pharmacists to provide child friendly MURs should beinvestigated further to prove the benefit of this service. The team has been in contact with NHS England regarding the prospect of a children’s MUR andNMS that would enable the service to engage with the child’s parents. This would open up the benefits of these services to more children. It should be notedhowever that ensuring patients are using their medications correctly is already part of the essential service contract for pharmacies.

AssessingthebenefitsthatcommunitypharmaciescanhaveonchildhoodasthmaoutcomesAndrewLilley*andLeanneTurner**

*SpecialistPaediatricPharmacist– Respiratory(PharmacyDepartmentAlderHeyChildren’sHospital)andrew.lilley@alderhey.nhs.uk**Clinical SpecialistPhysiotherapist(CommunityPhysiotherapyAlderHeyChildren’sHospital)

(box1)AsthmaControlTest

Completedpaperworkreceivedfrompharmacies(n=22) 68%

NumberofMURsperformed 23Inhalercounselling sessions

performed 32

NumberofNMS performed 3

(box2)

0

2

4

6

8

10

12

14

Improvement inAsthmaControl TestScorepost Pharmacy Intervention