Claire Guerin and Dr Aaron J Brady The Role of a Pharmacist Independent Prescriber on an Interventional Cardiology Ward Claire Guerin and Dr Aaron J Brady

Belfast City Workhouse ~ 1840 Then.......... Belfast City Workhouse ~ 1840

...........and now BCH Tower Block ~ 1986 University teaching hospital 900 beds 3rd largest storeyed building in Ireland

Introduction Coronary heart disease is the UK's biggest killer (82,000 deaths per year) Interventional cardiology (IC) involves interventional procedures for treatment of coronary heart disease presentations e.g. STEMI Although treatment dictated by findings in cath lab, patients must undergo full admission procedure including accurate drug chart To date - the role of an FY1 doctor, with a potentially limited knowledge of complicated poly-pharmacy regimens

Introduction The Crown Report (1999) widely accepted as the turning point for NMP ‘...increasing the professionals authorised to prescribe....will improve services to patients, make better use of the skills of professionals & make a significant contribution to the modernisation of the NHS’ Pharmacist Independent Prescriber (PIP) ‘... a practitioner responsible for assessment of patients with undiagnosed & diagnosed conditions & for decisions about the clinical management required, including prescribing’ Experienced PIPs ideally placed to prescribe timely and accurate admission and discharge medications on an IC ward PIPs could provide a significant contribution to accurate and timely prescribing, improving patient access to IC services

Aims Quantify the contribution of the PIP with respect to in-patient prescribing and prescribing of discharge medication Development and expansion of PIP service

Method Cross-sectional single cohort study All patients admitted to interventional cardiology ward eligible for inclusion in the study 14 week data collection period (Aug-Nov 2012)

Results: PIP Input 15.9 (SD ±14.1) in-patient medications prescribed per day by PIP 56 discharge prescriptions prescribed 3.1 (SD ±2.96) medicines prescribed per discharge prescription PIP prescribed antimicrobial therapy for 13 patients

Discussion DoH Key aim of NMP is to make better use of health professionals Pharmacists represent underutilised healthcare group Pharmacy prescribing yet to become fully embedded in routine practice (McCann et al. 2011)

Discussion 1st study looking at quantitative potential of a PIP in secondary care (capacity) PIP had a significant input into patient care Prescribed 37% of drug charts 16 medications per day 56 discharge prescriptions Antimicrobial therapy for 13 patients

Discussion New pharmacist prescribing model Pharmacist prescribing of patient drug charts on admission Pharmacist prescribing of discharge medication Pharmacist writing of formal GP discharge letters based on cath-lab reports Pharmacist-led ward service ??

Conclusion & Future Work Hospital pharmacy lends itself extremely well to PIP – well received by staff Business case approved for a further 0.5 WTE PIP to further enhance the service Further evidence is essential to realise potential of a PIP in secondary care

Acknowledgements Dr Aaron Brady MPSNI Pre-registration tutor

Questions?