Community Pharmacy Workbook Supply of varenicline (Champix ®)

Your details Pharmacist Name: Pharmacy: Date: Notes:

Introduction Community pharmacists who are SmokeStop trained in NHS Dorset are now able to supply varenicline via a patient group direction (PGD) ONLY a pharmacist who has carried out the required training can use the PGD and initiate treatment with varenicline Pharmacy technicians are not eligible to supply medicines under a PGD If the initiating pharmacist is not present on the day that a patient needs a repeat supply, the supply can be made by another pharmacist based on the principle that the initiating pharmacist has authorised a 12 week course of treatment under the PGD The pharmacy will need an SOP to cover this process

Place in therapy When pharmacotherapy is required to assist in supporting a quit attempt, patients should be assessed based on medical history, previous use and client choice NRT or varenicline may be used as a first line option for smoking cessation Patients should be fully informed of the risks and benefits of the available treatment options through verbal and written information Note: repeat courses of varenicline are not approved locally and are not covered by the PGD

When can I supply varenicline? The patient must be willing to quit and able to attend 1-1 support sessions You will have informed the patient about the choices of pharmacotherapy and discussed the most appropriate treatment with them Main exclusions (refer to PGD / SPC for full list): Patient has taken varenicline or bupropion previously Patient not willing for information to be passed to GP Pregnancy and/or breastfeeding Patient under the age of 18 You cannot supply varenicline to a patient who does not meet the criteria for supply under the PGD

When should I signpost? If the patient wishes to stop smoking but you cannot supply varenicline under the PGD: Discuss alternative therapies for smoking cessation Refer to the smokestop service for specialist help Refer to the patient to their GP - remember you could still provide 1:1 support if the GP was prescribing varenicline

The first consultation Complete the standard smokestop 1-1 form and the monitoring form Follow the varenicline PGD checklist form, ensuring that all the relevant information is provided to the patient. This information includes: Treatment schedule Administration Side effects Dose tapering Consent to share information General stop smoking advice Follow-up Where to get more information

The first consultation (continued) Check the patient understands advice given and ask them to sign the PGD consultation form Keep this form as a record of the consultation and patient consent Provide the first 2 weeks treatment as a titration pack and arrange the follow up appointment Remember – no form of pharmacotherapy should be supplied unless a quit date has been set!

Follow up consultations Provide a further 2 week supply of varenicline. (Do not supply any more than 2 weeks at any one time) A condition of supply is that the patient continues to attend fortnightly 1:1 support sessions For the final two weeks a starter pack should be provided to be used in reverse The total treatment quantity is 12 weeks supply

Records & Administration A record of each supply of varenicline must be made on the PMR and on the 1:1 record The patient’s GP must be notified of the supply of varenicline by fax. It is the responsibility of the pharmacist to inform the patient’s GP The pharmacy should submit a claim on a monthly basis for payment for supplies of varenicline (part of normal claim for all smokestop items)

Contract and PGD sign up sheet Varenicine can only be provided under the PGD in pharmacies that are signed up to provide the SmokeStop 1:1 service Each pharmacist that supplies varenicline under the PGD must have their own copy of the PGD and have returned a PGD signup sheet to the medicines management team at the PCT Once you have studied the PGD, the SPC and the workbook, please complete and submit the questions and declaration on survey monkey at: https://www.surveymonkey.com/s/FR2P7JB

Questions? If you have any questions after reading through this workbook, the PGD and the SPC please contact : Laura Everett (01305 361181 or e-mail: Laura.Everett@dorset-pct.nhs.uk) Les Riggs (01305 213617 or e-mail: leslie.riggs@dorset-pct.nhs.uk) Julia Booth (01305 213616 or e-mail: Julia.booth@dorset-pct.nhs.uk)