1. Independent Prescribing Pharmacist in Community Pharmacy
Chrishna Goyal
Independent Prescribing in the community
Hypertension Clinics
Working as an independent prescribing pharmacist in West of Scotland , I lead for patient care in the local community focusing the management of hypertension.
This involves either identifying suitable candidates (by medication history from the PMR in the community pharmacy) and inviting the patient for an ongoing blood pressure review or referrals from the GP practices.
The consultation includes measuring blood pressure , weight, calculating BMI and discussing lifestyle choices as appropriate.
Patients are enrolled in the Chronic Medication Service (CMS) to enable ongoing pharmaceutical care and the smoking cessation service when needed. D CC
HYPERTENSION CLINIC
Community pharmacy AC H
Independent prescribing
Managing medication
Access 6 days week
Local formulary
Partnership with GPs
Lifestyle Advice
- Smoking cessation
- Diet (BMI)
- Exercise
- Alcohol
- CV risk score -
Polypharmacy review in GP practice
Working in a GP practice a cohort of patients were identified based on the number of medications prescribed .
My role was to conduct an extensive review of their patient records to ascertain appropriateness of their medication against the diagnosed medical conditions.
This was discussed with the GP to rationalise their medication and discussed with patient before changes made.
The limitations of carrying out this activity within the community setting is lack of access to all relevant data.
Future practice developments for independent prescribing in the community
Produce a screening programme to identify undiagnosed hypertensive patients
Management of long term conditions with prescribing in the pharmacy e.g. asthma
Pain management
Medication substitution for MCS (manufacturers cannot supply)
Polypharmacy reviews in the community setting
Develop a suite of services bespoke for the independent prescribing role in community fully supported by the extended healthcare team
Protected learning time for service development
External stakeholders
GPs in Largs – discussing more complex patients , supporting with patient referrals, ensuring records updated to reflect the prescribing in community
General practice pharmacist – working together to look after patient groups
Phlebotomist – to ensure all relevant bloods are up to date to check liver and kidney function , cholesterol levels
Community Pharmacy Advisor at the Health Board – liaising between independent community prescriber and GP practice to gain access to patient notes
Patient representatives – to alleviate concerns with the care of their families and provide support
Acknowledgements
I would like to give my thanks to Fiona Maclean (NHSGG&C) who helped with the design of this poster template.
I would like to give my thanks to Felice Groundland who helped with the design and review of the poster
I would like to thank Matt Groundland, my preregistration trainee, for his input to the draft poster production