1. ii Breast Cancer Care and Community Pharmacy Scotland Project
Nicolas White, Breast Cancer Care
Amanda Rae, Community Pharmacy Scotland
Results
Introduction
Final documents circulated to the community pharmacies in the GG&C Health Board included:
A counselling proforma (figure 1) detailing common side effects that can affect patient compliance
A flowchart suggesting how this counselling service could integrate into pharmacy practice (figure 2)
A submission form to be returned to CPS
A counselling record log for the pharmacies.
Community Pharmacy Scotland (CPS) sign up to work with a charity every two years. The Charity Partner is chosen as one with a healthcare focus relating to the patient care we deliver in community pharmacy.
We were delighted to welcome Breast Cancer Care as the Charity Partner of CPS during 2016/17.
As part of this partnership, CPS held a Charity Golf Day, raising funds for Breast Cancer Care.
Historically, funds have been given to the Charity Partner with no further involvement from CPS.
This time we wanted something different, so the two organisations discussed how the funding could be used in the delivery of a joint project to support patient care.
Gather patient demographics (e.g. gender, age)
Gather information on duration of treatment of tamoxifen, letrozole or anastrozole
Explore patient compliance with medication, including reasons for non-compliance
Explore experience of possible side effects
Ask if patient has heard of Breast Cancer Care, and offer Helpline card.
Counselling proforma
Figure 1. Overview of counselling proforma
Aims
Each pharmacy was also sent Breast Cancer Care Helpline cards to signpost patients for support as appropriate, shown below:
Identify suitable patients taking one of the following breast cancer medicines – tamoxifen, anastrozole or letrozole – and create a pharmacy care record (PCR) if none exists
On first dispensing, counsel patient using breast cancer medicine Local Enhanced Service counselling proforma to aid discussion
Provide patient with Brest Cancer Care Helpline card if appropriate
Record details of counselling on the PCR and the recording log
Submit figures to CPS on the Breast Cancer Care submission form
To develop a joint project between Breast Cancer Care and CPS using funds raised to enhance and support patient care.
To develop a framework that could be used in future to support patient care through CPS Charity Partnerships. ii
Methods
A review of what we could deliver was undertaken. We discussed what useful information we might be able to gather through conversations and consultations with patients in community pharmacies.
We identified tamoxifen, letrozole and anastrozole as three key medicines taken long-term by patients following hospital-based treatment for breast cancer, and looked at how we could develop a project based on these. The prescribing data is well understood, however, there has been little collection and collation of information from patients on their long-term medication. Furthermore, we wanted to increase patient awareness of Breast Cancer Care in Scotland and how the organisation can support patients.
The number of patients on each of the medicines was identified and a review completed of how much support could be funded under the project.
Greater Glasgow & Clyde (GG&C) was selected as the Health Board Area where the analysis would be completed.
We approached GG&C Health Board for their support, and they gave permission to use their format for Locally Enhanced Service projects.
A draft of project plans was circulated to the Community Pharmacy GG&C Committee for its input.
The final documents were circulated to the community pharmacies in the Greater Glasgow & Clyde area.
Figure 2. Flowchart of counselling service
Approximately 30% of community pharmacies signed up to participate. Using their feedback, we have made changes to templates for future projects and now have a strong process ready and signed off for future use.
Conclusions
The collaborative work between CPS and Breast Cancer Care has provided us with a clear plan for future projects. We have learned how to develop a project between CPS and our Charity Partner and what we need to review.
Acknowledgements
NHS Greater Glasgow & Clyde
Community Pharmacy GG&C Committee
Community Pharmacies Greater Glasgow & Clyde