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Pharmaceutical Care Awards

Improved physical health monitoring for patients who are taking clozapine

Clozapine patients have welcomed point-of-care testing as part of a project that was a finalist at the recent Pharmaceutical Care Awards.

Nadia Attura

Patients who take clozapine have been given safe access to medicines and improved physical health monitoring thanks to a project offering point-of-care testing from a team that was a finalist in the Pharmaceutical Care Awards last month.

The project was headed by lead pharmacist Yogita Dawda, who worked with Claire Holland, medicines management lead nurse, both at Central and North West London NHS Foundation Trust.

They aimed to establish the model in five local boroughs for approximately 600 clozapine patients. The model required that the lead pharmacist and medicines management lead nurse implement nurse-led clinics while minimising disruption to the existing service.

Previously, patients attended a clinic twice a week and would often have to visit another department subsequently to have a blood test. This test would take two days to be processed before clozapine could be dispensed. The new service gave patients access to blood testing, medicines and physical health monitoring in one 30-minute appointment.

Championing this project was award judge Harry McQuillan, chief executive of Community Pharmacy Scotland. “The positivity for me in this project was the absolute emphasis on patient care, the patient experience and the absolute determination to radically improve all aspects of the service for those patients. Marvellous,” he told the audience.

Clinic attendance boosted

The project successfully reduced “did not attend” rates from 22 per cent to less than 1 per cent in comparable three-month periods. In a sample size of 50 per cent of one borough, monitoring for pulse, blood pressure and weight/body mass index increased from 74 per cent, 74 per cent and 72 per cent, respectively, to 96 per cent for all three measures, with the remaining 4 per cent refusing monitoring. Side effect monitoring increased from 4 per cent to 96 per cent in a sample of the same size.

“In addition, we developed a clozapine physical health monitoring booklet, which empowers patients to take onboard the management and monitoring of their own physical health and mental health,” said Mrs Dawda. The booklet allows healthcare professionals to communicate test results, trends and physical health test requirements.

“It is fundamentally about the physical health and well-being programme,” said Ms Holland. “We know that clients taking schizophrenia treatments are incredibly difficult to engage and motivate. And that is why we wanted to make it different. We did not just want ‘turn up for your medicine, here is your blood test, off you go’ — it has got to be more than that.”

The model has been implemented in three boroughs, with a further two clinics in an early development stage awaiting refurbishment. The project team hopes that the model can be replicated across other boroughs.

The Pharmaceutical Care Awards 2013 were run jointly by the Royal Pharmaceutical Society and The Pharmaceutical Journal, and were supported by GlaxoSmithKline. Coverage of the awards began in The Journal on 22/29 June (PJ 2013;290:731).

Citation: The Pharmaceutical Journal DOI: 10.1211/PJ.2013.11123185

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