NEWS NEWS IN BRIEF NEW WAYS OF WORKING
Medicines, vaccines and consumer healthcare company GSK is making wide-ranging changes in the way it works with healthcare professionals (HCPs).
This year sees GSK UK Phar- maceuticals introduce several new ways of working to build greater trust and transparency. By the beginning of 2016, the rest of the global business will have followed suit.
The changes are already beginning to transform how GSK works with HCPs, how it delivers medical information and education, and the way in which customer-facing teams are rewarded. The focus is on developing a sustainable and responsible business model that meets the high expectations of society.
The latest milestone in this year’s initiatives is that from July 2015, GSK’s UK operating company, with the exception of its rare disease unit, is to end the practice of paying health- care professionals to speak on its behalf to other prescribers about its products.
This is one of a series of chang- es to strengthen the company’s relationship with the health- care community by increasing transparency and being more responsive to their needs. Other changes being brought in are designed improve the exchange of information by an using an enhanced mix of channels, making internal GSK experts more available to share relevant information with other HCPs, and continuing to fund independent medical education and attendance at scientifi c conferences, but do- ing so at arm’s length through independent third parties.
Dr Stephen McDonough, GSK’s Vice President and Medical Director for the UK and Ireland, says the changes are driven by the company’s commitment to greater transparency.
“For us, success depends fi rst on HCPs’ trust in GSK. We are building a new operating model for engaging with HCPs that refl ects the changes in the healthcare environment today.”
36 - SCOTTISH PHARMACIST Getting the measure
of mental health Written by Wendy Ackroyd MRPharmS, lead clinical pharmacist in mental health for NHS Dumfries and Galloway.
I decided to try mental health pharmacy on for size, for six months. That was 15 years ago now. It was a good fi t.
When working in community pharmacy, I looked at a list of psychiatric drugs on prescriptions (usually combinations the BNF has a black dot against) and felt out of my depth to challenge it. I imagine there are a few of my colleagues who do this now.
Mental health problems are hard to measure – diagnostic criteria overlaps, you can have more than one at a time and the evidence base is… lets say RCTs contain a few less than the 18,000 subjects you see in a trial of a statin.
My fi rst experience of someone with acute mental illness was in the old rehab unit two months after starting. Asked by the nursing staff to “make them take their Quetiapine” I was left alone in a bungalow with a woman who was clearly psychotic, whom I’d never met before, and who really didn’t want to take medicines for a condition she didn’t believe she had. It didn’t exactly go well. Unsurprisingly she didn’t take her Quetiapine.
This was a long way from patient centred care. Thankfully things have moved on.
Working in mental health is not without its challenges. But being part of a team that helps individuals fi nd themselves again after their mind has lost its way is rewarding, fascinating, sometimes entertaining and occasionally heartbreaking.
And I love it.
In the acute service I help the team, which obviously includes the patient and their carer(s), fi nd a treatment that can fi t the individual. Using resources on the NHS Inform site to help people see what options they might have, we start people on their road to recovery.
Mental health problems are common but most people with them are
not in hospital. We will meet them wherever we are – from ITU, medical wards, maternity, nursing homes, GP surgeries, in our pharmacies and at home. There are many potential roles for us.
Mental and physical health is interconnected in the same way that the head is attached to the body, one affects the other, and the person must be considered as a whole.
Did you know that people with schizophrenia die, on average, around 20 years sooner than a matched population without schizophrenia? Cardiovascular disease, diabetes, smoking, poor diet and little exercise are involved, as are medicines whose side effects contribute to poor motivation, and metabolic syndrome. Physical health management and improvement is bread and butter to lots of pharmacists.
People often stop taking antidepressants before they get a chance to see any benefi t. Pharmacists can provide support, encouragement
and education on what to expect with treatments.
Lithium is an obvious high risk medicine we can focus on, it has numerous interactions and narrow therapeutic index – support, monitoring, education are obvious roles for us.
There are many roles for pharmacists, from formulary management issues to prescribing clinics for antidepressant reviews, sleep and hypnotic management and benzodiazepine withdrawal, from weight management to smoking cessation, cardiovascular risk factor monitoring and
management, education, support and signposting.
It starts with awareness of the issues and knowing who to ask. There are specialist pharmacists in mental health services across the UK. We are too few to do everything ourselves but are delighted to help our colleagues work with people who have mental health problems to achieve their best possible mental and physical health.
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