NEWS Hospital/Community working in Respiratory care
Patients with long term respiratory disease in the Western Trust area are benefiting from a new service.
In line with the Transforming your Care programme, the Western Integrated Care Partnerships have supported the new service which has been designed to review respiratory patients in a primary care setting. This new service is being led by Respiratory Case Management Pharmacist Carla Jones
Beginning in December 2014, Carla has so far worked with nine GP practices across Londonderry, Limavady and Strabane to identify and review the effective medicines management of patients with Chronic Obstructive Pulmonary Disease (COPD).
Within each practice Carla assessed patients, reviewing their diagnosis and level of prescribed treatment, with respect to their past medical history, symptom presentation, infection risk and overall quality of daily living. With over 600 patients now having been reviewed, the service has been shown to work very effectively.
Based at Altnagelvin Hospital Carla explains how the responsive service works, “I initially identified a gap in care pathways for patients with COPD
whilst working in the Acute Medical Unit over the last number of years.
“Whilst appreciating that many patients admitted with an exacerbation of COPD require a comprehensive review of their treatment and management to minimise future risk, the acute setting can be a difficult environment in which to undertake this work.
“Throughout the patient’s hospital stay the primary goal is to manage the acute condition and ensure the patient is safely discharged from the hospital environment to their usual place of residence. This of course helps to minimise infectious risk but does reduce the opportunity for medication review.
“That said making amendments to a patient’s prescribed medicines at the time of an acute episode is not preferable, particularly where medication step-down is proposed. As such I appreciated that the effective review of patients living with long term respiratory conditions should ideally be undertaken in primary care and it has been wonderful to have had the opportunity to do so through this work.
“The benefits of reviewing patients at a primary care level have already
shown to have had a significant impact on the quality of lives of patients with COPD.”
Carla undertakes a 30 day follow-up telephone consultation with all patients that have been reviewed and the feedback has been overwhelmingly positive, with many patients expressing significant improvement in symptoms and daily management post intervention. There will be further follow-up of patients 12 months post review to establish the potential impact of this work on exacerbation frequency and hospital related admissions.
Carla explained that patient education is an important aspect of her work. “Educating patients empowers them with the knowledge and understanding required for good decision making, be it with respect to medicines adherence, the continued desire to smoke or whether to engage with the Pulmonary Rehabilitation service. These for example are all significant well established factors when determining the effectiveness of the management of respiratory conditions in the longer term.”
This is in line with the principles set out in Transforming your Care, which enables care to be provided closer to home and on a more individual basis.
Carla Jones, Respiratory Case Management Pharmacist
Offering feedback on the service one Derry GP said, “Our practice engaged with the service extremely well, patients offered very good feedback and it was a great support to our staff. Our Practice Nurses had identified COPD and asthma as clinical areas were they would like to evolve and they felt this was achieved through Carla’s support.”
Carla explained that the therapeutic management of patients has become in a sense increasingly difficult for Practice Nurses with the pharmaceutical market now being inundated with such a vast number of new inhaled therapies. She added product knowledge is important as applying the appropriate choice and level of treatment is instrumental in the effective management of patients in the longer term.
Chemists’ Concra Castleblayney
The beautiful and spectacular Concra Wood in Castleblayney was the final venue of the year for the Ulster Chemists’ Golf Society. Superb weather and a fantastic course ensured that the golfers had a great day of golf and catching up with colleagues and friends.
Peter Lemon and Ruairi Magee from UnitedDrug Sangers with Adrian Woods.
Brendan Wilson and Garth Newberry.
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