Prescribing Pharmacist

Barry Strickland-Hodge Dr

Description

Prescribing has traditionally been the responsibility of medical doctors but independent prescribing courses are now firmly established in the UK and increasing numbers of healthcare professionals have taken on prescribing responsibilities. The Prescribing Pharmacist reflects these changes, beginning with an overview of pharmacist prescribing and continuing with an exploration of consultation, patient clinical assessment, team working, and understanding cultural and religious issues and ethics. Internal and external influences on the new prescriber are considered, as well as medicines optimisation. The authors also look at prescribing for specific patient groups, such as the elderly, the very young, pregnant women and breast-feeding women, and finally move on to specific medicines that require special care when prescribing. Each chapter of the book refers and links to the Royal Pharmaceutical Society framework written in 2016, A Competency Framework for All Prescribers, which is reproduced, with permission.Written by a team of pharmacy experts, this book is intended for any pharmacist who is thinking of becoming an independent prescriber, those on pharmacy courses and those who are already qualified as independent or supplementary pharmacist prescribers, who may use it as a reminder of important points covered on their course.

Sujets

• Médecine
• Pharmacy

Informations

• Publié par: M&K Update Ltd
• Date de parution: 08 août 2019
• Nombre de lectures: 1
• EAN13: 9781910451533
• Langue: English

Extrait

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The Prescribing Pharmacist
Dr Barry Strickland-Hodge
Dr Mary-Claire Kennedy
The Prescribing Pharmacist
Dr Barry Strickland-Hodge and Dr Mary-Claire Kennedy (Editors)
ISBN: 978-1-910451-03-8
First published 2019
All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording or otherwise, without either the prior permission of the publishers or a licence permitting restricted copying in the United Kingdom issued by the Copyright Licensing Agency, 90 Tottenham Court Road, London, W1T 4LP. Permissions may be sought directly from M&K Publishing, phone: [phone], fax: [phone] or email: [e-mail]
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British Library Cataloguing in Publication Data
A catalogue record for this book is available from the British Library
Notice
Clinical practice and medical knowledge constantly evolve. Standard safety precautions must be followed, but, as knowledge is broadened by research, changes in practice, treatment and drug therapy may become necessary or appropriate. Readers must check the most current product information provided by the manufacturer of each drug to be administered and verify the dosages and correct administration, as well as contraindications. It is the responsibility of the practitioner, utilising the experience and knowledge of the patient, to determine dosages and the best treatment for each individual patient. Any brands mentioned in this book are as examples only and are not endorsed by the publisher. Neither the publisher nor the authors assume any liability for any injury and/or damage to persons or property arising from this publication.
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Designed and typeset by Mary Blood
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Contents
List of contributors
Foreword
List of abbreviations
1 An introduction to pharmacist prescribing
Asa Auta and Barry Strickland-Hodge
2 The consultation, diagnostic process, diagnosis and influences on prescribing
Catherine Gill and Barry Strickland-Hodge
3 Patient clinical assessment
Catherine Gill
4 Patient partnership and prescribing
Rani Khatib, Janet Holt, Catherine Gill and Barry Strickland-Hodge
5 Prescribing for specific groups of patients
Afthab Hussain
6 Medicines requiring particular care when prescribing
Afthab Hussain
Appendix: A Competency Framework for All Prescribers: Section 6
Index
List of contributors
Editor and contributor
Barry Strickland-Hodge BSc (Pharm), MSc, PhD, FRPharmS, FHEA
Visiting Professor of Prescribing Practice, School of Healthcare, University of Leeds
Co-editor
Mary-Claire Kennedy PhD, FHEA, MRPharmS
Module Lead for Independent and Supplementary Prescribing for Pharmacists,
Lecturer in Pharmacy Practice, School of Healthcare, University of Leeds
Contributors
Asa Auta B.Pharm, MPH, PhD
Senior Lecturer in Pharmacy Practice, University of Central Lancashire
Catherine Gill RGN, SPQ, MA, PgCert (Clinical Teaching)
Lecturer, Lead for Prescribing for Nurses and Midwives, School of Healthcare, University of Leeds; and Lead Partner for Learning and Teaching, Caritas Group Practice
Janet Holt PhD, MPhil, BA(Hons), RGN, FHEA
Senior Lecturer, Adult Nursing, School of Healthcare, University of Leeds
Afthab Hussain BSc, PhD, PGCertHE, FHEA, FRSB
Senior Lecturer in Biomolecular Sciences, School of Life Sciences, Coventry University
Rani Khatib BPharm (Hons), PGDipClinPharm, DPharm, FRPharmS, MESC
Consultant Pharmacist in Cardiology and Cardiovascular Clinical Research Leeds Teaching Hospitals NHS Trust
Foreword
In 1670, Jonathan Goddard, a London physician, wrote ‘only doctors should prescribe’ in his ongoing campaign against the encroachment of apothecaries into what he saw as his area of practice. I am an apothecary who qualified as a pharmacist in the days when Goddard’s phrase still rang true. It is a joy to have been part of the development of the supplementary and then independent prescribing courses for pharmacists. Courses were accredited from 2003 and the first intake of pharmacists took place in 2004.
Changes have continued since then, with the introduction of independent prescribing courses for pharmacists, which were accredited in 2006. Initially, the range of preparations that could be prescribed by pharmacist independent prescribers was relatively limited, with no controlled drugs, though this changed again in 2012 when independent prescribers were enabled to prescribe from the whole of the British National Formulary within their limitations or scope of practice. Three drugs, when used for addiction, were excluded but this does not appear to have caused any great consternation among prescribing pharmacists to date.
When independent nurse prescribing was introduced, nurses were also unable to prescribe any controlled drug. As with pharmacists, a controlled drug was identified by adding the letters CD after the drug name, so even drugs identified with CD INV P were included in the restricted prescribing list for nurses. (It’s strange to think that a nurse could buy pholcodine linctus but not prescribe it!) Unlicensed medicines were also restricted until 2012 so any mixture of two or more licensed drugs would be classed as creating an unlicensed medication and could therefore not be prescribed.
It would therefore appear that most of the barriers to a smooth transition from doctor-only prescribing to prescribing by nurses, pharmacists and other healthcare professionals, have been eradicated or at least significantly reduced. In May 2016, the General Pharmaceutical Council (GPhC) published a Prescribers Survey Report. This stated that at the beginning of November 2015 there were 3,944 annotated prescribers on the GPhC register, representing about 8% of the total number of pharmacists on the register.
This short book introduces pharmacist prescribing and begins by looking at where we are now. In 2016, the Royal Pharmaceutical Society (RPS) undertook a review of the existing competency framework and produced a more all-encompassing list of competencies to be achieved by all potential and existing prescribers, including medics, dentists, nurses and pharmacists. This list should form a major part of the work-based learning element of any prescribing course. The list of competencies is reproduced as the appendix in this book with permission of the RPS.
The body of the book considers more detailed prescribing issues, such as consultation, patient clinical assessment, working in teams, understanding cultural and religious issues and ethics. In Chapter 2, influences on the new prescriber in particular are considered. There will always be influences and attempts to make any prescriber consider new products. Medicines optimisation is another very important aspect of prescribing and for this the RPS good practice guidance is referred to in detail in Chapter 4. The book then looks at specialist patient groups, such as the elderly, the very young, pregnant women and breast-feeding women, and finally moves on to particular medicines requiring special care when prescribing.
This book is intended for any pharmacist thinking of (or interested in) the idea of pharmacist independent prescribing, those on pharmacy courses and those who are already qualified as pharmacists, who may use it as a reminder of important points covered on their course.
Barry Strickland-Hodge, Pharmacist, Apothecary and Visiting Professor of Prescribing Practice at the University of Leeds, 2019
References
Goddard, J.A. (1670). Discourse, setting forth the unhappy condition of the practice of physic in London. Royal Society VIII: 442–55 (Available at the Leeds Subscription Library).
General Pharmaceutical Council (GPhC) (2016). Prescribers Survey Report. https://www.pharmacyregulation.org/sites/default/files/gphc_prescribers_survey_report.pdf (last accessed 11.5.2019).
List of abbreviations ABPM ambulatory bp monitoring ACEI angiotensin converting enzyme inhibitors APTT activated partial thromboplastin time AVPU Alert, Voice, Pain, Unresponsive BHS British Hypertension Society BMA British Medical Association BNF British National Formulary BNF-C BNF for Children BP blood pressure BPM beats per minute CAS Central Alerting System CCG Clinical Commissioning Group CD INV P Controlled drug exempt from all requirements other than the need to retain invoices for two years CKS Clinical Knowledge Summary CMDh Coordination Group for Mutual Recognition and Decentralised Procedures-human CMP clinical management plan CNS central nervous system COPD chronic obstructive pulmonary disease CPD continuing professional development DH drug history DMARD disease-modifying anti-rheumatic drug DN District Nurse DOAC direct oral anticoagulant dTT dilute thrombin time EAM external auditory meatus ECG electrocardiogram eGFR estimated glomerular filtration rate EHC emergency hormonal contraception EWTD European Working Time Directive FH family history GI gastrointestinal GPhC General Pharmaceutical Council HBPM home blood pressure monitoring HPC history of presenting complaint HRT hormone replacement therapy HV Health Visitor ICE Ideas, Concerns and Expectations INR international normalised ratio IRET infrared in-ear thermometer LFT liver function test LMWH low molecular weight heparins MDRD modification of diet in renal disease MHRA Medicines and Healthcare products Regulatory Agency NEWS National Early Warning Score NHS National Health Service NICE National Institute f