Abstract Objective To review patient satisfaction with the change in practice towards telephone consultations during and after the coronavirus disease 2019 pandemic for head and neck cancer follow up. Method A retrospective analysis was conducted of head and neck cancer telephone appointments during a six-month period in a tertiary referral centre. Results Patients found the telephone consultations beneficial (98 per cent), with 30 per cent stating they were relieved to not have to attend hospital. Patients who travelled further, those with lower stage disease and patients with a greater interval from initial treatment were most satisfied with the telephone consultations. Sixty-eight per cent of patients stated they would be happy to have telephone consultations as part of their regular follow up after the pandemic. Conclusion Patients found the telephone consultations beneficial and 30 per cent considered them preferable to face-to-face appointments. This study demonstrates that telephone consultations can be used as an adjunct to face-to-face appointments in an effort to reduce hospital attendances whilst maintaining close follow up.
Ritonavir is one of the main components of Paxlovid® an oral COVID-drug with numerous clinically significant interactions. This, results in increased numbers of adverse events, raising concerns for patient safety.
Aim and Objectives
The aim was to describe the frequency, type, and severity of detected drug-drug interactions in Paxlovid® recipients identified during pharmacy screening. This service was introduced since numerous instances of inappropriate prescribing, particularly with co-medications, were noted at the pharmacy despite prescriber consideration at the point of prescribing.
Material and Methods
A retrospective monocentric quantitative data analysis was performed after ethical approval in an Austrian clinic in Vienna. All patients prescribed Paxlovid® were included and data collected from the patients' electronic records. A data collection tool was developed and piloted to ensure inter-rater reliability. Drug-drug interactions including prescribing recommendations were determined using the COVID-19 Drug Interactions checker developed by the University of Liverpool.
Results
122 of 140 (87.1%) included patients required dose reduction, alternative COVID medication, or interventions to prevent interactions or overdosing. In 33 cases the necessary action was performed by the doctors at the point of prescribing. However, in 89 (63.6%) cases the required action was not identified at the point of prescribing but identified during the pharmaceutical medication analysis after Paxlovid® was ordered in the pharmacy. Since interventions were made prior to the patient receiving the supply, all patients in this group benefitted from the pharmaceutical service leading to enhancement of patient safety.
Conclusion and Relevance
This study demonstrated that many drug-drug interactions were identified through the pharmaceutical intervention. This shows that pharmacist involvement in prescribing highly interacting drugs such as Paxlovid® is beneficial to enhance patient safety and mitigate risks.
Abstract Introduction The General Medical Service (GMS) contract was produced in Scotland in an attempt to tackle General Practitioner (GP) workforce issues. The pharmacotherapy work stream is part of this and provides a framework for pharmacy teams, dividing services into level 1 (core), level 2 (advanced) and level 3 (specialist).1 A statement by the Royal Pharmaceutical Society (RPS) and the British Medical Association (BMA) discussed the introduction of pharmacotherapy hubs to complete level 1 work for multiple practices, centralising the medicines reconciliation process. Theoretically, this would release pharmacists to carry out clinical and more advanced/specialist services.2 There are currently 8 pharmacotherapy hubs within NHS Lanarkshire (NHSL), incorporating level 2 and 3 services into job plans for General Practice Clinical Pharmacists (GPCPs). No work has been undertaken to explore changes in practice since the implementation of these hubs. The qualitative study explored drivers and motivators for pharmacists in practice, shaping future pharmacotherapy services in NHSL and Scotland. Aim To explore the views and attitudes of primary care pharmacists towards their practice role in NHSL following the implementation of the pharmacotherapy hub. Methods Ethical approval was granted from the School of Pharmacy and Life Sciences Ethics Committee (Robert Gordon University). Pharmacists working within the 8 hub localities were invited to participate via email correspondence if they had over 6 months experience in practice pre-hub implementation and then 6 months post-hub implementation. Participants attended a one-to-one interview to share their views towards their practice role since the hub was implemented. Interviews were recorded, transcribed verbatim and thematically analysed. Results Twelve pharmacists across six localities participated. The five key themes identified were job role, managing time, professional development, professional belonging and patient care. The implementation of the hub was an enabler for pharmacists to partake in advanced pharmacotherapy tasks. Pharmacists negatively perceived level 1 core pharmacotherapy tasks in comparison to level 3 clinical patient-facing time. Participants linked the hubs impact on practice with role development, an increase in autonomy, confidence and job satisfaction. Discussion/Conclusion The hub has enabled in-practice pharmacists to move to a more sustainable balance between core and advanced/specialist tasks. Collaboration is required between pharmacy teams and practices to understand the pharmacist role in pharmacotherapy. Further recommendations include continuing the roll-out of pharmacotherapy hubs, standardisation of pharmacist clinical time balanced with core tasks and implementation of protected learning time for pharmacy teams. The study was open to response bias but this was addressed by using semi-structure interview guides in the one-to-one interviews. Researcher bias was minimised by two researchers analysing the data and practicing reflexivity. The study was open to recall bias due to participant’s retrospective thinking. In NHSL prioritising the hub roll-out and collaboration with stakeholders are essential. This will ensure the balance between efficient pharmacotherapy services and maintaining attractive roles, contributing to a sustainable workforce. References 1. Scottish Government. GMS Contract: 2018 [Internet]. Scotland: Scottish Government; 2017 [citied 2023 Nov 18]. Available from: https://www.gov.scot/publications/gms-contract-scotland/pages/6/ 2. Royal Pharmaceutical Society Scotland (RPS), British Medical Association (BMA) Scotland. Joint RPS and BMA Scottish GP Committee statement on the Pharmacotherapy Service. [Internet]. Edinburgh: Royal Pharmaceutical Society of Scotland; 2021 [citied 2023 Nov 18]. Available from: https://www.rpharms.com/Portals/0/Joint%20BMA-RPS%20pharmacotherapy%20service%2013%20Jan%202023_1.pdf
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