Improving healthcare outcomes through clinical pathways


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The Royal Pharmaceutical Society (RPS) has produced a document showing how pharmacists can ‘further contribute to the delivery of optimal care pathways to support their local health economies, improve patient care and reduce unwarranted variation.’

Here are four clinical pathways ways through which pharmacies can achieve the best outcomes.

  1. Respiratory diseases

Healthy Living Pharmacies (HLPs) have showed to improve the public health and the quality of services.

They play a vital role in tackling smoking issues compared to pharmacies that aren’t accredited.

The evaluation of the HLP work programme revealed that 70% of patients with a respiratory condition showed an improvement in the management of their condition, as a result of the pharmacist intervention.

There was also a 140% increase in smoking quits from pharmacies in Portsmouth compared with the previous year.

Through the use of Medicines Use Reviews (MURs) and additional support to patients, pharmacies can reduce hospital admissions and ease some pressure off the system.

The Isle of Wight reduced emergency admissions by 50% after its pharmacies provided asthma patients with more advice on how to better use their inhalers.

  1. Circulation and endocrine system

Pharmacies can identify patients at high risk of developing diabetes 2, atrial fibrillation (AF) and hypertension.

Screening tests in a pharmacy in Kent enabled to detect 109 new patients with hypertension and nine with AF, out of 594.

The New Medicine Service (NMS) service, which supports people with long-term conditions, has proven to reduce NHS costs and improve health gains.

An economic evaluation showed that people referred to NMS are 10% more likely to take their medicines as prescribed compared to people not referred to the service.

  1. Mental health

Pharmacists play an important role in looking after patients’ mental health, as they’re often the healthcare professionals who have the most contact with people suffering with mental health issues.

The quality criteria in the new community pharmacy national contract is for 80% of all pharmacy staff working in patient facing roles to be trained ‘Dementia Friends’.

A community pharmacy-led audit of more than 3,100 care home residents with dementia, who were prescribed antipsychotic drugs, saw antipsychotic doses reductions in 20% of residents and drug discontinuation in 17% of them.

  1. Frailty and complex case management

Discharge Medicine Use Reviews (DMRs) contribute to medicines optimisation and supports patients to understand any changes to their medicines intake.

Post-discharge MURs provide a seamless care pathway for patients who transfer from hospital to a community setting.

Referring patients who are most likely to be re admitted into hospital for an MUR on discharge reduce the risk of readmission and hospital stay.

By supporting housebound patients to make better use of their medicines, a pharmacy home medication review service in Croydon reduced emergency admissions and saved £180,000.

Pharmacists can find out their local area’s priorities via the NHS RightCare programme.

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