Developing a post-myocardial infarction medicines optimisation clinic: core competencies for upskilling pharmacists and initial patient feedback
Background Medicines optimisation and adherence support are essential to secondary prevention after myocardial infarction (MI). Following successful implementation of a consultant pharmacist-led post-MI medicines optimisation clinic, the service was expanded by training advanced clinical pharmacists...
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BMJ Publishing Group
2023-06-01
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| Series: | BMJ Open Quality |
| Online Access: | https://bmjopenquality.bmj.com/content/12/2/e002152.full |
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| author | Rani Khatib Una Laverty Gina Mcgawley Alistair Hall Chris Pepper Ruth Price Franki Wilson |
| author_facet | Rani Khatib Una Laverty Gina Mcgawley Alistair Hall Chris Pepper Ruth Price Franki Wilson |
| author_sort | Rani Khatib |
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| description | Background Medicines optimisation and adherence support are essential to secondary prevention after myocardial infarction (MI). Following successful implementation of a consultant pharmacist-led post-MI medicines optimisation clinic, the service was expanded by training advanced clinical pharmacists to manage clinics (with appropriate multidisciplinary team support).Methods Key steps in the development process were: definition of a key competency framework based on relevant qualifications and experience, knowledge, skills and clinic management practicalities; creation and enaction of trainee-specific development plans to address gaps (including independent learning, teaching from multidisciplinary colleagues and shadowing in clinics); establishment of relevant protocols and proformas to ensure consistent standards (eg, a patient self-reporting tool for identifying adherence barriers, consultation proforma, directory of clinical parameters and pathway for onward referral when needed); phased clinic roll-out, initially under supervision; and gathering of feedback from patients and colleagues. Clinic letters from 50 attending patients were reviewed to quantify resulting interventions; the first 50 anonymously completed patient feedback questionnaires were also analysed.Results Expansion of the service initially doubled capacity. A review of clinic letters from attending patients demonstrated that various interventions were recommended, including further investigations, medication changes, lifestyle adjustments and onward referrals. Most respondents to the patient feedback questionnaire thought the clinic was patient friendly and welcoming (n=48/50; 96%); felt listened to (n=48/50; 96%); considered that adequate explanation was given (n=47/50; 94%); and felt clear plans were provided (n=45/49; 92%). Most agreed that it was valuable (n=44/50; 88%), and the mean rating was 4.48 (on a scale of 1 (very poor) to 5 (excellent)).Conclusions A person-centred post-MI medicines optimisation service was successfully delivered by appropriately trained advanced cardiology pharmacists. A structured competency framework and training programme were required, but once completed, the clinic was highly valued by patients. A similar model could be rolled out elsewhere with adaption to local requirements. |
| format | Article |
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| institution | OA Journals |
| issn | 2399-6641 |
| language | English |
| publishDate | 2023-06-01 |
| publisher | BMJ Publishing Group |
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| series | BMJ Open Quality |
| spelling | doaj-art-17450f4ee78f46cfbc430047d4c00bc12025-08-20T01:57:59ZengBMJ Publishing GroupBMJ Open Quality2399-66412023-06-0112210.1136/bmjoq-2022-002152Developing a post-myocardial infarction medicines optimisation clinic: core competencies for upskilling pharmacists and initial patient feedbackRani Khatib0Una Laverty1Gina Mcgawley2Alistair Hall3Chris Pepper4Ruth Price5Franki Wilson6associate professorPharmacy Department, Leeds Teaching Hospitals NHS Trust, Leeds, UKCardio-Respiratory Department, Leeds Teaching Hospitals NHS Trust, Leeds, UKCardio-Respiratory Department, Leeds Teaching Hospitals NHS Trust, Leeds, UKCardio-Respiratory Department, Leeds Teaching Hospitals NHS Trust, Leeds, UKCardio-Respiratory Department, Leeds Teaching Hospitals NHS Trust, Leeds, UKDepartment of Pharmacy, Leeds Teaching Hospitals NHS Trust, Leeds, UKBackground Medicines optimisation and adherence support are essential to secondary prevention after myocardial infarction (MI). Following successful implementation of a consultant pharmacist-led post-MI medicines optimisation clinic, the service was expanded by training advanced clinical pharmacists to manage clinics (with appropriate multidisciplinary team support).Methods Key steps in the development process were: definition of a key competency framework based on relevant qualifications and experience, knowledge, skills and clinic management practicalities; creation and enaction of trainee-specific development plans to address gaps (including independent learning, teaching from multidisciplinary colleagues and shadowing in clinics); establishment of relevant protocols and proformas to ensure consistent standards (eg, a patient self-reporting tool for identifying adherence barriers, consultation proforma, directory of clinical parameters and pathway for onward referral when needed); phased clinic roll-out, initially under supervision; and gathering of feedback from patients and colleagues. Clinic letters from 50 attending patients were reviewed to quantify resulting interventions; the first 50 anonymously completed patient feedback questionnaires were also analysed.Results Expansion of the service initially doubled capacity. A review of clinic letters from attending patients demonstrated that various interventions were recommended, including further investigations, medication changes, lifestyle adjustments and onward referrals. Most respondents to the patient feedback questionnaire thought the clinic was patient friendly and welcoming (n=48/50; 96%); felt listened to (n=48/50; 96%); considered that adequate explanation was given (n=47/50; 94%); and felt clear plans were provided (n=45/49; 92%). Most agreed that it was valuable (n=44/50; 88%), and the mean rating was 4.48 (on a scale of 1 (very poor) to 5 (excellent)).Conclusions A person-centred post-MI medicines optimisation service was successfully delivered by appropriately trained advanced cardiology pharmacists. A structured competency framework and training programme were required, but once completed, the clinic was highly valued by patients. A similar model could be rolled out elsewhere with adaption to local requirements.https://bmjopenquality.bmj.com/content/12/2/e002152.full |
| spellingShingle | Rani Khatib Una Laverty Gina Mcgawley Alistair Hall Chris Pepper Ruth Price Franki Wilson Developing a post-myocardial infarction medicines optimisation clinic: core competencies for upskilling pharmacists and initial patient feedback BMJ Open Quality |
| title | Developing a post-myocardial infarction medicines optimisation clinic: core competencies for upskilling pharmacists and initial patient feedback |
| title_full | Developing a post-myocardial infarction medicines optimisation clinic: core competencies for upskilling pharmacists and initial patient feedback |
| title_fullStr | Developing a post-myocardial infarction medicines optimisation clinic: core competencies for upskilling pharmacists and initial patient feedback |
| title_full_unstemmed | Developing a post-myocardial infarction medicines optimisation clinic: core competencies for upskilling pharmacists and initial patient feedback |
| title_short | Developing a post-myocardial infarction medicines optimisation clinic: core competencies for upskilling pharmacists and initial patient feedback |
| title_sort | developing a post myocardial infarction medicines optimisation clinic core competencies for upskilling pharmacists and initial patient feedback |
| url | https://bmjopenquality.bmj.com/content/12/2/e002152.full |
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