P428 Pharmacist led clinic in Inflammatory Bowel Disease
Kwok, J.(1)*;Smith, J.(2);Gashau, W.(2);Shuttleworth, E.(2);
(1)Lancashire Teaching Hospitals NHS Foundation Trust, Pharmacy, Preston, United Kingdom;(2)Lancashire Teaching Hospitals NHS Foundation Trust, Gastroenterology, Preston, United Kingdom;
Only 13% of IBD teams across the UK have a specialist pharmacist within the MDT (1). Pharmacists have a crucial role in safe and effective medication prescribing and monitoring (2). Studies have shown that pharmacist led clinics are acceptable to clinicians and patients (2). At our trust we set up a pharmacist led biologic switch clinic where a specialist pharmacist counselled regarding biologic therapy switch from intravenous (IV) to subcutaneous (SC) medication and assessed disease burden at baseline and follow up. We set up thiopurine clinic where the specialist pharmacist arranges monitoring and facilitates pre-emptive switch of stable patients to shared care prescribing with the GP, in line with the national commitment of providing convenient and easy access to services. We analysed patient feedback, biologic and shared care prescribing data to assess the impact of our pharmacist-led clinics.
Patients who had been scheduled in thiopurine and biologic switch clinic were sent with questionnaires either by post or email. Both paper and electronic data were collected and analysed using Microsoft ExCel. Biologic therapy and thiopurine prescribing and monitoring databases were setup and data were captured and analysed retrospectively.
112 patients were switched from IV biologic therapy to SC therapy of which 8 patients needed to be switched back to IV due to either an adverse reaction or uncontrolled IBD. By reducing drug cost and increasing hospital CIU capacity, the biologic switch clinic has generated significant financial savings to the organisation (estimated £333,666 per annum).
In thiopurine clinic, 80 patients were identified as suitable candidates for shared care agreement with primary care. 88% patients have been successfully transferred to primary care and the remaining 12% remained under secondary care because the GP opted-out.88% of patients who had been scheduled in pharmacist led clinic were happy with the service and the remainder had a neutral opinion regarding the service (see chart). Some patients fed-back that the telephone consultation did not happen at scheduled time or they preferred face to face clinic.
Pharmacist led clinic led to significant cost savings, increased accessibility to thiopurines and was acceptable to patients. In response to patient feedback we amended our appointment letters to clarify appointment time frames and give pharmacist contact details for further patient queries. We have also set up face to face clinics for patients preferring this option.
1 Burns, Corrinne. Only 13% of IBD teams meet standards for pharmacist. London: Pharmaceutical journal, 2021
2 IBDUK. The hidden cost and a vision for change. London: Crohn's and Colitis care in the UK, 2021