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Introduction to Medicines Calls for Health Advisors

Introduction to Medicines Calls for Health Advisors. NAME Medicines Information Pharmacist NAME Medicines Information Service. Timetable. Timetable. NHS Direct’s Pharmacy and Medicines Services. Why learn about Pharmacy and Medicines? Research has shown.

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Introduction to Medicines Calls for Health Advisors

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  1. Introduction to Medicines Calls for Health Advisors NAME Medicines Information Pharmacist NAME Medicines Information Service

  2. Timetable

  3. Timetable

  4. NHS Direct’s Pharmacy and Medicines Services Why learn about Pharmacy and Medicines? Research has shown • More than 40% of all answers to calls include advice about medicines • More than 6% of all calls to NHSD are for advice about medicines

  5. NHS Direct’s Pharmacy and Medicines Services Types of medicines? Where can medicines be obtained?

  6. NHS Direct’s Pharmacy and Medicines Services National Policy for Handling MedicinesNP005

  7. NHS Direct’s Pharmacy and Medicines Services

  8. Timetable

  9. What is UK Medicines Information? • UKMI- supports MI needs of NHS health professionals • ~½ million enquiries per year • 16 regional & 260 local centres • Specialist services - pregnancy, breastfeeding, liver disease, dental • Training, websites, QA, drug reviews www.ukmi.nhs.uk

  10. Staff Pharmacists Pre-registration pharmacists Secretarial support Services to NHS Direct Complex medicines calls MI skills training Quality Assurance National work Mon- Fri 9am - 8.00pm Weekends 9am – 3pm Except Bank Holidays Speed Dial 004 What is UK Medicines Information?

  11. Timetable

  12. NHS Direct’s Pharmacy and Medicines Services All calls to NHSD can be categorised as Injury, Illness or Information. ‘The purpose of CSPT is to get the patient to the right endpoint at the right time and thereby use NHS resources appropriately’ See Using CSPT Effectively e-learning tool and Using CSPT in the Call Handling Phase of Care Delivery workbook

  13. NHS Direct’s Pharmacy and Medicines Services Call Streaming and Prioritisation Tool (CSPT) • See Using CSPT Effectively e-learning tool • Questions arranged to rule out the highest level of care first and lead to lower prioritisation last • Questions support HA as they explore symptoms in a structured and consistent manner • Examples – abdominal pain, breathing, fever

  14. NHS Direct’s Pharmacy and Medicines Services Call Streaming and Prioritisation Tool (CSPT) • ‘Are you calling for Health Information?’ If ‘yes’ leads to drop down menu with five selections • Repeat prescriptions • Access to services • Medicines enquiry • Health Information • None of the above

  15. Identification and prioritisation of medicines calls All Health Information calls assigned the same priorities nationally: P4 for Health Information calls The National Health Information Queue

  16. Identification and prioritisation of medicines calls All P4 calls now subdivided into either • Medicines (M) calls or • Health Information (H) calls M calls prioritised M1, M2 or M3 H calls prioritised H1, H2 or H3 Annotating calls

  17. Identification and prioritisation of medicines calls

  18. Identification and prioritisation of medicines calls Annotating H calls

  19. NHS Direct’s Pharmacy and Medicines Services Medicines questions Health Advisors can deal with ‘ I’ve run out of my blood pressure tablets. How can I get some more?’ ‘My Dad’s oxygen cylinder is nearly empty. How do I get another one?’ ‘I’m on holiday and have forgotten my inhalers. Can you help?’ ‘I need the Morning-After Pill. Where can I get it?’ ‘I’ve run out of my contraceptive pill. What should I do?’ ‘Are there any late night pharmacies in my area?’

  20. NHS Direct’s Pharmacy and Medicines Services Examples

  21. Timetable

  22. Workshop 1 Annotating Medicines Calls

  23. Identification and prioritisation of medicines calls

  24. Timetable

  25. Timetable

  26. The National Poisons Information Service • 24 hour, UK wide clinical toxicology service for healthcare professionals • 5 Poisons Centres: Belfast, Cardiff, Birmingham, Edinburgh, Newcastle • National Number: 0844 892 0111 • Staffed by poisons information specialists, nurses, pharmacists, physicians • Information & advice on diagnosis, treatment and management of poisoning

  27. The National Poisons Information Service Previously • All potentially toxic ingestion calls were prioritised P1 and handled by Nurse Advisors But • Many calls were found to be low toxicity and did not warrant the high priority eg. Sudocrem® Now • HAs can handle calls on ingestions of low toxicity substances

  28. The National Poisons Information Service Top 10 hits on TOXBASE by NHS Direct users in 2005

  29. The National Poisons Information Service What to ask • Substance ingested? • Label information:brand, manufacturer, ingredient(s), symbol • any other information which may help assess risk • How much? • size of container or packet? • any spilt on clothes/carpet? • When? • Symptoms? • Treatment given?eg. made vomit, given drink, washed area • Age of patient? (for risk assessment)

  30. Timetable

  31. Substances of Low Toxicity by Ingestion Substances of Low Toxicity Refers to swallowing only – not inhalation, injection or skin contact See Low Toxicity poster at all workstations at NHS Direct and link on NHSD national Intranet homepage

  32. The National Poisons Information Service • Advise caller to call back if “new or worsening symptoms occur….while waiting for nurse advisor to call” • Low toxicity poster is based on those substances listed as low toxicity on Toxbase (NPIS database) • Call placed in queue which is managed by clinical supervisor – will be upgraded if appropriate. • Caller will get call back from a nurse advisor within P3 timescale in all cases Use of the Low Toxicity Poster is safe because

  33. Timetable

  34. Workshop 2 – Toxic or not?

  35. Timetable

  36. What is a medicine? • Active ingredient • Excipients e.g. bulking agents, tablet coatings, colours, flavours, stabilisers, pH adjusters. • Form e.g. tablet, capsule, suppository, injection, cream, patch, eye drops

  37. What is a medicine? Naming medicines

  38. What is a medicine? Legal classification of medicines

  39. What is a medicine? Controlled Drugs (CDs) Misuse of Drugs Act 1971 CDs are POMs with stricter controls on production, supply or possession

  40. What is a medicine? Simple analgesics (pain killers) Paracetamol Ibuprofen Aspirin Co-codamol

  41. What is a medicine? Paracetamol • Reduces pain and fever • Used for mild to moderate pain eg toothache, • headache • Side effects not usually a problem • Must not exceed recommended dose – dangerous • in overdose 10–15g (20–30 tablets) or 150 mg/kg in 24 hours can cause severe liver / renal damage and death. • Must not take with other products containing • paracetamol

  42. What is a medicine? Ibuprofen • Reduces pain, fever and inflammation • Used for mild to moderate pain eg toothache, headache, muscle pain, period pain • Side effects include: Heartburn/indigestion, stomach ulcers, stomach bleeds, allergy – rash, wheezing, breathlessness, worsening of asthma • Should not be taken if: Allergic to aspirin, stomach ulcer or previous stomach bleed, or on meds to thin the blood • Use with caution in asthma, high blood pressure

  43. What is a medicine? Aspirin • When used as a pain killer has similar effects and precautions as ibuprofen. • Must not be given to children under 16 years. • Also used at low doses to prevent heart attacks and strokes.

  44. What is a medicine? Co-analgesics Many painkillers contain a combination of more than one drug Often paracetamol + other(s) Examples: Co-codamol contains paracetamol and codeine Co-dydramol contains paracetamol and dihydrocodeine Co-proxamol contains paracetamol and dextropropoxyphene Co-codaprin contains aspirin and codeine

  45. What is a medicine? Cough and cold products Many cough and cold products contain analgesics Beechams Powders® Aspirin 600mg + caffeine 50mg Lemsip Max® Paracetamol 500mg + caffeine 25mg Nurofen Cold and Flu® Ibuprofen 200mg + Pseudoephedrine 30mg

  46. Timetable

  47. Overview of Community Pharmacy Services • No appointment necessary • 6 million people visit community pharmacies daily. • 94% of population visit at least once per year • Care can be sought on behalf of others • Role of pharmacist is as medicines expert – advise on the treatment of illness and how to take medicines

  48. Overview of Community Pharmacy Services What services do community pharmacies offer?

  49. Overview of Community Pharmacy Services

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