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PharmOutcomes Gallery

Our gallery page features published papers and peer reviewed articles evidencing the value of the role pharmacists and their teams play in both improving patient access to services and generating efficiency savings for a cash strapped NHS. There are many innovative service delivery models being commissioned across the country that see community pharmacists and their teams successfully integrated into care pathways. Pinnacle Health LLP will always seek to share examples of best practice as one of our primary aims as a social enterprise is to remove commissioning barriers and evidence the value of such integration. Please browse our gallery page to find out about what has worked well in other areas of the country and for more information on any of the featured services please contact our team on the Help tab.

Integrating Community Pharmacy Testing for Hepatitis C with Specialist Care

Clinical Pharmacist
Pharmacy-based testing has the potential to reach at-risk individuals who are not tested for HCV elsewhere. When combined with integrated specialist referral, it has the potential to reduce the burden of undiagnosed HCV and engage new diagnoses directly with specialist care.

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Electronic referral from hospital to community pharmacy

BMJ Open
Hospital pharmacy staff were able to use an information technology (IT) platform to improve the coordination of care for patients transitioning back home from hospital. Community pharmacists were able to contact the majority of patients and results indicate that patients receiving a follow-up consultation may have lower rates of readmission and shorter hospital stays. Those patients who received a community pharmacist follow-up consultation had statistically significant lower rates of readmissions and shorter hospital stays than those patients without a follow-up consultation.

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Evaluation of an NHS-funded Emergency Supply Service

BMJ Open
A total of 2485 patients were managed across 227 community pharmacies (15 December 2014 to 7 April 2015). Most patients presented on Saturdays, with increased activity over national holidays. Older age was associated with increased service use. Of the 3226 medications provided, 439 were classified as high risk. Patients found this service easy to access and were willing to access the community pharmacy in the future for medication-related issues. In the absence of this service, 50% of patients would have missed their medication(s) until they saw their doctor and a further 46% would have accessed an alternative service. The cost of National Health Service (NHS) service(s) for patients who would have accessed an alternative OOH service was estimated as 37 times that of the community pharmacy service provided.

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Early Recognition of Coeliac Disease through Community Pharmacies

International Journal of Clinical Pharmacy
This proof of concept study has shown that community pharmacies using a point of care test can effectively recognise and refer patients for confirmatory coeliac disease testing with high levels of customer and service provider satisfaction. Of the 551 individuals tested, 52 (9.4%) tested positive. 277 (50.3%) were tested for accessing irritable bowel syndrome treatment, 142 (25.8%) due to presenting for diarrhoea. The proportion of patients testing positive with different symptoms or for different treatments were similar. Of 43 customers who returned the satisfaction survey, all would recommend the service to others, believing the community pharmacy to be a suitable location.

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Reablement through Community Pharmacy after Hospital Discharge

International Journal of Pharmacy Practice (Abstract 0048)
This evaluation sought to determine whether a structured domiciliary community pharmacist review was associated with changes in numbers of admissions, hospital bed days and deaths. Community pharmacist review, as part of a reablement service, was associated with statistically significantly fewer admissions, hospital bed days and 30-day readmissions. Structured domiciliary visits by community pharmacists, targeted to patients at high risk of medication-related problems, are likely to help patients stay out of hospital.
Please Note: There are an additional four abstracts in this journal edition that utilised PharmOutcomes in their evaluations.

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National Acute Kidney Injury Audit

Specialist Pharmacy Service
This audit reports on more than 14,000 patients who visited community pharmacies across England in 2016. Hydration advice was provided to 94% of patients with urinary tract symptoms/infections. Data on prescriptions for urinary tract infections relevant to the antimicrobial resistance agenda was also collected.
The audit, linked to the prevention of acute kidney injury and recent NHS Patient Safety Alerts, was led by the NHS SPS Medicines Use and Safety Team, in collaboration with other national pharmacy organisations.

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Increasing seasonal influenza vaccination uptake using community pharmacies

International Journal of Pharmacy Practice
Eighteen community pharmacies vaccinated 2837 patients and accounted for 9.7% of all patients vaccinated on the island. The pharmacy service contributed to improved patient vaccination rates in both the over- and under-65 age groups and those vaccinated for the first time. Pharmacies vaccinated proportionately more carers and frontline health-care workers than medical practices. Patient satisfaction with the pharmacy-based service was high, with access seen as a major advantage over general medical practice. The pharmacy-based service also vaccinated patients that ordinarily would not have accessed medical services. Involvement of community pharmacies in the seasonal influenza vaccination programme can help increase vaccination rates and is associated with high levels of patient acceptability.

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Medicines Optimisation for Older People

International Journal of Pharmacy Practice
By focussing on patients over the age of 65 years with four or more medicines, community pharmacists can improve medicine adherence and patientquality of life. 441 patients completed the 6-month study period and pharmacists made 142 recommendations to prescribers, largely centred on potentially inappropriate prescribing of NSAIDs, PPIs or duplication of therapy. At follow-up, there was a significant decreasein the total numberof falls experienced and a significant increase in medicine adherence and quality of life. Cost per QALY estimates ranged from £11,885 to £32,466.

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National NSAID Audit

Specialist Pharmacy Service
In 2014 a clinical audit on NSAID safety was made available across England via the PSNC and NHS Specialist Pharmacy Service. 1,278 community pharmacies took part in the audit, reporting 16,366 patients prescribed NSAIDs. The audit identified almost 3,000 patients regularly prescribed NSAIDs without any gastro-protection; many were aged over 65 so at particular risk of gastro-intestinal damage. The majority of these patients were notified to prescribers by the pharmacy for a safety review. Inadequate prescribing of gastro-protection with NSAIDs is a common error known to cause avoidable harm. The audit illustrates how community pharmacies can help address this important safety issue.

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Perceptions of Pharmacist Access to GP Patient Records

International Journal of Pharmacy Practice (Abstract 0007)
Community pharmacists have been campaigning for access to patient general practitioner (GP) records in order to provide the safest possible care; whilst hospital pharmacists already have access to summary care records (SCR). Recently, a proof-of-concept project has been launched in which 127 pharmacies across five regions in the UK have access to the SCR. Some GPs and patients have been resistant to pharmacist access due to concerns around confidentiality, with some questioning the need for pharmacists to have access to GP records. The aim of this study was to investigate customers' willingness to allow pharmacist access to their GP record as part of a larger study investigating customer attitudes to community pharmacy.

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From Community Pharmacy to Healthy Living Pharmacy

Research in Social and Administrative Pharmacy
These data point to a largely successful introduction of the HLP program in Portsmouth and the potential for improving client health. Staff interviews suggest that adoption and sustainability of the scheme depend on achieving the right skill mix, including the introduction of healthy living champions, motivation of the entire staff team and the provision of adequate funding for services offered

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The New Medicines Service Random Controlled Trial

Nottingham University
The randomised controlled trial showed that 10 weeks after receiving the NMS consultations from their community pharmacists, patients were more likely to be taking their medicine (or had sought help from their prescriber), compared with those who received the normal service from their pharmacist. Seven in every 10 patients who received the NMS from their pharmacist took their medicine or had sought help from the prescriber, compared with six in every 10 in the control group who received the normal service. Economic modeling showed that the service could increase a patient’s length and quality of life while costing the NHS less, when compared with patients who did not receive the service.

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Evaluation of Inhaler Technique Improvement Project

Cambridge Institute for Research Education and Management
Thames Valley and Wessex Health Innovation and Education Clusters (HIECs) commissioned the Cambridge Consortium to evaluate the outcomes of anInhaler Technique Improvement Project that was undertaken across the South Central region in the period 2011-2012.

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