Masters of Clinical Research (MClinRes) at the University of Manchester

Vanessa Reid, The University of Manchester

The evidence that pharmacists improve adherence, make treatment interventions that would otherwise lead to patient harm and improve patient disease is proven but there is much resistance from secondary care to invest in specialist pharmacists in an outpatient clinic setting as we are more expensive to employ as band 7/8a pharmacists than specialist nurses band 6/7. There is very little evidence to show what a pharmacist brings to the outpatient clinic setting over a specialist nurse and so hospital trusts are very reluctant to invest in more specialist clinical pharmacists when there are cheaper specialist nurses that they can be employed in those roles. I want to try and prove that pharmacists are more valuable than nurses at drug education when a patient is initiated on treatment, which can improve a patient’s understanding of the new treatment they are starting and hence improve adherence to that treatment.

I want to also show how pharmacists and specialist nurses can work in combination to use the best of their skills to improve patient’s adherence to treatment in long term conditions such as in rheumatology. I hope to highlight that each clinical pharmacist has a unique skill set that when used in combination along with physicians can greatly improve the multi-disciplinary approach to treating long term conditions.

The overall aim of the project is to provide evidence that pharmacists are a necessary component along with clinicians and specialist nurses in the long-term management of patients with long term conditions to provide adherence to treatment and better long-term outcomes.

Specifically, we aim to see if there is any difference in the DMARD education and counselling that is provided by a rheumatology specialist nurse and rheumatology specialist pharmacist in a DMARD initiation clinic.

Objectives include:

  1. To follow-up how the Methotrexate adherence project has affected the patient education where a standardised patient training tool exists and, if there is a difference between nurses and a pharmacist when using the standardised patient training tool.
  2. To identify if there are specific areas of DMARD counselling other than methotrexate that is different between nurses and a pharmacist where, there is no standardised patient training tool available. This will provide the evidence to provide onward training to either party if necessary.
  3. To explore patient satisfaction with a non-clinician led general DMARD education service by using a modified version of the Leeds Satisfaction Questionnaire.

To explore whether there is a difference in patient satisfaction when patients are provided with DMARD education by a nurse or a pharmacist using a modified version of the Leeds Satisfaction Questionnaire.

This project is running from 01/09/2019 and is due to finish on 30/06/2021