Exploring the perceived and potential medicines optimisation role of pharmacy for young people with long-term conditions, through the case study of juvenile arthritis
Dr Nicola Gray, Green Line Consulting
Previous work by our team has shown that young people living with juvenile arthritis experience challenges with their medication. These challenges can be practical, like getting repeat prescriptions or remembering to take medicines. Young people also make difficult decisions about the benefits of taking medicines versus the side-effects that they sometimes experience. Juvenile arthritis is a condition where the medicines can be complicated, including injections and other medicines that are used in higher doses than you would normally see. The needs of a young person change as they get older. If we can give young people more support who take medicines for arthritis, we will also learn more about how we can help young people with other conditions like asthma and diabetes.
Young people and families value the care and support of their clinical team, but rarely mention pharmacists. As pharmacists are trained to give advice and support when people take medicines, it seems like a missed opportunity. Pharmacists are available both in hospitals and out in the community, and could be an accessible person to ask. They could also be a constant support while the young person changes from children’s to adults’ health services. We do not know, however, what pharmacists think they could do, both now and in the future (with more training or resources). The aim of this project is to explore the current and possible role/s of pharmacists in helping young people and families to manage their arthritis medicines.
We will take the results from our ‘Arthriting’ project with young people, and we will form discussion groups of pharmacists across the UK so that they can see what young people and parents said about medicines. These pharmacists will come from hospital and community settings, and we will ask them how they could work better together for these patients. We will ask them for ideas about what they could do – now and in the future – to help young people and their families. Different countries in the UK have different services that could meet the needs of young people, like the Chronic Medication Service (CMS) in Scotland. The CMS has a ‘high risk medicine’ service for methotrexate – one of the medicines used in juvenile arthritis. Hopefully the different countries can learn from each other.
We think that care models will be successful if they are:
- Acceptable to young people, parents and health professionals
- Deliverable in our current health service
- Responsive to the needs of young people of different ages and backgrounds
- Effective for different arthritis conditions and healthcare settings
- Offering long-term improvements in care and health
Once pharmacists have shared their ideas, we will do telephone interviews with other professionals who care for young people with arthritis – including doctors, nurses, physiotherapists, and occupational therapists – to see whether and how they think pharmacists could help. A final set of focus groups will test whether professionals think the new models of care are acceptable and viable. We will ask young people what they think of the proposals.
The project is now complete with final report published. To see more information: