P30
A PHARMACIST LED IMMUNUSPRESSION AND MONITORING CLINIC –IS IT A
GOOD THING?
Lamerton, E1, O’Riordan, E2
1
Pharmacy Department, 2Renal Department, Salford Royal NHS Foundation Trust
BACKGROUND: Increasing numbers of renal patients are prescribed complex
immunosuppressive drug therapy for non-transplant indications. With the support of the lead
clinician for vasculitis, a role was identified for the specialist pharmacist independent prescriber
to develop a dedicated clinic to address the specific needs of this patient group. During the
period reviewed, additional patients were also seen in the clinic for review of intolerance of cotrimoxazole. This was outside the primary remit of the clinic. A review of the number of
patients seen, number of visits and reason for attendance is presented, with qualitative
information from a survey of the consultant team.
DESIGN: 1, A retrospective review of the completed clinic episodes from the previous
36months was obtained from the electronic patient record system. A review of letters and
clinical notes was carried out on the identified patients. The information was cross referenced
with the prospective data held by the renal pharmacist to identify reasons for clinic attendance.
2, An anonymous survey was emailed to the Renal Consultants (n=12) by a pharmacy secretary.
An explanatory note ensuring responses would not be attributed to individuals accompanied the
survey. Responses (9/12) were returned and any identifying information removed before
collating and returning to the renal pharmacist.
RESULTS:
101 patients attended clinic
Primary reason for clinic attendance – education, prescribing or monitoring of:
Combination of
Cyclophosphamide Rituximab
MMF
CNI/
Other
immunosupression
azathioprine
eg
cyclophosphamide/
mycophenolate
(MMF)
18
12
6
18
4
43
CONSULTANT SATISFACTION: All consultants had referred patients to the clinic and plan
to refer more patients. 100% of reported patient feedback to the consultants was positive. The
main benefits cited were decreased risk of patient harm from drug therapy with potential
significant toxicity, rapid access, supply, education and monitoring all in one clinic, targeted
advice, and good communication and hand over to medical staff. The only negative factor
reported is the need for some patients to attend an additional clinic.
CONCLUSION: The unique clinic utilises the clinical and prescribing skills of the specialist
renal pharmacist and is positively welcomed by Consultant Medical staff. The service will be
developed further with integration into other renal clinics within the hospital. Availability of the
service to outreach patients is being considered.