Pharmacy type
Hospital
Pharmacy context
The pharmacy supplies high-risk methotrexate injections to patients who have not taken these medicines before. The pharmacy team ensure the patient fully understands how to use their new medicine. And it checks that the person is administering their medicine safely prior to issuing a further supply.
Relevant standards
- 4.2 - Pharmacy services are managed and delivered safely and effectively
Why this is notable practice
The pharmacy supplies high-risk methotrexate injections to patients who have not taken these medicines before. The pharmacy team ensure the patient fully understands how to use their new medicine. And it checks that the person is administering their medicine safely prior to issuing a further supply.
How the pharmacy did this
The pharmacy provided a methotrexate counselling service on behalf of the gastroenterology, dermatology, and rheumatology clinics within the hospital. This was a 30-minute counselling session with the pharmacist. And it was held to support people commencing methotrexate injections. The pharmacist had completed a post-graduate diploma in clinical pharmacy. He had liaised with the outpatient clinics to ensure the counselling provided was relevant. And that it covered each clinic’s expectations. The appointment provided an opportunity to ensure the patient understood how to use the medicine. And for the pharmacist to answer questions and provide any additional information required. The pharmacist used a clinic-specific checklist to ensure they covered all counselling points. And it sent the completed checklist back to the clinic for information.
The appointment took place in the pharmacy’s consultation room. The pharmacist demonstrated how to administer the injection. And the patient self-administered their first dose during the appointment with guidance and support from the pharmacist. The pharmacy supplied the patient with an initial four weeks of medicine. The patient returned to the pharmacy after this initial period for a review. If the review found no concerns, the pharmacy went on to supply a further eight weeks of medicine. Prescribing was transferred to the patient's GP following the four week review.
Patients were able to contact the pharmacy for advice. And the pharmacy acted on any problems identified within the initial four weeks. For example, a person had called the pharmacy after two weeks as they could not tolerate the weekly injections. As a result, the pharmacy had contacted the outpatient clinic and the patient was transferred to methotrexate tablets to improve their compliance.
What difference this made to patients
The pharmacy provides a detailed counselling service for a medicine which is considered to be high-risk. It uses a checklist template which helps to ensure people are receiving the same standard of counselling each time. And the pharmacy provides feedback to the outpatient clinic to allow it to follow up with patients. The pharmacy reviews patients to check they are managing with their medicine and that it appears to be working.
Highlighted standards
We have identified the standards most likely and least likely to be met in inspections, and highlighted examples of notable practice for each of these standards; to help everyone learn from others and to support continuous improvement: