1. Claire Guerin and Dr Aaron J Brady
The Role of a Pharmacist Independent Prescriber on an Interventional Cardiology Ward
Claire Guerin and Dr Aaron J Brady

2. Belfast City Workhouse ~ 1840
Then
Belfast City Workhouse ~ 1840

3. ...........and now BCH Tower Block ~ 1986 University teaching hospital
900 beds
3rd largest storeyed building in Ireland

4. Introduction
Coronary heart disease is the UK's biggest killer (82,000 deaths per year)
Interventional cardiology (IC) involves interventional procedures for treatment of coronary heart disease presentations e.g. STEMI
Although treatment dictated by findings in cath lab, patients must undergo full admission procedure including accurate drug chart
To date - the role of an FY1 doctor, with a potentially limited knowledge of complicated poly-pharmacy regimens

5. Introduction
The Crown Report (1999) widely accepted as the turning point for NMP
‘...increasing the professionals authorised to prescribe....will improve services to patients, make better use of the skills of professionals & make a significant contribution to the modernisation of the NHS’
Pharmacist Independent Prescriber (PIP)
‘... a practitioner responsible for assessment of patients with undiagnosed & diagnosed conditions & for decisions about the clinical management required, including prescribing’
Experienced PIPs ideally placed to prescribe timely and accurate admission and discharge medications on an IC ward
PIPs could provide a significant contribution to accurate and timely prescribing, improving patient access to IC services

6. Aims
Quantify the contribution of the PIP with respect to in-patient prescribing and prescribing of discharge medication
Development and expansion of PIP service

7. Method Cross-sectional single cohort study
All patients admitted to interventional cardiology ward eligible for inclusion in the study
14 week data collection period (Aug-Nov 2012)

8. Results: PIP Input
15.9 (SD ±14.1) in-patient medications prescribed per day by PIP
56 discharge prescriptions prescribed
3.1 (SD ±2.96) medicines prescribed per discharge prescription
PIP prescribed antimicrobial therapy for 13 patients

9. Discussion
DoH
Key aim of NMP is to make better use of health professionals
Pharmacists represent underutilised healthcare group
Pharmacy prescribing yet to become fully embedded in routine practice (McCann et al. 2011)

10. Discussion
1st study looking at quantitative potential of a PIP in secondary care (capacity)
PIP had a significant input into patient care
Prescribed
37% of drug charts
16 medications per day
56 discharge prescriptions
Antimicrobial therapy for 13 patients

11. Discussion New pharmacist prescribing model
Pharmacist prescribing of patient drug charts on admission
Pharmacist prescribing of discharge medication
Pharmacist writing of formal GP discharge letters based on cath-lab reports
Pharmacist-led ward service ??

12. Conclusion & Future Work
Hospital pharmacy lends itself extremely well to PIP – well received by staff
Business case approved for a further 0.5 WTE PIP to further enhance the service
Further evidence is essential to realise potential of a PIP in secondary care

13. Acknowledgements
Dr Aaron Brady MPSNI
Pre-registration tutor

14. Questions?