Care using Chronic Medication Service

The key intervention within the chronic medication service is the pharmaceutical care planning process. Pharmacists are expected to undertake an initial risk assessment and patient profile within three months of a patient registering.

The patient profile contains five sections:

  • General Health
  • Medical Conditions
  • Allergies and Sensitivities
  • Patient Factors

Completing the risk assessment and patient profile allows you to identify those patients who have sub-optimal therapeutic management, side effects or poor compliance. Any patient identified should be prioritised for further pharmaceutical care planning.

Pharmaceutical Care Planning involves three stages and concludes in the generation of a patient specific care plan. Within the Pharmacy Care Record (PCR) there are now support tools to facilitate CMS interventions. These look at New and High Risk medicines and are explained in greater detail elsewhere on this website.

Care Plan Steps

Step 1: Identifying Pharmaceutical Care Needs and Issues

This step supports:

  • Judging a patient’s understanding of their condition and if they know what each of their medicines are for
  • Identify any unresolved pharmaceutical care needs and issues which you wish to address

At the end of the process you will identify:

  • Product Specific Needs e.g. identifying the need for an additional or alternative medicine
  • Service Specific Needs e.g. providing patient counselling and advice
  • Patient Factors e.g. age or relevant medical problems
  • Medication Risk Factors e.g. reduced renal clearance

Step 2: Formulating the Pharmaceutical Care Plan

This step supports:

  • Prioritising Pharmaceutical Care Issues
  • Identify any desired outcomes
  • Propose any necessary actions required to address the issues
  • Document the issues, outcomes and actions in a pharmaceutical care plan

Any desired outcomes and proposed actions should be agreed with your patient and where appropriate supported by other practitioners. Documentation of the pharmaceutical care plan and patient profile will be done using the web-based Pharmacy Care Record (PCR). The care plan will form the basis of ongoing monitoring and review of the patient to ensure the issues identified are auctioned.

Step 3: Implementing, Monitoring and Reviewing the Pharmaceutical Care Plan

This step supports:

  • Implementation of the Care Plan for the patient
  • Monitoring Progress towards each of the outcomes identified
  • Reviewing the Care Plan

Pharmacists will be expected to monitor and review the care plan on an ongoing basis. Implementation might be counselling the patient, ensuring they have their medication monitored appropriately or referring to the GP due to a loss of symptom control if required. Pharmaceutical Care planning is a dynamic process and it is important that regular review of the care plan is undertaken.

NES Pharmacy Support

NES have a programme of resources that can be accessed to support frontline care. This can be accessed via their website and portal system.