Option 5 - Making insulin treatment safer: How Can Medicines Safety Be Improved?

Theme 4 asks How Can Medicines Safety Be Improved?

Since graduating with BSc Hons from Queen’s University Belfast (QUB) in 1982, Rosemary Donnelly has worked as a clinical pharmacist, completing an MPhil in 2007 and qualifying as a pharmacist prescriber in 2006. After joining the diabetes team in 2005, Rosemary set up and ran a Diabetes Cardiovascular Risk Clinic. She currently consults at weekly outpatient clinics for adults with diabetes and manages a Trust-wide Type 2 Insulin Titration Service. Rosemary regularly participates in pharmacist education for QUB and the Northern Ireland Centre for Pharmacy Learning and Development (NICPLD) and provides diabetes education for primary care teams through her involvement in Project ECHO NI. As a member of the NI Diabetes Strategy Group, Rosemary also contributes to strategic and planning decisions for diabetes management across NI. More recently, Rosemary led the ‘Making Insulin Treatment Safer in Northern Ireland’ Project which won the Royal College of Physicians Patient Safety Award in 2018.

‘Making insulin treatment safer’

The National Diabetes Inpatient Audit Reports repeatedly detail a high percentage of management and prescription errors with insulin. These events increase patient risk and lengthen hospital stay. Foundation Doctors, who undertake most prescribing, receive little support to fulfil this important role. Reports also indicate that inpatients would like to be more involved with their diabetes management. The Making Insulin Treatment Safer (MITS) initiative aims to improve the experiences of inpatients prescribed insulin, the education of the Foundation Doctors who write most of their prescriptions and the appropriateness of these prescriptions. The MITS team developed a reflective debriefing tool (SMAC²). This was used to conduct formative case-based discussions with junior doctors; encouraging them to reflect on an insulin prescribing event and subsequently make SMART commitments to improve prescribing and involve patients in their decision making.

David Thomson qualified as a pharmacist from the then Robert Gordon’s Institute of Technology in the last millennium and spent his formative years in community pharmacies across Scotland, culminating in his appointment as a Primary Care Services Manager for a large multiple covering  Scotland,  Northern Ireland and the North of England. In 1999 he was appointed Director of Pharmacy for the Primary Care Trust in NHS Greater Glasgow and continues in a similar capacity in his current role. David is a Fellow of the Royal Pharmaceutical Society and a previous recipient of the Society’s Charter Award. He is a past member of the RPS Scottish Pharmacy Board and the Assembly and immediate past Treasurer. A strong advocate for the Society, he is particularly vocal on the benefits of membership. David is proud to have been associated with Pharmacy Management for nigh on the past 20 years and continues to be actively involved through the Editorial and Scottish Boards. Above all, he is a passionate enthusiast for community pharmacy and continues to advise the Chief Pharmaceutical Officer, Scottish Government on such matters.

‘How Can Medicines Safety Be Improved?’

Medicines remain the most common intervention in a clinical situation with pharmacy involvement an endorsement of trust integral to the effectiveness of treatment. Medicines not only have the ability to improve or maintain a patient’s well-being but the power to cause significant harm if used inappropriately. The advent of more potent treatments increasingly being used in the community setting improves access to care with this trend only likely to continue. Whatever the route of supply pharmacists need to be involved in designing the package of pharmaceutical care required to optimise treatment for each individual patient that considers lifestyle, co-morbidities and risk of adverse events. It is not enough to rely on the heritage and historical legacy that pharmacy brings to the table without formally recognising the value of this as part of the developing role in a more meaningful way. This session will consider various options to support pharmacy involvement in improving medicine safety.