Journal of Pharmacy Management - Jan 2022

Journal of Pharmacy Management • Volume 38 • Issue 1 • January 2022 would incorporate the theory of self-testing, in addition to face-to-face practical demonstrations and assessments in line with national and local guidance. 5,7 We understood the challenge of delivering the practical aspect of the training programme without face-to-face clinics and therefore arranged to integrate new and forward-thinking technologies to facilitate the self-testing initiative. To overcome this, we worked closely with the Trust Transformation Project Leads to specifically discuss virtual technology, a method that was not extensively used or known in the hospital. Primary care was only starting to rapidly deploy the use of a video consultation platform in the community, and our Hospital Transformation Leads facilitated using Attend Anywhere as the preferred virtual platform, which could also integrate patient education and consultations. Attend Anywhere video consultation technology allowed us to book patients to enter a ’virtual waiting area’ before being consulted by a member of the pharmacy anticoagulation team via a secure video interface. Self-testing contracts were updated to inform patients of their responsibilities as a patient enrolled on the programme, and the duties and responsibilities of the anticoagulation clinic as the service provider. On successful completion of the virtual training programme, patients were signed off as competent to self-test and formally enrolled onto the programme, subject to a satisfactory venous comparison quality assurance check. The venous comparison involved obtaining a venous INR sample (either in community or at the clinic), on the same day as obtaining a self-testing INR. The two values were required to be within +/- 0.5 INR of each other to be deemed satisfactory, assuring both parties of the accuracy and reliability of results. This comparison also allowed an assessment of the patient’s competence to self-test and report effectively; this would need to be repeated bi-annually. Letters were subsequently sent to the patient’s GP and community pharmacy to inform them of the patient’s transition to self-testing. Results Our data shows that, of the patients that were attending the outpatient clinic for venous INR tests Self-Testing Scheme 19% DOAC Switches 26% GP/District Nurse Monitoring 6% 51% reduction in footfall Figure 2: Showing all the different initiatives contributing to reduction in footfall of patients across the Trust 8