NHS Fife Pharmacy 30:Layout 1 - Community Pharmacy
NHS Fife Pharmacy 30:Layout 1 - Community Pharmacy
NHS Fife Pharmacy 30:Layout 1 - Community Pharmacy
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Remember the 999F5 Code!<br />
Please remember that Nicotine is one of the items under the public health service being captured on the urgent<br />
supply forms CP(US). Traditionally data captured on these forms is linked to the GP practice; however the items<br />
under the Public Health Service (Nicotine, Levonorgestrel and Azithromycin), are not to go against GP practices.<br />
To this end, ISD has set up a ‘dummy’ code for each health board so that data can be captured and reported on.<br />
The code for <strong>NHS</strong> <strong>Fife</strong> is 999F5. This should be applied to all relevant CP(US) forms with immediate effect. The<br />
code should be used by all community pharmacy colleagues, including locum and relief pharmacists.<br />
Nicorette Invisi Patch® - a New 16-<br />
hour Transdermal Nicotine Patch<br />
Earlier this year, Nicorette Invisi Patch® was launched.<br />
This 16-hour transdermal nicotine patch comes in three<br />
different strengths, 25mg, 15mg and 10mg. The Invisi<br />
Patch® is semi-transparent and smaller than the original<br />
Nicorette® patches. See below the recommended<br />
dosage regimen for the Invisi Patch®:<br />
Dose Regimen<br />
Duration<br />
Nicorette Invisi<br />
Step 1<br />
First 8 weeks<br />
Patch® 25mg<br />
Nicorette Invisi<br />
Step 2<br />
Next 2 weeks<br />
Patch®15mg<br />
Nicorette Invisi<br />
Step 3<br />
Last 2 weeks<br />
Patch® 10mg<br />
It is intended that the Invisi Patch® is worn through the<br />
waking hours (approximately 16 hours) being applied<br />
on waking and removed at bedtime. Those who<br />
experience excessive side effects with the 25mg Invisi<br />
Patch® which does not resolve within a few days should<br />
change to the 15mg Invisi Patch®. This should be<br />
continued for the remainder of the 8 weeks and then<br />
stepped down.<br />
For full prescribing information on Nicorette Invisi<br />
Patch® products see www.emc.medicines.org.uk/ for<br />
the summary of product characteristics.<br />
The original Nicorette ® patches (15mg, 10mg and<br />
5mg) remain available. Clients started on the Invisi<br />
Patch® should be continued on this version as the Invisi<br />
Patch® is not interchangeable with the original<br />
Nicorette® Patches.<br />
VOUCHER SCHEME USERS - Until such times as the<br />
vouchers can be reprinted please write clearly on the<br />
voucher “Nicorette Invisi Patch® “, where the client<br />
should be dispensed the Invisi Patch®.<br />
4 If you require this newsletter in alternative formats, please telephone 01383 565375.
HEAT TARGETS • VOUCHER SCHEME • COMPETITION WINNER • TOBACCO ISSUES CONFERENCE<br />
ISSUE <strong>30</strong><br />
<strong>Fife</strong> <strong>Pharmacy</strong> News<br />
JUNE/JULY 2009<br />
Note from the Editor<br />
Welcome to the latest edition of <strong>Fife</strong> <strong>Pharmacy</strong> News! In this issue, we’ve decided to focus on the importance of the stop smoking service<br />
within <strong>Fife</strong>, and the huge role that pharmacy services plays in supporting those who choose to stop . I hope you’ll find this special edition<br />
an interesting and informative read!<br />
Fiona Forsyth, Communications Officer<br />
<strong>Fife</strong>’s HEAT Targets –<br />
How is it going?<br />
BACKGROUND<br />
The Scottish Cabinet Secretary for Health and Wellbeing is<br />
responsible for all Scotland’s Health Boards. To help <strong>NHS</strong> Scotland<br />
deliver key objectives as determined by the Cabinet Secretary, all<br />
health boards are monitored against a set of objectives and measures<br />
called HEAT Targets. These are divided into four areas; Health<br />
Improvement, Efficiency and Governance, Access to Services and<br />
Treatment. Smoking Cessation is part of the Health Improvement<br />
category, where the key objective, through stop smoking services is<br />
to reduce adult (16+) smoking rates from 26.5% (2004) to 22%<br />
(2010). In <strong>Fife</strong>, the target is to support 8% of the smoking<br />
population in successfully quitting (one month post quit).<br />
PHARMACY’S ROLE<br />
The Public Health Service element of the <strong>Pharmacy</strong> Contract aims to<br />
ensure as many smokers as possible are offered support to stop<br />
smoking through a <strong>Community</strong> <strong>Pharmacy</strong> Smoking Cessation<br />
Service. Smoking affects the health of everyone and despite the<br />
2008 ban on smoking in public places, there are still moderately high<br />
levels of smoking throughout <strong>Fife</strong>.<br />
WHERE ARE WE?<br />
Over the last eight years there has been a reduction in smoking rates.<br />
In Scotland, this has reduced from nearly 25% to 20%.<br />
Collaboration between <strong>Community</strong> <strong>Pharmacy</strong>, Primary Care<br />
Development Pharmacists, <strong>Fife</strong>’s Smoking Cessation Service and<br />
associated specialist workers means we are able to identify ways to<br />
resolve issues and provide the appropriate support. This aids in the<br />
improvement of both activity levels and data capture and keeps us<br />
moving in the right direction to help achieve the targets.<br />
STOP SMOKING – <strong>NHS</strong> STATISTICS<br />
This is the third annual release of statistics from the national smoking<br />
cessation monitoring in Scotland, covering the 2008 calendar year.<br />
Information is taken from the agreed national minimum dataset for<br />
smoking cessation services (developed by PATH, part of ASH<br />
Scotland), following consultation with services and others and is<br />
based on 'quit attempts' made during the year.<br />
WHO’S GIVING UP?<br />
(Scotland)<br />
• 4.8% of the smoking population made a quit attempt<br />
• 60% of quit attempts were by females and 40% males<br />
• 80% of quit attempts were from people living in urban<br />
areas and 12% rural areas<br />
• 1733 quit attempts were made by pregnant women<br />
• 70% of quit attempts involved the use of NRT<br />
WHERE ARE WE GIVING UP?<br />
Quit attempts made in <strong>Pharmacy</strong> Services and in Non- <strong>Pharmacy</strong><br />
<strong>NHS</strong> Cessation Services (2008)<br />
<strong>NHS</strong> Board <strong>Pharmacy</strong> Non-pharmacy<br />
<strong>Fife</strong> 18% 92%<br />
HOW ARE WE GIVING UP?<br />
Percentage of quit attempts made by pharmacotherapy (2008)<br />
<strong>NHS</strong> Board NRT Varenicline Bupropion<br />
<strong>Fife</strong> 58% 34% 0%<br />
Scotland 70% 17% 0%<br />
If you would like to submit an article or make any suggestions to <strong>Fife</strong> <strong>Pharmacy</strong> News, please contact :<br />
Fiona Forsyth, Communications Officer, <strong>NHS</strong> <strong>Fife</strong>, <strong>Pharmacy</strong> Services<br />
Pentland House, Lynebank Hospital, Halbeath Road, Dunfermline, <strong>Fife</strong>, KY11 4UW<br />
Tel: 01383 565375
No Butts! –<br />
John’s the Winner<br />
One lucky winner has been<br />
chosen from the recent<br />
competition to name the new <strong>Fife</strong><br />
<strong>Pharmacy</strong> Smoking Cessation<br />
Service. The competition<br />
attracted a good number of<br />
entries from <strong>Pharmacy</strong> staff<br />
throughout <strong>Fife</strong>.<br />
The panel of judges from <strong>Fife</strong>’s<br />
Smoking Cessation Service and<br />
<strong>Fife</strong> <strong>Pharmacy</strong> decided that “No<br />
Butts – Ask your Pharmacist!”<br />
was the most appropriate name for the service.<br />
Many suggestions were received and in the end the winner, John<br />
Thompson, <strong>Pharmacy</strong> Manager from Lindsay and Gilmour<br />
<strong>Pharmacy</strong> in Inverkeithing was chosen for his creative and<br />
informative entry. John received a voucher for a meal for two for<br />
his efforts.<br />
To explain the reasoning behind the name, John said, “I put lots<br />
of thought into my entry and tried to use some psychology too!<br />
Stopping smoking can be really difficult so hopefully, our service<br />
will help people to be less afraid to ask their local pharmacy for<br />
help and advice to stop smoking.”<br />
Combination NRT –<br />
The Benefits<br />
Nicotine replacement therapy (NRT) medications are well known<br />
to provide effective treatment for tobacco dependence.<br />
However, there is now strengthening evidence which<br />
demonstrates that to further improve the value of NRT it is<br />
possible to combine one medication providing passive nicotine<br />
delivery (e.g. transdermal patch) with another medication that<br />
allows nicotine delivery at the patient’s discretion (e.g. gum,<br />
inhaler).<br />
Combining NRT medications not only fulfills the smoker’s<br />
requirement for an effective, slow delivery method which helps<br />
achieve a constant concentration of nicotine, but also reacts to<br />
breakthrough cravings and withdrawal symptoms by providing a<br />
fast acting preparation which can be taken on demand for<br />
immediate relief.<br />
Combination NRT therefore, has huge potential to provide<br />
effective treatment for tobacco dependence in difficult to<br />
manage patients.<br />
And a New Logo too!<br />
In addition to our<br />
new name, “No Butts<br />
– Ask your<br />
Pharmacist!” We also<br />
have a new logo for<br />
our service. Look out<br />
for it in the coming<br />
months to help<br />
highlight the<br />
<strong>Pharmacy</strong> service.<br />
<strong>Fife</strong> Tobacco Issues Conference<br />
Pittencreiff Park in Dunfermline was the venue for <strong>Fife</strong>’s Tobacco Issues<br />
Conference on 27 May 2009. Promoting Excellence through Alliance was the<br />
theme where various organisations with an interest in reducing tobacco use<br />
came together. This year’s conference was held in an attempt to influence the<br />
development of local activities involving parents, schools and the local<br />
community in education programmes for young people, promotion of smoke<br />
free homes, reducing under age tobacco sales and further developing stop<br />
smoking support.<br />
Dr Mike Roworth, Public Health Consultant, <strong>NHS</strong> <strong>Fife</strong> opened the conference<br />
which began with an<br />
informative look at the national<br />
picture from Mary Cuthbert,<br />
Tobacco Control Division –<br />
Scottish Government. Smoking<br />
Cessation Support within<br />
Scottish workplaces was<br />
presented by Nina Torbett from<br />
the Centre for Healthy Working<br />
Lives, and Heather Sloan from<br />
the Renfrewshire CHP Health<br />
Improvement Team gave an<br />
insightful presentation on<br />
methods and approaches to<br />
encourage engagement.<br />
Pupils from Kirkland High School at the <strong>Fife</strong> <strong>Pharmacy</strong><br />
stand attending the conference<br />
The conference also included information on local enforcement issues, given<br />
by Geoff Bates, <strong>Fife</strong> Council Trading Standards as well as an overview of<br />
Alliance Working from Janet Wilson, the Local Alliance Officer from ASH<br />
Scotland.<br />
Workshop sessions took place during the event; Smoke Free Homes and Zones<br />
led by Kay Samson, Tobacco Issues Co-ordinator and Julie Lennox from FMR<br />
Research, as well as Current Local Provision: Successes and Challenges, led by<br />
Mike Roworth, Andrea Smith, Development Pharmacist and the Quit 4 Life<br />
<strong>Community</strong> Midwives. Prevention and Young People, led by Emma Cepok<br />
and Brian Pringle from ASH Scotland, Engagement; the 3Rs (Reach,<br />
Recruitment, Retention) with Belinda Morgan from Board's PFPI Team and,<br />
Stop Smoking in the Workplace led by Nina Torbett from the Centre for<br />
Healthy Working Lives, supported by Katie Provan.<br />
Delegates came together from a diverse list of organisations including; <strong>NHS</strong><br />
<strong>Fife</strong>, <strong>Fife</strong> Council, Richmond<br />
Fellowship, Kirkland High School,<br />
Coal Industry Social Welfare<br />
Organisation and CVS <strong>Fife</strong>.<br />
The Speakers at the conference: Mary Cuthbert (Tobacco<br />
Control Division – Scottish Government), Nina Torbett<br />
(Centre for Healthy Working Lives), Heather Sloan<br />
(Renfrewshire CHP Health Improvement Team), Janet Wilson<br />
(ASH Scotland), Dr Mike Roworth (Public Health Consultant,<br />
<strong>NHS</strong> <strong>Fife</strong>), Geoff Bates (<strong>Fife</strong> Council Trading Standards) and<br />
Kay Samson (Tobacco Issues Co-ordinator, <strong>NHS</strong> <strong>Fife</strong>)<br />
Throughout the day, poster<br />
presentations were on display<br />
highlighting valuable<br />
information and the various<br />
services (including <strong>Fife</strong><br />
<strong>Pharmacy</strong>) dedicated to<br />
providing stop smoking<br />
support. Feedback from the<br />
conference has been very<br />
positive.<br />
2
<strong>Fife</strong> <strong>Pharmacy</strong> Voucher Scheme<br />
<strong>Community</strong> Midwife’s<br />
Perspective<br />
Quit 4 Life is a specialist midwife led service which offers support<br />
and advice to pregnant smokers. The midwives who provide this<br />
service, Pamela Galloway and Helen Lowrie have undertaken<br />
specialist training and provide one to one support in clients’ own<br />
homes throughout <strong>Fife</strong>. <strong>Fife</strong> <strong>Pharmacy</strong> News met with Pamela<br />
Galloway, who supports North East <strong>Fife</strong> and the Kirkcaldy and<br />
Levenmouth areas, to find out how the <strong>Fife</strong> Voucher scheme helps<br />
in this challenging role.<br />
Pregnant women can<br />
be referred to the<br />
service by GP’s, Health<br />
Visitors, Midwives,<br />
Dentists, Pharmacists<br />
or any other health<br />
professional. Women<br />
can also self refer. On<br />
average, the service<br />
receives between 40<br />
and 50 referrals each<br />
month, the majority<br />
of these come from community and clinic midwives.<br />
Approximately 2% of referrals are received from GPs, with a further<br />
2% from Health Visitors.<br />
Vouchers are designed for healthcare workers who are unable to<br />
prescribe medicines, and by using the <strong>Fife</strong> the voucher scheme,<br />
Pamela feels that the service has been streamlined. After an initial<br />
consultation, clients can take the voucher straight to their local<br />
pharmacy to receive the most appropriate NRT product quickly and<br />
efficiently. Pamela explains, “Many pregnant women who smoke<br />
feel self-conscious and are afraid they will be judged. Using the<br />
voucher provides a fast and easy way for them to obtain NRT”.<br />
The voucher scheme means that both Pamela and Helen have<br />
responsibility for prescribing NRT. This saves time and helps to<br />
ease the pressures on GPs and community pharmacy staff.<br />
Vouchers speed up the client journey as clients can go straight to<br />
the pharmacy, with no need for a visit to their GP.<br />
Pamela Galloway and Helen Lowrie, <strong>Community</strong> Midwives<br />
Pamela says, “Our service also provides a way to help other<br />
smokers living within the pregnant women’s household. It’s a<br />
useful way of signposting partners and relatives to gain help and<br />
potentially stop smoking too!”.<br />
… And on to<br />
<strong>Community</strong> <strong>Pharmacy</strong><br />
After the voucher has been completed by the Smoking Cessation<br />
Midwives, it is usually taken to the client’s local community<br />
pharmacy. <strong>Fife</strong> <strong>Pharmacy</strong> News caught up with the team at<br />
McIntyre’s <strong>Pharmacy</strong> in Glenrothes to track the final part of the<br />
voucher’s progress.<br />
The voucher scheme differs from the community pharmacy<br />
smoking cessation programme in that it allows the pharmacy to<br />
dispense NRT products safe in the knowledge that the recipient has<br />
already received the support, advice and encouragement required<br />
to help them stop smoking. Should any problems occur or if the<br />
client’s requirements are not straightforward, the voucher always<br />
includes a reference point and contact telephone number staff can<br />
call for assistance. Vouchers come to the pharmacy via a variety of<br />
routes such as GP surgeries and local smoking cessation schemes as<br />
well as from the <strong>Community</strong> Midwife service.<br />
Bernadette Brown,<br />
Locum Pharmacist with<br />
McIntyres says, “This is<br />
an excellent scheme in<br />
which community<br />
pharmacies are part of<br />
the bigger picture”.<br />
These sentiments are<br />
echoed by Susan<br />
Dallas and Wendy<br />
Mitchell, <strong>Pharmacy</strong><br />
Technicians who lead<br />
the pharmacy’s smoking cessation service. “The vouchers offer<br />
flexibility, choice and ease of use and allow us to help even more<br />
people to stop smoking”, explains Wendy.<br />
The team at McIntyre’s <strong>Pharmacy</strong>, Glenrothes<br />
Listen Up! …… Local Radio to help <strong>Fife</strong> Stop Smoking<br />
<strong>Fife</strong> <strong>Pharmacy</strong> has teamed up with <strong>Fife</strong>’s leading commercial radio network, Kingdom FM to launch a<br />
unique local radio campaign, encouraging people to find out what’s on offer from their local community<br />
pharmacy.<br />
The campaign will run across <strong>Fife</strong> and reach approximately 42,000 listeners each week over a twelveweek<br />
period from mid August 2009.<br />
The campaign will include four areas of community pharmacy services;<br />
Minor Ailment Service, Healthy Living, General medicines information as well as Stop Smoking Advice.<br />
Each area will be highlighted by a short but informative series of statements, broadcast throughout the<br />
day for the campaign duration. Hopefully the stop smoking message will encourage more listeners to<br />
use their local pharmacy to gain the advice and support they need to help them stop smoking!<br />
3