Improving antibiotic resistance in Ghana

Contributors from Korle-Bu Teaching Hospital in Ghana: Dr Daniel Ankrah, Mark Harrison, Tony Osei, Priscilla Ekpale, Julia Selby, Jennifer Laryea, Asiwome Aggor, Frempomaa Nelson, Helena Owusu, Grace Aboagye and Agnetta Ampomah

The Commonwealth Partnerships for Antimicrobial Stewardship (CwPAMS) educates, trains and supports overseas health workers to tackle the growing challenge of antimicrobial resistance. Partnerships are running in Ghana, Tanzania, Uganda and Zambia, with the support of UK health workers including pharmacists.

Here, the Korle-Bu Teaching Hospital in Ghana – North Middlesex University Hospital NHS Trust (NMUH) partnership to explore their motivations and hopes for their project.

Read more Improving antibiotic resistance in Ghana

From community pharmacist to Medical Science Liaison

Sinead Monaghan, Medical Science Liaison, Sanofi

I graduated with a master’s degree in pharmacy from Queen’s University Belfast.I undertook my pre-registration year in a community pharmacy chain in Northern Ireland. I was employed as a pharmacist manager with the same company post pre-registration year. I spent a further four years as a community pharmacist.

I thoroughly enjoyed this role, especially being a pharmacist tutor. This very much sparked my interest in training others. I had always been curious about alternative pharmacist roles, but felt my knowledge of career paths was limited.

Read more From community pharmacist to Medical Science Liaison

Professional Standards – committing to change and improvement

By Suzanne Scott-Thomas, Chair of RPS in Wales

Professional standards are central to improving practice, creating a more responsive service for our patients and increasing efficiencies.

Part two of this blog on the value of professional standards highlights another example of how using the RPS Hospital Pharmacy Standards has helped reshape a service, along with tips on creating change and improvement.

Read more Professional Standards – committing to change and improvement

Improving care with professional standards

by Suzanne Scott-Thomas, Chair of RPS in Wales

As pharmacists, we need to know that the services we provide are effective, safe, and efficient. This way we can make sure patients are getting the care they need and deserve. We also need to know that the services are continuing to meet the requirements of an ever-changing healthcare environment.

Read more Improving care with professional standards

Social prescribing – linking patients with support

by Hemant Patel FRPharms, English Pharmacy Board member

Today is Social Prescribing Day. So, what is social prescribing?

Social prescribing enables GPs, pharmacists, nurses and other primary care professionals to refer people to a range of local, non-clinical services via a link worker.

Social prescribing schemes can involve a variety of activities which are typically provided by voluntary and community sector organisations. Examples include volunteering, arts activities, group learning, gardening, befriending, cookery, healthy eating advice and a range of sports.

Link workers give people time and focus on what matters to the person, and as part of their care, connect people to community groups and agencies for practical and emotional support.  With the recent publication of the NHS Long Term Plan and personalised care being marked as a priority, the NHS has promised to support at least 900,000 people to benefit from social prescribing by 2023. Pharmacists have a role to play here. Read more Social prescribing – linking patients with support

Biosimilar adalimumab is a test of shared decision making in the NHS

Co-written by the National Rheumatoid Arthritis Society, National Ankylosing Spondylitis Society, RNIB, Birdshot Uveitis Society, Psoriasis Association and Crohn’s & Colitis UK

The entry of new biosimilars and the creation of an NHS ‘local market of treatment options’ will see significant numbers of patients switched from the originator product, Humira, to one of four biosimilar alternatives this year.

Adalimumab is one of several biological drugs used in the treatment of autoimmune inflammatory diseases, including rheumatoid arthritis, ankylosing spondylitis, psoriasis, psoriatic arthritis, non-infectious posterior uveitis, Crohn’s and colitis.

While some patients will take this in their stride, for others the change will be met with feelings of apprehension. Read more Biosimilar adalimumab is a test of shared decision making in the NHS

Making a difference to mental health patients

By Caroline Dada, Lead Pharmacist for Community Services, Gender Identity & Medication Safety Officer

Mental health treatment has been transformed in the last 20 years leading to a significant reduction in the number of inpatient beds. The treatment of mental health is unrecognisable from the asylums of old, thank goodness!

This transformation has led to a major shift in care provision, with many patients with mental health problems being seen by the GP with limited specialist input. GPs have raised concerns about this change, reporting a need for increased knowledge and competence and improved co-operation between primary and secondary care. Patients are also concerned, with 22% reporting they needed more specialist input1. Read more Making a difference to mental health patients

Putting antimicrobial stewardship in a global context

By Diane Ashiru-Oredope, Global AMR lead, Commonwealth Pharmacists Association

The independent Review on Antimicrobial Resistance estimated that at least 700,000 deaths each year globally are attributable to drug resistance infections such as bacterial infections, malaria and HIV/AIDS. Unless action is taken, it is thought the burden of deaths from AMR could balloon to 10 million lives each year by 2050 and cost the global economy up to $100 trillion US Dollars.

To help address this, the Department of Health, through the Fleming Fund, has just launched the new Commonwealth Partnerships for Antimicrobial Stewardship (CwPAMS) scheme. This pioneering pharmacy-led initiative will send up to 12 volunteer teams of NHS pharmacists and specialist nurses to Ghana, Tanzania, Uganda and Zambia to work with local health workers to jointly tackle AMR. The scheme is now open for applications.

CwPAMS will help improve the detection and monitoring of resistant infections at the hospital level, take measures to reduce infection and put in place steps to use antibiotics effectively – all of which will help to keep antibiotics working better for longer whilst helping to stop the emergence of superbugs. The scheme is being led by The Tropical Health Education Trust and the Commonwealth Pharmacists’ Association (CPA) and is looking for multi-disciplinary approaches that involve pharmacy.

How will CwPAMS build capacity in AMS?

The CwPAMS programme will apply skills and knowledge from UK pharmacists to support capacity building for AMS in partner institutions. One important aspect of this is improving monitoring of antimicrobial consumption.

Robust monitoring mechanisms are required to help make informed decisions on where to focus efforts to reduce unnecessary use of antimicrobials, and assess the impact initiatives are having. Whilst monitoring both antimicrobial consumption is included in all national action plans on AMR, the capacity to implement this in most low and middle income countries is low. Enhancing monitoring capacity for AMS can also support building wider systems capacity and enable more effective stock control.

How will the CwPAMS scheme benefit pharmacists in the NHS?

There are important benefits for NHS pharmacists not to overlook when considering whether to apply, including:

  • opportunities to develop frugal yet innovative solutions to share with the UK 11/9/2018
  • improved leadership capacity
  • increased job satisfaction
  • improved understanding of digital technology in health
  • greater understanding and experience of working with limited resources and appreciation of the cost of resources within the NHS
  • opportunities for professional development.

How can you get involved and what support is available?

CPA are encouraging pharmacists to apply for this new and exciting opportunity. We recognise applying for grants can seem daunting to those not well immersed in doing so; the RPS are able to offer a range of valuable support in preparing applications. Contact the RPS Research Support Service or email research@rpharms.com.

CPA & THET will also be providing training for those who are awarded grants. To find out more visit the CPA website which includes access to the grant call documents. The grant call closes on 4 January. You can also email the CPA team directly via amr@commonwealthpharmacy.org.

 

Pharmacy breakthroughs in mental health treatment

By Julie Wakefield, RPS Museum volunteer

From the 1950s onwards there have been significant breakthroughs in the medicines used to treat mental health problems.

In the early 1900s the drugs used in psychiatry were the ‘chemical straightjackets’ such as opiates, bromides, and barbiturates that simply sedated patients.

This all changed in the 1950s with the introduction of chlorpromazine for psychosis, lithium for bipolar disorder, and imipramine for depression.

It began a pharmacological revolution because it demonstrated that drugs, not just psychotherapy, could restore mental health.

Antidepressants

Imipramine was the first of a class of drugs called ‘tricyclic’ antidepressants. In 1955, researchers gave it to 40 depressed patients. The results were dramatically successful. The pharmaceutical firm Geigy had produced the first drug in the history of psychiatry that acted specifically against depression.

Since then many more of these drugs have been developed, with varying side effects. However, imipramine is still considered by many psychiatrists to be the gold standard of antidepressant therapy.

Antipsychotics for Schizophrenia

Many pharmacy historians have regarded chlorpromazine as the single most important drug in the history of psychiatry. Chlorpromazine treated the symptoms of schizophrenic psychosis with less sedation than previous drugs.

A trial on 38 psychotic patients in the early 1950s showed that it could not only calm the patient but also treat a whole range of their symptoms. These included hallucination, delusions, confusion, anxiety states and insomnia.

Chlorpromazine was the first of a class of drugs called ‘typical’ antipsychotics for schizophrenia. A dopamine antagonist, it works by blocking the uptake in the brain of excessive levels of the neurotransmitter (a chemical that helps transmit signals in the brain) dopamine, believed to partly cause the symptoms of schizophrenic psychosis.

Bipolar Disorder

Just as chlorpromazine brought relief to sufferers of schizophrenia, lithium carbonate, launched in 1954, became the ‘gold standard’ treatment for bipolar disorder. Lithium is a mood stabiliser used in the prevention and treatment of mania associated with bipolar disorder (manic depression).It is still the most common treatment today as it both treats and prevents mood disorders.

The pharmaceutical treatment of mental health in 2018

However despite the significant developments in psychiatric medication over the last 70 years, many patients with mental health problems are still not receiving a high enough standard of care.

As part of its mental health campaign, the Royal Pharmaceutical Society is exploring how pharmacy teams can help improve the physical health of people with mental health problems.  People with mental health problems often have more difficulty accessing healthcare than others and the life expectancy of those with a serious mental illness is 15-20 years less than average.

A key part of improving this is ensuring patients get the best outcomes from their medicines, so reducing adverse events, minimising avoidable harm and unplanned admissions to hospital, while using resources more efficiently to deliver the standard of care that people with mental health problems deserve.

How pharmacists can support older people with mental health issues: a personal view

By Dr Amanda Thompsell, Chair of the Faculty of Old Age Psychiatry of the Royal College of Psychiatrists

Having met with members of the Royal Pharmaceutical Society to talk about their mental health campaign it made me reflect on the many ways that pharmacists support older people with mental health issues.

Not only do pharmacists give helpful advice around reducing unnecessary medications, on side effects and potential drug interactions and ways to improve adherence, but pharmacists help in so many other ways that can go unnoticed. Read more How pharmacists can support older people with mental health issues: a personal view