by Sarah Thomas, Lead Pharmacist Moorfields Eye Hospital NHS Foundation Trust
Covid-19 has caused various challenges for patients and healthcare professionals related to medicines. In particular, patient access to medicines and effective patient-pharmacy interaction to help patients use their medicines effectively.
With elective services suspended at our ophthalmic specialist hospital and medicines frequently being posted to patients seen via clinician video-consultation, the tradition of a patient having the opportunity to speak with us in person as part of their hospital appointment pathway has temporarily diminished.
At first, this lack of pharmacy contact may seem unimportant, being an unavoidable result of the pandemic, however patients need our medicines support more than ever at this time and with the rapid deployment of clinical video-consultations this is exciting time for pharmacy to transform its traditional service models and join in digital innovation. This is exactly what we have done at Moorfields and the initial results have been better than expected.
Ophthalmic medicine support
Ophthalmic medicines, namely eye drops, often get overlooked unlike say inhalers and insulins for which patients get frequent support to help them use them effectively. Eye drops however warrant a similar level of patient support as they are not always easy to use correctly. With evidence that up to 50% do not use their medicines as intended and our local data suggesting it is significantly higher in ophthalmology, supporting our patients no matter what their eye condition is essential across our profession. This will help avoid potential negative treatment outcomes, poorer quality of life, polypharmacy, more appointments, surgery, and a financial and resource burden on the NHS. So, as a medicines optimisation pharmacist, one of my primary concerns at the start of lockdown was how we can overcome the absence of our face-to-face interactions to avoid all these potential consequences.
Telemedicine – the virtual solution
Working with our digital innovation team to develop pharmacy-led clinics for pharmacists and technicians to support patients via NHS-approved safe and secure video-conferencing has been a valuable extension to our service, and one which we plan to retain through Recovery as part of our medicines optimisation strategy.
Although still in infancy and with staff still being trained, it has already enabled us to reach out and help patients who may not otherwise have been helped appropriately for a very long time. For example those physically unable to squeeze their eye drops into their eyes, effectively missing doses through losing drops down their face and running out of medicines before their repeat supply. We have also helped patients who prior to Covid-19 had relied on neighbours to open/administer their eye drops. With those neighbours isolating they have not been using their medicines at all. Being able to resolve such issues using telemedicine, improve quality of life and clinical outcomes, connecting with patients in their own home has been very a rewarding experience for the team.
Patient feedback has been overwhelmingly positive, with all patients so far saying they now feel more confident in managing their condition and medication. Patients report that they are grateful we are offering video consultations to support them with their medicines as they have been struggling at home unknowingly administering eye drops incorrectly, and say they feel more relaxed at home to speak with us than when at the busy hospital appointment.
Urge to adapt
Seeing first-hand the benefits to patient care and how the overall delivery of healthcare is changing, I’d urge all pharmacies to embrace and consider widening accessibility of your pharmacy expertise via telemedicine. Although we are a specialist ophthalmic pharmacy and had funding and digital support, the principals can certainly be adapted and there is plenty of resource and support including the RPS training. This is an exciting time for us as a profession and perhaps what has what has been most striking is not assuming age is a barrier to using technology – my first virtual patient was almost 90 with partial sight and very keen and adept at connecting via her iPad!