Rheumatology specialist pharmacist

The role of the rheumatology pharmacist is to promote the safe and effective use of every one of the patient's medicines. Usually this means working with other members of the healthcare team to highlight areas of the patient's therapeutics which could be improved.

Pharmacists are typically able to respond to the medication related queries of patients with a range of co-morbidities such diabetes, CVD and stroke and osteoporosis. These complex patients tend to benefit from someone who can devote their time solely to their pharmaceutical care. This will usually entail detailed medication, and to a lesser extent social, family and medical histories being taken and a care plan produced. These care plans will feature interventions which serve to rationalise drug therapy by suggesting the most evidence based combinations relevant to the patient’s medical and personal needs.

The benefits to the patient include increased compliance and concordance and a strengthening of the trust relationship between prescriber and patient. Often just having an open and honest dialogue between pharmacist and patient about drug therapy can allay many patients’ fears and improve patient outcome.

Rheumatology specialist pharmacists are usually clinical pharmacists who have a range of knowledge and skills appropriate to the disease area. Many will also hold a post graduate clinical qualification giving them advanced knowledge of pharmacology and therapeutics. They are also ideal for providing a liaison service with local pharmacy teams in primary and secondary care, and can help in the production of policy documents such as Patient Group Directions and Shared Care Guidelines.

As many clinical pharmacists have experience of critical appraisal and healthcare resource utilisation, they can often prove invaluable to the team when considering the managed entry of new drugs. This usually involves the pharmacist preparing independent product evaluations for acute trust formulary/drugs and therapeutic committees.

Liaising with hospital pharmacy teams, the rheumatology pharmacist can quickly resolve supply issues and when working with primary care prescribing advisors at local PCTs, can help in the transfer of patients between primary and secondary care. Some rheumatology pharmacists are also involved in clinical research, being the named pharmacist in trial protocols, and being the first contact for medicine related trial queries.

Stewart Glaspole, Clinical Pharmacist with Special Interest in Rheumatology, Brighton and Sussex University Hospitals NHS Trust