HIGH RISK MEDICINES SUPPORTING PATIENTS AND PRESCRIBERS ON

HIGH RISK MEDICINES: SUPPORTING PATIENTS AND PRESCRIBERS ON A NOVEL CLASS OF ORAL ANTICOAGULANTS #doacbooklet Cristina Coelho 1, Elaine Mc. Ivor 1, Steve Mc. Glynn 1, Yvonne Semple 2, Dr Campbell Tait 3, Dr David Murdoch 4 1 Pharmacy Services, NHS Greater Glasgow and Clyde; 2 Pharmacy, Golden Jubilee National Hospital 3 Department of Haematology, NHS Greater Glasgow and Clyde; 4 Department of Cardiology, NHS Greater Glasgow and Clyde INTRODUCTION OBJECTIVES Direct oral anticoagulants (DOACs) are a relatively new class of medicines used to prevent and treat blood clots. DOACs are considered high risk medicines due to the potential for causing a bleed. 1. To develop a DOAC patient information booklet and alert card to assist collaborative decision-making and highlight key safety messages. This is expected to support selfmanagement of patients which is a strategic priority for NHS Scotland. 2. To develop an online FAQ bulletin to aid safe prescribing and support clinicians. Unlike warfarin, DOACs do not require routine blood tests, however, they still carry a bleeding risk. In the UK, bleeding risks and signs of haemorrhage due to warfarin are highlighted to patients using a standard ‘yellow booklet’. This also includes an alert card for patients to carry to highlight their bleeding risk to healthcare professionals (HCPs). It was recognised in NHS Greater Glasgow and Clyde (NHSGGC) that there was no equivalent generic booklet or alert card for DOACs and therefore these resources were developed. METHODS • In addition to patient information, given the complexity of DOAC prescribing, the need for prescribing information for HCPs was also identified and therefore a Frequently Asked Questions (FAQ) bulletin was developed. • AIM • To develop resources to assist the safe, patient-centred use of DOACs. A multidisciplinary group including pharmacists, doctors, nurses and a patient representative was convened to develop the DOAC booklet and alert card through a series of meetings. The NHSGGC ‘CLEAR To All’ team advised on patient-friendly language and accessibility of the booklet and alert card. Evaluation of the DOAC booklet and alert card using an anonymous questionnaire is ongoing. The questionnaire is available online to all and has been distributed as a paper questionnaire to patients attending selected clinics in Primary Care and Acute Services. Development of the FAQ bulletin was led by the Pharmacy Medicines Information Team in conjunction with cardiology and haematology. RESULTS DOAC Patient Information Booklet and Alert Card FAQ Bulletin for Healthcare Professionals This resource was introduced to patients across NHSGGC via hospitals, outpatient clinics, family doctors and community pharmacies. An electronic version is available on the GGC Medicines website (http: //www. ggcmedicines. org. uk/) and by scanning the QR code above. The patient information booklet is suitable for the majority of patients on DOACs and contains information on: • How to take the medicine • How to manage missed doses • Side effects • Letting other people know • Things that may affect the medicine • Pregnancy and breast-feeding The FAQ for HCPs was developed and approved by NHSGGC Area Drug & Therapeutics Committee. It includes evidence based information, specific prescribing recommendations and case studies. It is available on the GGC Medicines website (http: //www. ggcmedicines. org. uk/) and by scanning the QR code above. Evaluation of DOAC Patient Information Booklet and Alert Card – Preliminary Results Demographics: Overall sample size: 71 respondents 42% HCPs from Acute Services; 35% HCPs from Primary Care; 7% patients; 4% HCPs from Community; 12% HCPs from other or unknown sectors ‘Very well prepared booklet. Good clear information provided. ’ Nurse, Acute Services NHS GGC Key findings: • Overall impression of the DOAC Patient Booklet (n=65): 35% excellent; 55% good; 8% not so good; 2% very poor • Opinion on whether DOAC Patient Booklet helps HCPs educating patients about DOACs (n=33): 91% yes; 3% no; 6% not sure • Opinion on whether DOAC Patient Booklet helps patients taking DOACs safely (n=36): 100% yes ‘If you take ill it lets • Patient opinion on how they find the information in the DOAC Patient Booklet (n=5): 100% easy to understand others know what ‘I think it is well laid out and a good source of information eg very specific with side effects of bleeding and when to seek help. I think it is simple to understand so a good book for patients. ’ Pharmacist, Acute Services NHS GGC you're on. So it could save your life. ’ Patient, NHS GGC CONCLUSIONS Pharmacists play a key role in the safe use of anticoagulants both from patient and prescriber perspective. Initiatives such as this empower prescribers to support a proactive role of patients in their treatment and in maintaining health. Discussions are underway with NHS Health Improvement Scotland to scope opportunities for the use of the DOAC booklet and alert card across Scotland. LET’S GET SOCIAL Twitter Facebook Email @NHSGGCMeds @UKMedicines. Info #doacbooklet NHSGGC Medicines Updates medinfo@ggc. scot. nhs. uk