P580 Benchmarking IBD Pharmacy Services to optimise, strengthen and align IBD Expert Pharmacy Practice
St Clair Jones, A.(1);Meade, U.(2);
(1)Brighton and Sussex University Hospitals, Department of Gastroenterology- Department of Pharmacy, Brighton, United Kingdom;(2)St.Mark, Pharmacy, London, United Kingdom; IBDUK
Background
UK IBD Standards 2019 (ibduk.org) for the first time embed and describe Specialist Pharmacy Services (SPS) as an integral part of the IBD multidisciplinary team (MDT) and enable recognition and commissioning of Expert Pharmacists in IBD (EPharmIBD). The Benchmarking Tool, comprised of the IBD Patient Survey and Service Self-Assessment 2019/2020 provides a benchmark of expert pharmacy practice.
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Methods
The Benchmarking Tool developed by IBD UK to drive quality defines A-D descriptors for all IBD standards (A=‘excellent, proactive’ to D=‘minimal, inadequate’ care). Descriptors for 4 (7%) standards describing SPS were developed through an e-Delphi process by IBD UK with EPharmIBD representation. Royal Pharmaceutical Society standards and SPS feedback were used to define descriptors for leadership, medicines expert role and MDT working. All UK IBD services were asked to complete the self-assessment between Oct 2019 and Jan 2020.
Results
10,222 IBD patients complete the IBD Patient Survey
166 (72%) paediatric and adult IBD services took part across the UK.
MDT Standard: 46% (n=81/166) of all IBD Services have pharmacist input to the IBD MDT, but only 13% of all adult services (n = 18/134) met or exceeded the standard for 0.6 WTE EPharmIBD /250,000 population.
Leadership role: 76% (n=98/129) of services with IBD leadership team work with a pharmacist of which 48% (n=47/98) work with an EPharmIBD on the annual formulary review. Of these teams 66% (n=31/47) work with an EPharmIBD on annual protocol/policy review, with actions and outcomes, actively develop pharmacy services within IBD.
Medicines expert role: Ward pharmacists in 95% (n=157/166) of IBD Services have access to an advanced generalist pharmacist for advice. Of these services 54% (n=84/157) are supported by an EPharmIBD but in only 41% (n=34/84) of these patients and ward pharmacists have access to an EPharmIBD on admission and during their stay for medication review, optimisation and personalised consultation.
Conclusion
Benchmarking shows a low level of pharmacy IBD expertise in the UK with a minority of services, ward pharmacists and patients having access to an EPharmIBD. Few IBD leadership teams work with an EPharmIBD and a small number of services have adequate EPharmIBDs commissioned.
In contrast where services report meeting the IBD Standards criteria for the number of EPharmIBDs, patients responding to the Patient Survey were more likely to be given appropriate information about potential treatments to help them make informed decisions.
This highlights the high need for advanced competencies and prioritisation of service commissioning in IBD.The pharmacy profession needs to respond urgently to this challenge to ensure high quality pharmaceutical care for IBD patients.