Background Shared care guidelines (SCGs) assist healthcare professionals and patients in clinical decision making while ensuring safety and continuity of care during movement of patients between primary and secondary care settings.
Purpose To develop shared care guidelines for rheumatology drugs taking into account the role of the community pharmacist.
Material and methods A literature review to identify existing foreign SCGs was carried out to design the optimal rheumatology shared care guideline template for a local scenario. Data from the Interface Pharmacist Network Specialist Medicines, summaries of product characteristics and international monitoring guidelines were used to compile the shared care guidelines for infliximab, methotrexate, azathioprine and hydroxychloroquine. A questionnaire assessing the design, content and layout of the SCGs was disseminated to an expert panel consisting of hospital and community pharmacists, specialist clinicians and general practitioners.
Results The SCGs consisted of 3 main sections. Section A outlined the pharmacological background of the drug, indications, drug administration and dosage regimen. Section B defined the associated responsibilities of the healthcare professionals working within the secondary healthcare infrastructure, general practitioner, community pharmacist and the patient. A shared care details sheet to address communication issues between the different healthcare settings was also designed. Section C included appendices for clinical particulars; monitoring and dosage worksheets; shared care request form; acceptance letter by GP to participate in shared care; and pharmaceutical care documentation sheet. All members of the expert panel (n=10) agreed that the community pharmacist who is dispensing the rheumatology medications is part of the extended healthcare team. All members agreed that communication with the community pharmacists should be improved and that the guidelines designed provide the necessary information and knowledge to participate in shared care. A common consensus was that ideally the guidelines should be more concise.
Conclusion Patient safety can be compromised as patients move across the primary and secondary care settings. The expert panel agreed that the SCGs compiled are essential for improving communication between healthcare professionals across different care settings, thereby improving patient care and safety.
References and/or acknowledgements Thanks Dr Louise Grech, Mr Dustin Balzan, Professor Anthony Serracino-Inglott and Professor Lilian Azzopardi for the constant support.
No conflict of interest
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