Pharmacy-led video clinics supporting patients with ophthalmic medicines adherence

Moorfields Eye Hospital NHS Foundation Trust is one of the largest providers of ophthalmology services in Europe. The Trust sees around 800,000 outpatients every year. It provides both acute and elective ophthalmic care from more than 20 sites.

The pharmacy team supports patients who use medicines for the best outcome.

Situation

Patients usually discuss their medication face-to-face with the pharmacy team during their hospital visit. As a result of the COVID-19 pandemic many patients were not able to do this as they were shielding or isolating. The pharmacy team was not able to discuss adherence.

They found that more traditional pathways had changed. More patients were calling the medicines helpline.

There was a need for virtual video consultations in pharmacy services.

At first, video consultation technology was not used at Moorfields. It was deployed quickly for clinical consultations as a response to the pandemic.

The technology was extended to pharmacy services. This meant that the team could provide medication support to patients. It also improve interactions with patients.

Aspiration

The team wanted to create a remote consultation service to help patients to get the most out of their medication. This means patients would not need to speak to pharmacy staff face-to-face.

Solution

The team proactively developed pharmacy-led video consultation services.

The video service enhances phone conversations. It allows the pharmacy team to see any problems patients are having using their medication. For example, if the team sees eye drops running down the patient's face, they could try to improve the patient's technique.

If a patient calls the pharmacy and has an issue that cannot be resolved over the phone, they are invited to a video consultation. Patients who needed a follow-up consultation after visiting the pharmacy were also invited to a video consultation.

Impact

The service helped patients use their medicines correctly and as a result improved adherence.

The team have seen several patients who were physically not able to squeeze eye drops into their eyes. This meant the patient missed doses and ran out of medicine before their next supply.

The team have also seen patients with arthritis who rely on a neighbour to open their eye drop bottle for them. However, during the pandemic, neighbours who were self-isolating were unable to help.

In many cases, the team have been able to identify and resolve the issues by:

• correcting techniques
• sending patients an eye drop compliance aid (a device to help patients apply their eye drops)
• signposting patients to online video tutorials
• doing follow-up consultations to review understanding and give advice

So far, patient feedback has been positive. 100% of patients have said they now feel more confident in managing their condition and medication.

Patients reported that they were struggling at home and did not realise they were applying eye drops incorrectly. They are grateful that video consultations are offered to support them.

The team have also implemented a dedicated pharmacy medicines helpline team. They use the ‘video pharmacy clinics’ to support patients.

Patients have expressed they enjoy staying in the comfort of their own home and they:

• feel more relaxed
• are more likely to discuss their experience and concerns about their medicine honestly
• do not feel the pressures that come with a hospital visit such as feeling stressed and overwhelmed with information

Functionality

• Attend Anywhere is a secure video consultation device and software.
• Assistance and advice are available from Attend Anywhere.
• The technology runs on a web browser, allowing patients and clinicians to sign in from anywhere.
• It’s possible to access to video calls into websites, existing systems, software, workflows and patient pathways.

Capabilities

• Video consultations allow patients to access care from home without needing to go to a hospital.
• The Attend Anywhere platform is used in many medical specialties and ophthalmic units. It’s now also used in support services like pharmacies.

Scope

The service can be used:

• for remote consultations
• to support communication between patients and pharmacy staff
• to support communication between clinicians and pharmacy staff
• for follow-up reviews which is routine practice for optimising medication
• for shared care if 2 pharmacy staff or clinicians join the live consultation with the patient

Key contact

Sarah Thomas, Advanced Specialist Pharmacist, Medicines Optimisation (including digital, genomics and personalised medicine), Moorfields Eye Hospital NHS Foundation Trust

sarah.thomas44@nhs.net