Understanding Supplementary Prescribing in Modern Healthcare

Clinical management plan: Discussion

Supplementary prescribing is one of the measures of clinical management that allows patients quicker access to medicine. Bissel et al (2008) explain that supplementary prescribing was introduced in 2003 for nurses and pharmacists in modern healthcare and allows them to prescribe medications in accordance with the clinical management plan following initial diagnosis by an independent prescriber and subject to the patient’s agreement. Thus, supplementary prescribing is premised on the doctor or dentist who is the independent prescriber, the nurse or pharmacist and the patient.

Supplementary prescribing can take place after a specified point in the patient episode, a diagnosis from an independent prescriber and the development of a clinical management plan by the independent and supplementary prescriber. However, complexities in the patient’s condition and the patient’s medical regime may make supplementary prescribing inappropriate. Implementation of supplementary prescribing is accompanied by a clinical management plan to support the recommendations (Bissel et al 2008).

A clinical management plan can be defined as a plan of care for a specific patient and the specified conditions to be managed by the supplementary prescriber. In developing the clinical management plan, the independent prescriber provides the diagnosis and parameters for the plan though they need not develop the plan by themselves. The clinical management plan is the foundation of supplementary prescribing and is thus obligatory to be present before supplementary diagnosis can be effected.

According to NHS Scotland (2003), the peculiar contents of a clinical management plan are; the name of the patient, the illness or condition to be managed by supplementary prescribing, the date when the plan is rolled out and when it is to reviewed by the independent prescriber, and the class or description of medicines prescribed as detailed in the annexed copy of plan. Other details are any restrictions or limitations of the strength of the prescribed dose and arrangements of communication between the independent and supplementary prescribers.

NHS Scotland (2003) details the responsibilities of the key players in the supplementary prescribing process. The independent prescriber is responsible for the assessment of the patient’s pre-diagnosis conditions, deciding on the care management plan and prescribing medication to the patients. Other responsibilities may include setting dates and reviewing clinical management plans.

The supplementary prescriber has the responsibility of continuing care of the patient who has been assessed clinically by an independent prescriber as per the annexed plan. This is achieved by duties such as contributing to the development of the clinical management plan and altering prescribed medicines within the recommended clinical management plan. The patient has a responsibility of providing consent to the supplementary prescribing and complying with the medicines prescribed through the care management plan as well as providing any information as may be required (NHS Scotland 2003).

In the clinical management plan, Trihexyphenidyl Hydrochloride tablets were administered to the patient Max Thousand to alleviate the conditions to be treated and meet the aim of the treatment detailed in the plan. The dosage detailed in the plan is supported by relevant findings. Dabhade et al (2010) explain that Trihexyphenidyl Hydrochloride is a synthetic antispasmodic drug useful in treating all forms of parkinsonism according to clinically approved dosage.

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References

Dabhade S, Shetty S, Gopinath A, Sridhar B and Sureja M. 2010: Simultaneous estimation of trifluoperazine hydrochloride and trihexyphenidyl hydrochloride in combined tablet dosage form by rp-hplc method. Int. J. Chem. Sci.: 8(3), 2010, 1684-1694

NHS Scotland. 2003: Supplementary prescribing by nurses within NHS Scotland; a guide for implementation. Scottish executive, Edinburg

Bissell, P, Cooper, R, Preston, L et al. 2008: An Evaluation of Supplementary Prescribing in Nursing and Pharmacy; Final Report for the Department of Health. Research Report, University of Sheffield

Annex: Clinical management plan