| Popis: |
This thesis describes the author's contribution, from 1997-2017, to medicines optimisation through use of a person-centred care approach to pharmacy practice. It outlines the author's publications in the area of pharmacy practice and older people together with copies of key publications and relevant authorship statements. The thesis is divided into four key themes: pharmacy and older people, clinical leadership, reducing preventable medicines-related hospital readmission and the development of a coaching approach in pharmacy practice. The thesis begins with describing the growth of the author's skills as a hospital pharmacist working with older people, which provides the content for the first theme. This includes development of the author's research skills and the start of collaboration with a cross-sector multidisciplinary team, led by a national leader in the care of older people. The second theme, of clinical leadership, incorporates the author's role as the first consultant pharmacist working with older people in England and also as a pharmacist prescriber in intermediate and long-term care. This includes the creation and leadership of the national consultant pharmacist group for England and information about pharmacist prescribing through publications and describes how practice focussed on what mattered to patients. The third theme focuses on reducing preventable medicines-related re-admissions and includes description of the development of the Integrated Medicines Management Service (IMMS), an award winning service, including delivery of person-centred consultations. The fourth and final theme outlines the development of a coaching approach to pharmacy practice including the use of health coaching. This includes development of the nationally utilised 'Four Es' (Explore, Educate, Empower, Enable), a structured approach to person-centred pharmacy consultations to support medication review, medicines adherence, reducing inappropriate polypharmacy and optimising safe deprescribing. This section of the thesis also describes collaboration with colleagues to develop the nationally recognised 'patient-centred polypharmacy process', joint-editing a peer-reviewed themed journal issue on deprescribing and devising and delivering learning events to provide pharmacy support for special populations. This thesis demonstrates that the author has contributed to the development of person-centred care in pharmacy practice. The author's work in this area supports medicines optimisation, thus improving the patient experience and the provision of safe, effective pharmacy services, which are embedded within everyday pharmacy practice. |
