Boehringer Ingelheim - November 2022 - case study 1
Improving patient health outcomes and optimisation of cardiometabolic care with Leeds Teaching Hospitals NHS Trust
Optimisation of Cardiometabolic Pathway – Boehringer Ingelheim UKIE
Working with Leeds Teaching Hospitals Trust, Boehringer Ingelheim UKIE established a new innovative cardiometabolic clinic. Around 1/4 of patients who suffer a heart attack have Type 2 diabetes (T2D)1. The presence of diabetes increases the risk of death by >2.5 times when compared to heart attack patients without the disease2. The pharmacist-delivered clinics scheduled for 6-8 weeks post heart attack, are a patient-centred approach to reducing risk.
The aim of the clinic is to:
- Optimise and reduce the cardiovascular risk factors amongst patients with T2D and cardiovascular disease.
- Provide better support for patients, including education and self-management.
- Enable patients discharged from clinic to have better diabetes control through improved medication adherence and medication optimisation by providing strategies to address a number of factors that may impact an individuals’ adherence to their medications.
- Enable timely interventions to reduce the need for further treatment escalation and reduced hospital stays.
- Offer patients with T2D post-MI, the use of guideline-directed cardio-protective diabetes agents.
- Identify the training needs to develop advanced pharmacists who can run such clinics as part of a Multi-Disciplinary Team.
Better for patients
- Thanks to the success of this clinic, patients were empowered with the tools needed to adopt healthier lifestyles. eg 38% of patients who attended clinic were provided with a home Blood Pressure monitor to better optimise BP, and 65% of smokers were provided smoking cessation advice including the prescribing of smoking cessation therapy.
- With 100% of patients surveyed expressing that their concerns relating to heart/diabetes health were addressed.
Better for the NHS:
- Improved workforce utilisation - upskilling pharmacists allowing Consultant physicians to manage more complex patients
- HCP skills (pharmacist) matched to patient needs - a high patient need exists to uncover barriers to adherence, provide health education and medicine optimisation.
- Improved compliance with guidelines - prescribing of guideline recommended pharmacological therapies in line with NICE & local guidelines
- Optimising therapy for the multimorbid patient - including recommended therapies for post MI secondary prevention, diabetes, and renal disease where identified.
Since its founding, the ‘one-stop clinic’ has helped reduce the waiting list burden for diabetes review. Whilst some patients still need a review by a diabetes specialist, many receive optimisation of their Cardio-Renal-Metabolic (CaReMe) medicines and risk factors without needing a referral to the diabetes service. Additionally, a reduction in patient visits required in both primary and secondary care. The combination of face to face and a virtual clinic approach is convenient for patients and reduces the pressure on the outpatient services.
Interim results demonstrate the importance of a CaReMe approach in cardiovascular risk reduction with patients achieving improvements in their HbA1c, lipid profile and BP control as well as a fall in BMI.
(NP-GB-103398 - November 2022)
References:
1 Unpublished data – Dr Rani Khatib
2 Haffner et al. N Engl J Med 1998;339:229–34 https://www.nejm.org/doi/full/10.1056/nejm199807233390404
Last modified: 13 November 2023
Last reviewed: 13 November 2023