RESPONSIBILITIES and ROLES. Specialist responsibilities
RESPONSIBILITIES and ROLES. Specialist responsibilities General Practitioner responsibilities
RESPONSIBILITIES and ROLES. Roles of NRCS
RESPONSIBILITIES and ROLES. Specialist clinician responsibilities
RESPONSIBILITIES and ROLES. Consultant / Specialist responsibilities
1. Confirmation of diagnosis and identification of suitable patients following full assessment
2. Initiation of appropriate therapy, and once stable request agreement of shared care with primary care
3. Discussion of risks and benefits with patients, outline possible side effects and explain their roles
4. To undertake a complete history, documenting: concomitant medicines; past and present medical and psychiatric disorders or symptoms; family history of sudden cardiac death, unexplained death, or malignant arrhythmia
5. To assess baseline cardiovascular status, including blood pressure and heart rate and taking a cardiac history before prescribing, getting specialist cardiac advice if appropriate.
6. Issuing initial prescription(s) until the patient is stabilised on treatment
7. To provide a copy of this information sheet to the patient to ensure that they are familiar with all roles
8. To request the GP takes over prescribing under this agreement using the approved form. (see appendix 2)
RESPONSIBILITIES and ROLES. Pharmacy undertakes to:
RESPONSIBILITIES and ROLES. 1 Initially prescribe and stabilise the patient on the treatment regimen and monitor transplant graft function.
RESPONSIBILITIES and ROLES. Specialist responsibilities General Practitioner responsibilities Patient's role
RESPONSIBILITIES and ROLES. Consultant responsibilities:
RESPONSIBILITIES and ROLES. ▪ Ensure that FBC, liver and renal function are within normal parameters to allow Hydroxychloroquine to commence. Ensure maculopathy has been asked about, prior to recommendation. ▪ If abnormalities found at baseline inform GP as soon as possible. ▪ Initiate treatment with Hydroxychloroquine or advise GP on initiating treatment. ▪ Discuss the benefits and side effects of treatment with the patient and inform GP this has occurred. ▪ Ask the GP whether he or she is willing to participate in shared care, and agree with the GP as to who will discuss the shared care arrangement with the patient. ▪ Review the patient's condition and monitor response to treatment regularly where indicated. ▪ Advise GP if monitoring is needed, and the frequency. ▪ Monitor any other parameters considered necessary, or advise GP on which to monitor. ▪ Communicate promptly with the GP when treatment is changed or needs to be changed by the GP, any results of the monitoring undertaken, and assessment of adverse events. ▪ Have a mechanism in place to receive rapid referral of a patient from the GP in the event of deteriorating clinical condition. ▪ Advise GPs on when to stop treatment (if appropriate). ▪ Report adverse events to the MHRA via Yellow Card Scheme. ▪ Ensure that clear backup arrangements exist for GPs to obtain advice and support. ▪ Reply to the request for shared care as soon as practicable. ▪ Prescribe Hydroxychloroquine at the dose recommended. ▪ Adjust the dose as advised by the specialist. ▪ Monitor any parameters considered necessary, if agreed with the specialist to do so. ▪ Report to and seek advice from the specialist on any aspect of patient care that is of concern and may affect treatment. ▪ Refer patient to specialist if his or her condition deteriorates. ▪ Stop treatment on the advice of the specialist or immediately if an urgent need to stop treatment arises. ▪ Report adverse events to the specialist and to the MHRA via the Yellow Card Scheme. 1 Report to the specialist or GP if he or she does not have a clear understanding of the treatment. 2 Share any concerns in relation to treatment.
