Consultation, decision-making and therapy including referral
Models of consultation
Accurate assessment, communication and consultation with patients and their carers
Concepts of working diagnosis or best formulation
Development of a management plan
Confirmation of diagnosis - further examination, investigation, referral for diagnosis
Use or not to use medicines as opposed to other treatment options or when examining the patient
Able to work with patients and clients as partners in treatment
Influences on and psychology of use of medicines
Patient demand versus patient need
External influences, for example companies/colleagues/peers
Patient partnership in medicine-taking including awareness of cultural and ethnic needs
Use of Medicines in a team context
National and local guidelines, protocols, policies, decision-support systems and formulae
Rationale, adherence to and deviation from
Understand the role and functions of other team members
Documentation, with particular reference to communication between team members
Auditing, monitoring and evaluating use of medicines in practice
Interface between different professionals and the management of potential conflict
Budget/cost effectiveness
Issues relating to dispensing practices
Reviews diagnosis and generates treatment options within the clinical management plan
Able to refer back to medical practitioner when appropriate
Proactively develops dynamic clinical management plans
Clinical pharmacology including the effects of co-morbidity
Pharmacology, including pharmacodynamics and pharmacokinetics
Anatomy and physiology as applied to use of medicines practice
Basic principles of drugs to be prescribed - absorption, distribution, metabolism and excretion including adverse drug reactions, interactions and reactions
Patient compliance and drug response
Impact of physiological state in, for example the elderly, the young, pregnant or breast-feeding women, on drug responses and safety
Evidence-based practice and Clinical Governance in relation to use of medicines
National and local guidelines, protocols, policies, decision support systems and formulae - rationale, adherence to and deviation from guidelines
Continuing professional development - role of self and organisation
Management of change
Risk assessment and risk management, including safe storage, handling and disposal
Clinical supervision
Auditing and systems monitoring
Identifying and reporting ADRs and near misses
Drug calculations
Legal, policy and ethical aspects
Legal basis, liability and indemnity
Legal implications of advice to self-medicate including the use of complementary therapy and 'over the counter' medicines
Awareness and reporting of fraud
Drug licensing and monitoring
Yellow card reporting to the Committee of Safety on Medicines
Use of medicines in the policy context
Manufacturers' guidance related to literature, licensing and 'off label'
Ethical basis of intervention
Informed consent, with particular reference to client groups in learning disability, mental health, children, the critically ill and emergency situations
Principles of use of medicines for ocular use under exemptions and application to practice
Professional accountability
Accountability and responsibility for assessment and use of medicines
Maintaining professional knowledge and competence in relation to use of medicines
Accountability and responsibility to the employer
Use of Medicines in the public health context
Duty to patients and society
Policies regarding the use of antibiotics available for use
Inappropriate use of medication including misuse, under- and over-use
Access to health care provisions and medicines
Orthoptic specific mdeications
Ocular pharmaceuticals, their types and ingredients (vehicle, buffers, preservatives, stabilisers, excipients, active ingredients) and properties (pH, osmolality, viscosity)
Ophthalmic wash (eyewash) solutions
Ophthalmic dyes (fluorescein, fluorexon, Rose Bengal, methylene blue, brilliant blue, lissamine green, indocyanine green) and their uses
Topical ocular anaesthetics (proxymetacaine, oxybuprocaine, tetracaine, lidocaine)
Mydriatric (tropicamide, phenylephrine) and their uses by Orthoptists
Cycloplegics (cyclopentolate, tropicamide, atropine) for diagnostic and therapeutic purposes
Antibiotics and bacterial resistance, red eye differential diagnosis (Chloramphenicol/ Fusidic Acid)
Non-prescription medicines (medicines which are available over the counter from a shop or pharmacy) are included for supply and administration in the course of professional practice (e.g. phenylephrine 2.5%, fluorescein and ocular lubricants).
On successful completion of this module students should be able to:
1. understand pharmacodynamics, pharmacokinetics, pharmacology and therapeutics relevant to medicines use within their professional scope of practice and how these may be altered by certain characteristics
2. understand the legal context relevant to the use of exemptions in legislation for the sale, supply and administration of medicines, as well as current local and national policy and guidance concerning medicines use
3. understand the differences between the sale, supply and administration of medicines using exemptions, other supply / administration mechanisms and prescribing mechanisms
4. understand the various pharmacological and non-pharmacological approaches to disease management relevant to their practice and the risks and benefits of each option
5. understand the importance of shared decision-making with service users to encourage self-care and adherence with medicines advice
6. make a decision about whether to sell, supply or administer medicines using exemptions, based on a relevant examination, assessment and history taking
7.undertake a thorough, sensitive and detailed patient medical history, including an appropriate medical history
8. communicate information about medicines clearly with service users and others involved in their care
9. evaluate each potential treatment option with respect to an individual service user, taking into account relevant factors, the service user's circumstances, co-morbidities and other medicines taken
10 demonstrate safe use of medicines
11. undertake drug calculations accurately
12. monitor response to medicines and modify or cease treatment as appropriate within their professional scope of practice, including referral to another professional
13. identify adverse medicine reactions, interactions with other medicines and diseases and to take appropriate action
14. recognise different types of medication error and respond appropriately
15. understand antimicrobial resistance and the roles of infection prevention and control
Time management
Patient interviewing on medicines use
Recognising products
Communication
Clinical decision making
Analytical skills
Professionalism
