Carol Mills, a smoking cessation nurse at Sefton Support Stop Smoking Service in Liverpool, is commended for her action in helping people who want to quit using Champix to get faster access to the drug. Carol realised that people who wanted to use Champix were having to wait much longer for the drug than those opting to use nicotine replacement therapy had to wait for those products.
Carol felt that this disparity could be a reason why some clients were not fully compliant with their treatment and that this could hinder their quit attempt. In particular, she was concerned that the barrier to accessing Champix might contribute to DNAs (did not attends) and LTFUs (lost to follow up) figures and believed that making access to the drug easier would improve the quality of the service provided and make the client’s quit journey a little easier.
At that time, people choosing Champix had to take a request letter to their GP, collect the prescription a couple of days later and then go to the pharmacy for it to be dispensed. Meanwhile, clients using nicotine replacement therapy have always been able to go directly to the pharmacy to collect their chosen treatment.
To make access to Champix as convenient, Carol liaised with 66 local pharmacists to set up a patient group direction (PGD), similar to the NRT voucher scheme. Now, after the initial consultation, appropriate clients are referred directly to a community pharmacy where the PGD is followed and Champix dispensed, removing the need to see a GP.
In the first year of the PGD, 1,202 smokers quit successfully. The results show an increase of 8 per cent in CO validated Champix quitters and a 14 per cent decrease in Champix clients lost to follow up. Client feedback has been positive, especially from people who had previously needed a Champix prescription from their GP.
Carol developed and delivered the initial training for pharmacists. She continues to work closely with community pharmacies, and if a pharmacist leaves, ensures training is arranged with the new pharmacist to main accessibility and continuity for clients.
Carol’s nominator Colette Kearney, team leader of the Sefton Stop Smoking Service, says Carol has demonstrated ‘hard work, determination and perseverance’ in developing, implementation and sustaining the PGD.