|Title||Therapeutics in Cardiac Science|
Clinical Scientists in Cardiac Science are not currently permitted to issue prescriptions as either supplementary or independent prescribers. However, there are circumstances known as patient-specific directions whereby medicines can be given by another professional following the directions of an approved prescriber. Provider organisations should have arrangements in place that enable these legal requirements to be implemented. This therapeutics module is included in this HSST curriculum to provide the underpinning knowledge and understanding of a range of therapeutics utilised within Cardiac Science to support the Clinical Scientist in HSST to work with other clinicians and healthcare professionals as part of the multidisciplinary team.
By the end of this module the Clinical Scientist in HSST, in respect to Cardiac Science, will be able to critically analyse, synthesise, evaluate and apply knowledge of appropriate cardiac-specific therapeutic interventions relevant to clinical practice, including non-medication-based therapeutic and preventative interventions (e.g. pacemaker programming) within the scope of practice of a Consultant Clinical Scientist.
Knowledge and understanding
By the end of this module the Clinical Scientist in HSST, with respect to their clinical practice/scope of practice, will analyse, synthesise, critically evaluate and apply their knowledge with respect to the:
- mode of action, indications, contraindications, side effects, interactions and dosages of commonly used cardiac drugs in adult and paediatric patients;
- range of adverse reactions to commonly used drugs, including complementary medicines;
- practical challenges and psychological barriers that adversely impact on patient adherence and strategies that support patients and improve adherence;
- drugs requiring therapeutic monitoring and interpretation of the results;
- involvement of patients/carers in shared decision making in their treatment and care;
- use of medications appropriate for use in pregnancy and during breast feeding;
- prescribing and medication errors in adults and children and strategies to reduce errors;
- effects of age, body size, organ dysfunction and concurrent illness on drug distribution and metabolism relevant to the Clinical Scientist in HSST’s practice;
- the importance of following updates on drug trials in cardiac drugs in paediatrics;
- roles of regulatory agencies involved in drug use, monitoring and licensing (e.g. National Institute for Clinical Excellence [NICE], Committee on Safety of Medicines [CSM], Medicines and Healthcare products Regulatory Agency [MHRA] and hospital formulary committees);tools used to promote patient safety in prescribing, including electronic clinical record systems and other IT systems;
- safety and efficacy of treatment strategies in relation to the design of clinical trials, including ethical/regulatory approval from relevant bodies such as the UK Gene Therapy Advisory Committee, MHRA, on-site research governance committee and local ethics committee, compliance with Good Clinical Practice, EU Directive 2001 and Declaration of Helsinki.
Technical and clinical skills
Although not undertaking independent prescribing of medications, by the end of this module the Clinical Scientist in HSST will be expected to critically reflect and apply in practice a range of clinical and communication skills to advise and communicate effectively with relevant clinicians and other healthcare professionals and will, within the multiprofessional team:
- review the continuing need for, the effect of including adverse drug interactions and the adverse effects of long-term cardiac medications relevant to the Clinical Scientist in HSST’s clinical practice;
- recognise and anticipate avoidable defined drug interactions, including with complementary medicines;
- suggest appropriate dose adjustments following therapeutic drug monitoring or physiological change (e.g. deteriorating cardiac function);
- employ validated methods to improve patient compliance with prescribed medication;
- the principles of compliance in ensuring that drug regimens are followed;provide comprehensible explanations for the use of drugs to the patient and to carers when relevant;
- utilise non-medication based therapeutic interventions and preventative health interventions.
Attitudes and behaviours
By the end of this module the Clinical Scientist in HSST will be expected to evaluate their own response to both normal and complex situations, consistently demonstrating the professional attributes and insights required of a Consultant Clinical Scientist working within the limits of professional competence, referring as appropriate to senior staff, and will:
- recognise the benefit of minimising the number of medications and interventions taken by a patient to a level compatible with best care;
- remain open to advice from other health professionals on medication issues;
- ensure information is shared promptly and accurately with a patient’s health providers, including between primary and secondary care;
- participate in adverse drug event reporting processes;
- remain up to date with therapeutic alerts and respond appropriately.