Appendix 3: Telephone Review Info & Pro Forma Tool
Nurse-led biologics telephone review clinic
Aim:
· To review the stable patient on anti-TNFa therapy at 6 months, who has a yearly biologics review appointment.
· To ensure that if problems arise for the patient, these will be picked up at this clinic and appropriately referred.
· To enable the doctor to write a repeat prescription for anti-TNFa therapy utilising information from this clinic.
Method:
· Conduct a telephone-led discussion with each patient using a pro forma clinical tool.
Patient referrals:
· Patient who is stable and requires a yearly clinic review appointment.
· Patient will be referred from the biologic clinic – name and MRN should be emailed to CNS.
· Patient should be advised that they will be contacted in 5 months by letter with regard to telephone review clinic, with details of date and time of telephone call.
· Letter should include instructions to have SVUH blood tests done no more than 1 week prior to telephone review or if being done by GP, should be done no more that 10 days prior to telephone review and should be forwarded by fax to CNS.
Requirements for clinic
Pro forma tool:
· Patient addressograph
· Date
· Telephone contact details
· Biologics clinic checklist (as per biologics workbook)
· Blood test results reviewed and documented (as per biologics workbook)
· Medication list
· Comments
· Signature of reviewing CNS
Patient Chart
Biologics Workbook
To Notify:
Nurse Manager
ADON – Margaret Boland
Practise Development
Filing
Nurse led biologics telephone review clinic
Addressograph Contact Telephone No:
Consultant:
Diagnosis:
Current Medications:
______
Anti-TNFa: Enbrel ÿ Humira ÿ Infliximab ÿ
Biologics Checklist (see biologics work book) ÿ
Blood test results reviewed and documented (see biologics work book) ÿ
Comment:
______
Consultant review and decision: ______
Telephone review documented in patient chart ÿ
Pharmacy Details:
Signed: Date: