The role of pharmacy technicians in the care of people with M.E./CFS

"I Love Technicians" badgeToday is Pharmacy Technician Day so here’s a blog explaining what pharmacy technicians are and if you’re a technician, how you can support people with myalgic encephalomyelitis (M.E.), sometimes known as chronic fatigue syndrome.

If you’re not a technician you might be wondering what a pharmacy technician is. These are qualified health professionals registered by the General Pharmaceutical Council (or GPhC), meaning that they have to maintain the professional standards set by the GPhC.

Technicians work as part of the community or hospital pharmacy team along with dispensing assistants and counter assistants, under the supervision of the pharmacist. Technicians also work in mental health, primary care, prison service, the armed forces and the pharmaceutical industry. Find out more about community pharmacy technicians and hospital technicians on the Association of Pharmacy Technicians website.

I am a pharmacist living with M.E. and I have written M.E./CFS: a guide for pharmacy teams in conjunction with the national charity Action for M.E. I was a dispenser before deciding to study for my pharmacy degree so I know that the pharmacy team has such an important role in patient care and that registered technicians could support patients with the illness as much, if not more so, than the pharmacist.

Many areas of the UK do not have a specialist service for patients with M.E., so primary care and in particular community pharmacies, may be the only regular healthcare contact a patient has. If you work in the hospital sector, you may also come across patients with the illness while they are being treated for other conditions, so it is important to know how to adapt your care to meet the needs of these patients.

There are around 250,000 people living with M.E. in the UK according to NICE guideline CG53 for the diagnosis and management of the illness. M.E. typically begins after viral stomach or chest infections or glandular fever, though the reason M.E. develops is not known. The severity of M.E. can range from mild, where a patient may be able to work part-time, to severe, where a patient is house- or bedbound, needing help with everyday activities such as eating and bathing. There is currently no cure for M.E. so you might not be able to tell they have the illness from their prescription but patients may be taking medication for some of the symptoms they experience and other conditions they may have.

One of the main symptoms is severe and persistent fatigue or exhaustion most, or all of the time. Simple physical or mental activities can leave people with M.E. feeling utterly debilitated and the impact of this can typically take a day or two to kick in, and is not significantly improved by resting. This is a key feature of the way M.E. affects people, and is known as post-exertional malaise (sometimes called ‘payback’).

Other symptoms include flu-like symptoms, muscle pain, sleep problems, digestive problems such as nausea, reflux and IBS, problems with concentration, thinking and memory, poor temperature control, dizziness, hyper-sensitivity to light and sound, and sweating. As with other patients with long term conditions, frustration, anxiety, low mood and depression are sometimes experienced by people with M.E. as a consequence of having to cope with the impact of the condition and its symptoms. To find out more about what living with M.E. is like, you can read my blog Out of sight, out of mind, and blogs from other people with the illness in the Our Voices section.

Patients can have any of these symptoms at any one time and the illness fluctuates over time and even throughout the day. A patient may seem fine one day but be ill the next so it is important to be flexible about the amount of help given to people with the illness. Talk to the person with M.E. to find out how their illness affects them and what support they need. Here are some of the ways you might be able to help:

  • The many symptoms, along with any other long term conditions they have, can mean that a patient is on several medications. Look out for patients that are having problems with side effects, interactions or taking multiple medicines as they may benefit from a Medicines Use Review (MUR) or medicines optimisation.
  • Memory and organisation skills can be affected by M.E. so offer suggestions for ways which could help the person remember to take their medication or order their repeat medication if they are finding this difficult. Text reminders, phone alarms and medication apps are popular with the people with M.E. I speak to, as well as paper-based prompt sheets.
  • If someone’s memory or communication is affected the Accessible Information Standard may apply to them, so ask what would help them, for example when providing information over the counter or on how to use a medicine e.g. they may benefit from a bullet point list of things you have covered.
  • Many people with M.E. are sensitive to noise and light, so consultations may be better conducted somewhere quiet, with dim lighting, if possible. These sensitivities make hospital appointments and stays difficult, so if there is anything you could do to improve their environment this would be helpful.
  • The fluctuating nature of M.E. may mean that a patient is well enough to collect their prescription sometimes but needs a delivery on other occasions, either if they are not well enough or if their mobility is too poor to leave the house.
  • If someone with M.E. has any new symptoms, including pain in a new location, they should be referred to their GP. The symptom may not be connected to M.E. and could be another serious illness or something easily treatable.
  • You could train the rest of your team on M.E. awareness and ways they can help these patients.
  • If a patient or their carer is struggling with managing their health or with the impact of the illness on employment, housing, or benefits, you could signpost them to the Action for M.E. website for information and support via factsheets, helplines, forums and local support groups.

The publication M.E./CFS: a guide for pharmacy teams goes into more detail and is available to download on the pharmacy page of  the Action for M.E. website.

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