The service is split into five distinct phases.
(1) Phase 1: clinician sign up.
(a) In this phase the clinician signs a service
authorization document which enables
the two SSS nurses to work with the
carers of the clinician’s patients. This
document acts as a contract between
Quintiles and the clinician and clarifies
the scope of the service.
(2) Phase 2: clinician engagement.
(a) In this phase the nurse sits down with
the clinician and looks at the practicalities
of how the service is going to
work. This will include everything
from the referral process to communication
between the nurse and the
clinician to formalizing processes
covering untoward incidents that may
occur during the service.
(3) Phase 3: carer referral.
(a) The service is intended to be an integral
part of the Strattera package.
When an enrolled clinician prescribes
atomoxetine they may also consider,
in conjunction with the patient and
their carer, whether the support service
is an appropriate option. If considered
useful, the support service is
discussed with the patient and their
carer and consent is obtained to refer
the carer into the service.
(4) Phase 4: service delivery.
(a) When a referral is received into the
support service a welcome pack is
sent out to the carer advising what
can be expected from the service. A
nurse is allocated to and makes contact
with the carer to welcome them
into the programme and to determine
the agreed level of support to be
offered throughout the 12-week
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programme. The support service at
the time of the collection of the data
described here was restricted to phone
calls but has since been expanded to
include newsletters and motivational
and reminder text messages which
can be opted out of at any time.
(b) During the current 12-week programme
the carer will on average
receive six calls of approximately 15
min duration, six newsletters, two
motivational texts per week and two
reminder texts per appointment. The
calls, newsletters and texts mirror
the themes of the first 12 weeks on
atomoxetine and will include topics
such as side effects, efficacy and
daily routine.
(c) At the end of the 12 weeks the carer
completes a satisfaction survey to provide
feedback on the service.
(5) Phase 5: clinician feedback.
(a) The final phase occurs when the
nurse ensures that the clinician has
received feedback on the carers
referred into the service. If atomoxetine
has been stopped the clinician
receives a discontinuation letter advising
how long the carer was in the service
and the reason for discontinuation.
If the carer completes the 12-week
service the clinician receives a discharge
summary advising how the
carer progressed through the 12
weeks, any issues that had been discussed
and the outcomes achieved.
During this final phase the clinician
also feeds back on their experience of
using the service.
The Lilly Global Patient Safety team trains
the SSS nurses annually on the capturing
and reporting of all adverse events which
are raised through the interactions with the
carers.
The following sections describe outcomes from
the service offered at the time when newsletters
and text messages had not been introduced.