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IntroductionChoosing appropriate medication when faced with intolerance or treatment non-efficacy can be challenging. Evidenced reasons for non-efficacy include medicinal interactions. Interactions between non prescribed products and psychotropics may be overlooked with negative consequences for clinical effectiveness and/or patient safety.AimThis study was conducted to explore the awareness and current practice of doctors in Tees, Esk and Wear Valleys NHS Foundation Trust (TEWV) with regards to obtaining and documentation of information on service users’ use of nonprescription products.MethodTEWV “Policy for Medicines Reconciliation on Admission of Adults to Hospital” states that lists of medicines prescribed by GP including those bought over the counter should be one of the minimum information available on admission. The availability of this information should ensure continuity of care and identification of adverse interactions. An electronic survey, using semi quantitative questionnaire, of doctors of all grades within the trust was used.Results69 responses were received. There was a high level (94.2%) of awareness of potential interactions and a corresponding high standard (94.2%) of practice in enquiring about use in medication history. Only 78.3% would document this and where indicated, only 50.7% would investigate further. There were 25 comments received under the themes of health concerns (4), choice and autonomy (5), responsibility (2), practice issues (10), survey design (1), training Issues (3).ConclusionThere was a high level of awareness among respondents but deficiency in documentation and further exploration indicating missed opportunities for health promotion.

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Objective: The uptake of clinical practice guidelines into practice is poor for many chronic conditions, including hypertension. What is missing is an implementation strategy for incorporating guidelines into primary care practice. Herein, we describe the development of the Hypertension Canada Professional Certification Program (HC-PCP), a novel approach to guidelines implementation. Design and method: First, we identified 15 competencies believed to be important for primary care professionals to master when providing hypertension care. These competencies were surveyed for consensus by front-line clinicians through the Hypertension Canada e-newsletter. Clinicians were asked to rank the importance (on a Likert scale from 1 = not important to 5 = very important) of each competency for a primary care provider when undertaking a certification in hypertension management. Results: A total of 121 clinicians responded to the survey. Of these, 38% were pharmacists, 31.4% were registered nurses, 10.7% were physicians, and 7% were nurse practitioners. There was at least one respondent from each Canadian province and territory, except for the Northwest Territories. All 15 competencies received a mean rank of at least 4. The competencies with the lowest rank was “Demonstrates a sound knowledge of the epidemiology of hypertension” (mean 4.07 (SD 0.85)) and the highest was “Ability to screen and identify hypertension” (mean 4.83 (SD 0.04)). We then used these competencies to develop an online certification program, the HC-PCP. Some features include regular quizzes, submission of a video outlining the learner's blood pressure measurement technique, and submission of 3 patient cases for expert review. The program was launched recently: www.hypertension.ca/professional-certification-program/. Conclusions: We have developed a novel online hypertension certification program based upon the Hypertension Canada guidelines. The HC-PCP has been launched to pharmacists first, and is also being tested in a stepped wedge randomized trial called RxPATH (www.epicore.ualberta.ca/home/rxpath/).