Medicines Optimisation

Medicines Optimisation What is it all about? Detailed analysis of Care Home residents’ medication Review of care home medicines systems and processes Identification of inappropriate polypharmacy Benefits: Improve health outcomes Reduction in hospital admissions Reduction in costs and waste Improve safety Ad hoc training Support with CQC preparation and action plans Shared learning Changes to practice Medicines Optimisation

Medicines Optimisation Care home residents often have complex medical needs and take multiple medicines. Making sure they are being prescribed the correct medicine and taking them as they should do is very important to reduce the risk of being admitted to hospital. Our four pharmacists and a pharmacy technician have worked with 40 care homes to improve the way that medicines for residents are prescribed, monitored and reviewed. 1. Identify Care Home 2.Arrange access to care home and aligned GP practice/s 3. Liaise with practice to gain access to system 4. Medication Review 5. Systems and processes 6. MDT meeting 7. Follow up Total Investment = £264k + Project management time Return on Investment = 374%

Medicines Optimisation more details… For each patient look out for: Monitoring Inherited prescribing, allergies Any medicines with no clear indication Documents e.g. Mental health reviews Identify how often medicines are requested/ repeated and any PRN medicines Any resident with dementia is READ coded correctly Identify if patient is taking ONS and review against local guidance / MUST score Collate all information from: Recent CQC reports Quality team to identify common medicines related issues and themes that have resulted in hospital admissions Community pharmacist to identify medicines system related issues Patients with concerns: Recent hospital discharge/new admissions Frequent fliers, polypharmacy High risk medication Poor medication adherence Multiple co-morbidities

Impact so far By March 2017 46% of Care Homes (42) would have received some form of Complex Care training

https://www.youtube.com/watch?v=5Xbg-haVWFw

Medicines optimisation in care homes discussion [15 mins] Split into tables and discuss the 3 questions [10 mins]: How do you think the impact on quality and safety should be measured? How you do you think that savings should be measured? Is a medication review necessary for all residents and who should deliver it in care home residents? (We have approx. 3500 care home beds) Feedback from each table [5 mins]