1. Medicines Optimisation

2. 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

3. 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%

4. 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

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

7. 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 care home beds)
Feedback from each table [5 mins]