More and more people are being diagnosed with several long term health conditions. This can lead to being prescribed multiple medicines to address each illness, but not necessarily with consideration to how the drugs work with each other. The result can be drugs cancelling each other out - losing their beneficial effects - or the patient reacting poorly to the combination of drugs, causing further health issues.
Coupled with the fact that it can be very confusing to understand how much to take of each drug and how often, the medicines are often taken incorrectly or not at all, leading to worse patient outcomes and wasting NHS resources.
A seven month pilot ran in Brighton and Hove CCG from August 2016 to February 2017 aiming to reduce levels of problematic polypharmacy in older adults at risk of medication-related harm.
Holistic level 3, face to face, medication reviews were carried out in care homes and other care settings with a focus on listening and shared decision making in order to evidence cash releasing savings and improve health outcomes in this patient population. The reviews were undertaken by an experienced pharmacist and pharmacy technician working closely with GPs, hospital colleagues and Age UK.
Multiple stakeholders were involved in setting up and delivering the service within the locality, a number of whom provided valuable feedback following the end of the pilot. We have developed an evaluation booklet that summarises the key findings from this work and includes key metrics.
We have also pulled together the full feedback from each stakeholder in the accompanying report that captures additional detail including lessons learnt from the work and resulting recommendations. This report also includes the dashboard with the final results.
All stakeholders believed this was an important and successful project and were pleased with the project outcomes. They also felt that this opportunity enabled key relationships to be built and developed where clear open lines of communication didn't previously exist. The work also highlighted areas for development and potential ways of adjusting current services in the locality to sustain the results delivered through this pilot and better serve this population.
We are currently scoping exactly what phase 2 of the project will look like but it is likely that it will be delivered in SASH and its corresponding CCGs. We are looking at how the AHSN can support improvements in managing polypharmacy in the hospital setting and the care home setting, taking learnings from the pilot project.
This page will be updated when we are in a position to share more, but if you would like any more information please contact us directly.
For more information please contact Lisa James, Programme Manager: Lisa.firstname.lastname@example.org
Medication-related problems in older people: Evidence based action
A collaborative learning event took place in April 2017 jointly led by KSS AHSN, Brighton and Sussex Medical School and Age UK Brighton and Hove. The theme of the event was medication-relation problems in older adults and we had a number of expert speakers on the day. The slides presented from the day are available below.
The event was well received will all delegates having an improved understanding of the topics presented on the day. The majority of delegates also felt that the importance of the patient perspective came through strongly on the day and encouraged a more patient-centric approach in managing medication problems in older adults.
Delegates shared what key learnings they took away after the event personally and what they would be taking back into their organisations for further discussion or action following the day. We also received really helpful feedback that we as the leading organisations can take forward into future events.
Please find the presentations from the event listed below.
We are unable to circulate the slides from Dr Nikesh Parekh’s presentation ‘Exploring the older person’s perspective’ and Dr Khalid Ali’s presentation ‘Medication harm following hospital discharge: The PRIME results’ as the findings will be submitted for publication and it isn’t possible to quote any results before final verification.
A multisectoral challenge for an ageing population.ppt, Dr Beatrice Gahagan, Senior Manager, Age-UK Brighton and Hove
Dosette box dilemmas.pdf, Jennifer Stevenson, Clinical Pharmacy Research Fellow, King's College London
Medication harm in the elderly – A European context.pdf, Professor Tischa van der Cammen, Professor Autonomous Ageing, University of Delft, Netherlands
Patient-centred deprescribing - process and safety.ppt, Professor Nina Barnett, Consultant Pharmacist and Pharmacy Adviser for older people, Royal Pharmaceutical Society
Problematic Polypharmacy - A pharmacist led intervention.ppt, Mairead O’Malley, Lead Pharmacist for Acute and Speciality Medicine, Brighton and Sussex University Hospitals Trust