The Royal Pharmaceutical Society (2016) reports integrating a pharmacy team in care homes would improve the efficiency, safety, and quality of medicines use for patients; offering immediate support in:
Safe transfer of information
Education, training; and standards
Palliative and end of life care.
Aims Pharmacists undertake level 3 clinical medication reviews (National Institute for Health and Care Excellence, 2014) aiming to manage and deliver safe, efficient and effective medicines optimisation support to patients, in line with NICE guidelines and local clinical governance (Butterfield & Shah, 2014; Kinley, Froggatt & Bennett, 2013; Swift, 2018).
Methods A Clinical Commissioning Group in South East England employs two full-time pharmacists working in partnership with the local hospice’s Care Home Support Team to provide specialist palliative medicines information and advice for the organisation. The project currently covers 16 care homes, including 700 to 900 patients. The pharmacists perform structured medication reviews to optimise the impact of medicines, minimise the number of medication-related errors and reduce medicines waste. These are carried out in agreement with patient, nurse, family/carer and GP. The pharmacists also offer support to care home staff by reviewing, monitoring and improving medicines-related policies.
Results From January 2017 to January 2018, 574 medication reviews took place, leaving a total of 4997 medicines and 1787 suggested medication changes. Approximately 76% of these changes were agreed and actioned by patients’ GPs, savings estimated using CCG costings of £169,986.96. A feedback survey to measure quality outcomes for patients, care homes and GPs is also underway.
Conclusions The introduction of pharmacists to the hospice’s care home support team has offered considerable medicines knowledge and support to care home residents, relatives, hospice and care home staff, GPs and other stakeholders. The pharmacy team aspires to expand, develop even further into specialist clinical areas such as dementia and palliative care, and continue improving health outcomes and patient quality of life.
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