Medicines optimisation The road to excellence
Workshop • Overview of meds optimisation • Your role in meds optimisation • Case study • What can you do on your road to excellence
What is Medicines Optimisation ? • Medicines optimisation is defined as 'a person-centred approach to safe and effective medicines use, to ensure people obtain the best possible outcomes from their medicines. Medicines Optimisation applies to people who may or may not take their medicines effectively. • Who is involved ?
Medicines optimisation - What do you currently do?
Benefits of medicines optimisation • Quality – Residents/family/ care workers are involved in decision making – Residents/family/ care workers satisfaction and experience – Reduce admissions to hospital • Safety – Unnecessary medicines stopped • Savings – Prescribing budget reduced – Reduced admission to hospital
How well do we use medicines? • CHUMs study (2009) >66% care home residents were exposed to one or more medication errors • We waste £300 million on waste medication ? • £150 million medication waste is avoidable? • 6% of readmissions to hospital are caused by medication
Meet Alice • 90 year old • Mobility – wheelchair • Cognitive impairment • Hypertension, MI, • Rheum Art • Hosp admission confused unwell UTI • Treated with antibiotics and rehydrated • Routine monitoring detected atrial fibrillation • Rivaroxaban commenced in hospital • Discharged – no further follow up
Amlodipine 10mg tablets (BP) Alice is Cp-Amilofruse 2.5/20 (BP) Doxazosin 4mg tablets (BP) prescribed an Quetiapine 200mg tablets (antipsychotic) Zopiclone 7.5mg tablets (sleeping tablet extra 4 Folic Acid 5mg tablets (vitamins) Alendronic acid 70mg tablets (bone protection) Adcal D3 1.5g/10micrograms (bone protection) medicines on Paracetamol 500mg tablets (pain) Ferrous Sulphate 200mg tablets (iron) discharge Simvastatin 40mg tablets (cholesterol) Codeine Phosphate 30mg tablets (pain) Rivaroxaban 20mg tablets (blood thinning) Luventa XL 16mg ( dementia) Medicines use is Mirtazapine 15mg tablets (antidepressant) Morphine sulphate 10mg/5ml (pain) Laxido (laxative) ok isn’t it? Docusate Sodium (laxative)
Group work • Discuss Alice’s medication (pre/post hospital) • With your knowledge , how would you contribute to promoting medicines optimisation?
Is this tablet burden all necessary? • Are meds necessary / appropriate? • Lack of structured review • Rare resident involvement • Medication errors • Medication waste • Silo working
Medicines optimisation [NG5] March 2015 https://www.nice.org.uk/guidance/ng5 • This guideline covers safe and effective use of medicines in health and social care for people taking 1 or more medicines. • It aims to ensure that medicines provide the greatest possible benefit to people by encouraging medicines reconciliation, medication review, and the use of patient decision aids.
Medicines optimisation -What can you do to assist your home on the path to excellence? examples • Tool to measure the Quality Standard • Ensure improved instruction on medication – e.g. applying emollients • Utilise opportunity to gain information • Produce action plan
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