Pharmacists to tackle aged care overmedication

Hundreds of English pharmacists are set to be deployed into care homes to help reduce overmedication and unnecessary hospitalisations

NHS England has announced that around 180,000 people living in nursing or residential homes will have their prescriptions and medicines reviewed by the pharmacists and pharmacy technicians.

It says that elderly care home residents in the UK are being prescribed an average of seven daily medicines each, though around 10% of people aged 75 and over are currently being prescribed 10 or more medicines.

It highlights that studies suggest up to one in 12 of all hospital admissions are medicines-related, two-thirds of which are preventable.

NHS trials have shown that pharmacists reviewing medicines improved quality of life by reducing unnecessary use and bringing down emergency admissions.

The use of clinical pharmacists and pharmacy technicians to undertake structured medicines reviews of all new and discharged care home residents in Northumberland showed that one hospital readmission could be avoided for every 12 residents reviewed.

In East and North Hertfordshire, where this model was applied across 37 care homes, an annual drug cost saving of £249 per patient was seen.

Results from the six NHS England care homes vanguard sites piloting this approach show:

  • reduced reported emergency hospital admissions by 21%,
  • reduced oral nutritional support usage by 7%,
  • reduced ambulance call out by up to 30%; and
  • drug cost savings of £125-305 per resident.

The project will begin with NHS England funding recruitment of 240 pharmacists and pharmacy technicians, in coordination with GPs and practice-based clinical pharmacists.

“There’s increasing evidence that our parents and their friends – a whole generation of people in their 70s, 80s and 90s – are being overmedicated in care homes, with bad results,” says Simon Stevens, chief executive of NHS England.

“Let’s face it—the policy of ‘a pill for every ill’ is often causing frail older people more health problems than it’s solving.

“So expert pharmacists are now going to offer practical NHS support and medicines reviews in care homes across England.”

Sandra Gidley, chair of the Royal Pharmaceutical Society’s English Board, said the investment highlights the growing recognition that pharmacists who support care home residents can reduce medicines waste, improve efficiency and provide better health outcomes.

“Many pharmacists already play a vital role in care homes, including through supporting other staff as part of a multi-disciplinary team, and we know that our members will welcome the opportunity to get more involved in providing direct patient care,” she said.

“In order to make the most out of this chance to improve health outcomes, commissioners can also better co-ordinate and integrate patient care by drawing on the expertise and knowledge of pharmacists wherever they are based.”

The British Medical Association said it supported the move but also called for further investment of pharmacists into general practice.

“We welcome this scheme that will hopefully reduce medicine-related errors that can all too often result in hospital admissions for some of the most vulnerable people in society,” said its general practice committee chair Dr Richard Vautrey.

“The government must now follow through with this commitment to patients and provide every GP practice with its own pharmacist, which will not only ease workload pressures on doctors, but also ensure that these errors are prevented in the wider community.

“The BMA has already secured investment for this in Northern Ireland, so it’s time ministers build further on the current clinical pharmacist scheme and provide sustainable and recurrent funding to support a roll-out for practices throughout the UK.

“Every hospital ward has a linked pharmacist. It’s about time every practice had one too.”

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