Getting the most out of medicines
Medicine reviews have hit the headlines recently for all the wrong reasons, but their importance shouldn’t be overlooked
Posted: 8 August 2016
Writer: Susanne Lynch, head of medicine management at NHS South Sefton CCG
My role at NHS South Sefton CCG and NHS Southport and Formby CCG is to support patients and prescribers to ensure Sefton residents get the most out of their medicines through the practices, chemists and care homes that we work with.
A key part of the medicine management team’s function is to carry out medicine reviews. It’s surprising what difference these reviews can make to a person’s health and wellbeing. Sometimes it can be as simple as changing the way someone takes their medication, which can lead to a huge improvement for the patients involved and, in turn, their families and carers.
There are various ways in which we receive requests. GP practices might highlight an issue with an individual’s medication, or a request may come to us straight from the patients themselves. This might result in a home visit or a review at a practice but we will organise for one of our specialist pharmacists to contact them and complete a medicine review either face to face, over the phone or by completing a full review of their clinical notes.
The pharmacist will have a chat with the patient and look at what they are being prescribed, what medication they have at home and whether they are being offered the best form of treatment for their illness. They will then take the time to speak to them about the results of the review and encourage the patient to discuss what is important to them.
Referrals also come to us through Virtual Ward in south Sefton. This is a 12-week pro-active support programme, which seeks to refer patients to the services they need from across health and social care. The Virtual Ward team meets regularly and will refer patients to medicine management if they feel a patient will benefit from a review.
A recent assessment that we carried out following a referral from Virtual Ward focused on a patient with breathing problems. The pharmacist discovered that the patient wasn’t using their inhaler correctly and so wasn’t getting the full benefits of their medication. They were able to improve the patient’s inhaler technique and also found that they had a number of out-of-date inhalers, which they took away for safe disposal. It sounds simple but this has really improved the patient’s confidence in using their inhaler and ensured that they are using it in the right way.
The team has also worked with several patients who are not sure what time to take their tablets or need help remembering. Usually the team provides a medication alarm clock, allowing the patient to be more independent so they don’t have to rely on others. This is the kind of thing that people aren’t aware of until they speak to us but it can really change a patient’s quality of life.
We also visit care homes to review medication and support the homes with their medicine processes.
Last year we carried out more than 500 care home reviews in Sefton. This resulted in over 40 hospital admissions being avoided, over 500 medicines being stopped and 300 changes to residents’ medicines. The savings identified as a result of our medicine reviews exceeded £52,000. This was from various exercises such as patient education, encouraging patients to only order what they need to reduce waste, and improving inhaler techniques but more greatly from medicine optimisation and adherence.
Some of the stories that I hear from the team still surprise me, such as people not knowing how to take their prescription properly and the amount of people who are using inhalers incorrectly, even though I’ve been in this role for a fairly long time now.
It’s so important that people are aware of the help that is available to them. I must say it is really rewarding when you receive feedback from patients and their families on how the reviews have helped them.