Experts are today (Tuesday) calling for a visiting pharmacist for every care home across Great Britain to improve medicines safety for the elderly. Yearly cost reductions of £60 million, due to medicine reviews carried out by pharmacists, and a further reduction of £75 million through the prevention of avoidable hospital admissions are possible.
The NHS could reduce costs by £135 million a year through the widespread introduction of a pharmacist for every care home across Great Britain according to a Royal Pharmaceutical Society (RPS). ‘The Right Medicine - Improving Care in Care Homes’ report.
It concludes that pharmacist led medicine reviews in care homes will only improve safety for elderly care home residents, but also reduce NHS costs by preventing avoidable hospital admissions.
In light of the report’s findings, RPS, Alzheimer’s Society, The Patients Association and Care England are jointly calling for a pharmacist, as part of the healthcare team, to urgently take charge of the whole system of medicines, and their use, within a care home. The report suggests, this will improve patient care, reduce NHS drug waste and prevent serious harm caused by inappropriate medicines use in elderly residents.
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Sandra Gidley, Chair of the RPS English Board said: “Care home residents take an average of seven medicines a day with some taking double or treble this amount. Without a regular review of what’s still needed, this cocktail of drugs causes poor health, a lower quality of life and costly unnecessary admissions to hospital.
"At a time when GP workloads are overwhelming and the NHS needs every penny, pharmacists can provide the solution by stopping the use of unnecessary medicines, upgrading residents to newer types of medicines with fewer side-effects and reducing the amount of wasted medicines.
"Having a pharmacist responsible for the use of medicines in a care home as part of the team of health professionals would also bring significant savings through regular reviews.
"The evidence is clear: now is the time for the NHS to act and improve the care of residents by ensuring a pharmacist has responsibility for the whole system of medicines and their use within a care home.”
"There are currently 405,000 care home residents in the UK aged over 65 with approximately 97 per cent being prescribed at least one medicine."
Nearly three quarters are exposed to a minimum of one potential medicine administration error. The RPS estimates that pharmacist-led medicine reviews with residents and their families can save up to £60 million per year as a result of a pharmacist stopping, reducing, starting or changing medication.
Pharmacist-led medicine reviews in care homes have also been calculated to save £190 per resident by preventing avoidable hospital admissions caused by potential drug related adverse events.[*5] When the RPS applied this cost reduction to the number of elderly care home residents across the UK taking at least one medicine, it was estimated that over £75 million per year could be achieved.
Laurie Thraves, Alzheimer’s Society said: “With 70% of people in care homes estimated to have dementia, having a pharmacist on hand to support people with the condition to manage and review their medication on a regular basis would be a welcome measure.
Many people with dementia live with other long-term health conditions and there is a danger that, without effective management, they could end up on a number of drugs which could interact negatively with each other, exacerbating the symptoms of their dementia. Having a visiting pharmacist in care homes has the potential to both save money and improve quality of life.”
The number and proportion of older people continues to rise, with over 11.4 million (18 per cent of the population) aged 65 and over in mid-2014, up from 11.1 million (17 per cent) last year. The number of older people using care homes rose by 21 per cent from 135,000 to 164,000 from 2005-13.
The RPS’s ‘The Right Medicine - Improving Care in Care Homes’ report can be viewed at http://www.rpharms.com/our-campaigns/pharmacists-improving-c... from 23 February.
A qualitative assessment is made of the potential impact of each intervention with regard to the impact of that intervention preventing a hospital admission. A cost avoidance figure of £3,500 is attributed to each potentially saved hospital admission. This is based on the average length of stay for an older person presenting at A&E.
Looking after your elderly loved one’s interests:
If you (or your relative) is having a review of their medicines in a care home, or would like one, here are the kind of questions you should ask:
1. How can I get a review of my medicines and can I and my son/daughter/carer be involved?
2. At the review, I would like to know:
o What my medicines are for?
o Do I still need all of them?
o Would I feel better if any of my medicines were changed?
o What are the risks and benefits of stopping or staying on each of my medicines?
o Do I have medicines for all my health issues – if not, what’s missing?
o What help can I get if I struggle to take some of my medicines?
3. After the review what should I look out for if changes have been made to my medicines?
4. If I have further questions who should I contact and how?
About the Royal Pharmaceutical Society
The Royal Pharmaceutical Society (RPS) is the professional body for pharmacists in Great Britain. We represent all sectors of pharmacy in Great Britain.
Age UK estimate calculated from Care of Elderly People Market Survey 2013/14, Laing and Buisson, 2014. As referenced in Age UK (2015) Later Life in the United Kingdom Available at: http://www.ageuk.org.uk/Documents/EN-GB/Campaigns/CIC/Care_i...
Alldred DP et al. Care Home Use of Medicines Study (CHUMS) Medication errors in nursing & residential care homes ‐ prevalence, consequences, causes and solutions Report to the Patient Safety Research Portfolio, Dept of Health. Available at: http://www.birmingham.ac.uk/Documents/college-mds/haps/proje...
The Health Foundation. Multidisciplinary review of medication in nursing homes: a clinico-ethical framework. 2010. Available at: http://www.health.org.uk/programmes/shine-2012/projects/mult...
Bower S, Whiteside H. CHAMOIS project (Care Homes And Medicines Optimisation Implementation Service). Journal of Medicines Optimisation 2015 1:(1):18-24
Butterfield L, Shah J. Care home medication review by clinical pharmacists across Brighton and Hove CCG. 2014. Available at: http://www.kssahsn.net/what-we-do/our-news/events/Care%20Hom...
Office of National Statistics. Population Estimates for UK, England and Wales, Scotland and Northern Ireland, Mid-2014. Available at: http://www.ons.gov.uk/ons/rel/pop-estimate/population-estima...
Age UK. Care in Crisis report 2014. Available at: http://www.ageuk.org.uk/Documents/EN-GB/Campaigns/CIC/Care_i...
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