A clinico - ethical framework for multidisciplinary review of medication in nursing homes

1. A clinico-ethical framework for multidisciplinary review of medication in nursing homes Interim Results Lack of structured review Progress to date 91 patients reviewed • 300 interventions • 62 patients (68%) ≥1 med stopped • 28 patients (31%) referred to POAS Service costs funded by Shine include Clinical Pharmacist support (0.5WTE; approx £32,000 p.a.). Other costs (e.g. POAS, GP time) to be determined Excess medicines (sometimes inappropriate) Annualised savings from stopping 142 & starting 16 medicines £15,368 £169 per patient reviewed Communication issues: most patients were unaware of what treatment they were on Long medication rounds and timing not patient -centred For every £1 of pharmacy resource… …£6 was saved For every two patients reviewed… …one had at least one medicine stopped Our objectives Optimise medicines use in care home residents… …ensuring that residents or their family are fully involved in any decisions around prescribing and de-prescribing of medicines Qualitative data being collected from key stakeholders, patients and families 142 medicines stopped; 16 started Having done the SHINE I think it is an excellent model. It really made me think, involving the family is a really good idea. I suspect a lot of them don’t mind the changes you have made but it is very positive to have them involved. I think it helped to improve the relationships with the care home. GP involved in a SHINE Care Home Review 17.5% reduction n=718 n=592 For every 5 medicines reviewed… …one was stopped Methods Next steps Continue review; target 326 patients in 12 care homes Detailed qualitative data Commission service, post-Shine Patient involvement in decisions Our Team Wasim Baqir, Julian Hughes, Peter Derrington, Nisha Desai, Steven Barrett, Jo Mackintosh, Yvonne Storey, Joan Lowerson, Aileen Beatty, Richard Copeland, Jane Riddle, David Campbell, Annie Laverty, Sandra Gray.