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MEDICINES and Older People

MEDICINES and Older People. Hira Singh Prescribing Adviser (Middlesbrough PCT and Redcar & Cleveland PCT Medicines Management Team) March 2008. Who are we?. What are Medicines Management Services?. £50m spent on drugs in primary care across South Tees.

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MEDICINES and Older People

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  1. MEDICINES and Older People Hira Singh Prescribing Adviser (Middlesbrough PCT and Redcar & Cleveland PCT Medicines Management Team) March 2008

  2. Who are we?

  3. What are Medicines Management Services? £50m spent on drugs in primary care across South Tees.

  4. NSF for Older People (March 2001)Medicines SupplementAIMS To ensure that older people: gain maximum benefit from their medicines to maintain and increase their quality and duration of life. Do not suffer unnecessarily from illness caused by excessive, inappropriate or inadequate consumption of medicines. Are not denied access to medicines that would benefit them

  5. Some Statistics…..

  6. COMPLIANCE OR CONCORDANCE As many as 50% of older people may not be taking medicines as intended Why might this be? (communication between primary & secondary care) Older people and their carers need to be more involved in decisions about their treatment. Older people and their carers need more information about the risks and benefits of their treatment.

  7. PRIMARY / SECONDARY INTERFACE ISSUES Poor two-way communication between hospitals and primary care Changes in medication after discharge from hospital (unintentional changes are too frequent)

  8. ACCESS TO INFORMATION AND SUPPORT Access to pharmacy or surgery may be difficult, reducing contact with a range of health professionals. Carer’s potential contribution and needs are often not addressed (Informal and formal carers) Advice on practical aspects of medicine taking may be lacking.

  9. Prescribing medicines is the most frequent NHS healthcare intervention Medicines Management team have been involved with: FallsMental Health Continence Stroke Intermediate Care Review of repeat prescribing systems Care Homes Medication review Education / Training Training included awareness sessions on medicines for hospital social workers, carers etc

  10. Settings Home (independent) Home with informal carer support Sheltered housing Intermediate care Respite care Acute hospital care Home –with domiciliary care Long term residential care

  11. Who may be involvedWith prescribing & managing medicines? Domiciliary Care providers District Nurses Social Care GP Care Home staff (nursing or non-nursing) Consultant Informal carers Intermediate Care staff Pharmacist –community, primary or secondary care

  12. What have we done so far? • Practice Pharmacist in every GP Surgery • In Care Home • clinical medication review for residents • medicines policies and procedures (in home care setting) • training for staff • Worked to improve good quality training for carers in medicines • South of Tees Group / Regionally • Care Home Advisory Pharmacist • NB ‘Handled with Care’ report CSCI

  13. Domiciliary Care • Part of a Multi-agency working group • Its Aims: - To promote independence and safe, effective • use of medicines • Standardise policies across South Tees • Reduce reliance on MDS as the only means of support • Consider health /social care boundary issues • Decrease admissions to long term care by improving • safe & effective use of medicines

  14. Intermediate Care Pharmaceutical Care Award for pharmacy technician project Cross-boundary working (strategic group) Accessible to social care teams Links with clinical medication review in practices

  15. Medicines Awareness Sessions Local Authority employed carers Social Workers Discharge liaison teams District Nurses Occupational therapists Intermediate Care teams

  16. ..and patients and carers? Information leaflets (Medicines and Falls) ‘Sloppy Slipper’ events Talks to older peoples groups / carers groups Ask About Medicines Week – in older peoples clubs/nursing homes, council day centres & friendship groups. PCT Life Store Medication Review

  17. How do we make more progress? • Joint working • collect good information about why things go wrong – share it, and learn from it! • discharge planning and process • more access to pharmacist help in social care settings • ensure access to good quality training /education about medicines for all staff handling medicines.

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