The audit involved a pharmacist-led process for identifying patients who were currently prescribed ONS.
The aim of the project was to review the trends of prescribing of ONS in the PCN with a secondary aim of evaluating the effectiveness of pharmacist led clinics to deprescribing ONS.
It was found that majority (>60%) of ONS prescriptions were initiated in secondary care and by GPs. Only 8% of patients prescribed ONS were prescribed for an indication approved by the ACBS, and only 4% of prescriptions were for first line ONS products according to our local guidelines.
Data on the assessment of malnutrition was also collected, it was found that 63.7% of patients were not assessed using the Malnutrition Universal Screening Tool (MUST), or an equivalent objective test. Additionally, 57.3% of patients did not have a follow up review to reassess their malnutrition risk. Following consultations with pharmacists, 23% of ONS prescriptions were deprescribed (equivalent to cost savings of 20k per annum).This audit highlighted the importance of setting clear treatment goals and managing expectations at the point of initiation due to patients or their relatives becoming dependent on ONS despite being identical to using a food-first approach.
The results also highlighted the main sectors which need education surrounding malnutrition or require interventions. The outcomes of the audit were used to inform GPs, community dieticians and pharmacists of current practice and educate them on appropriate ONS prescribing. The data also informed efforts to work cross-sector with secondary care to improve objective malnutrition monitoring and patient education around ONS.
