Through an individual review in a persons own home, by listening to what the person wants with respect to their medication and by providing information, MESH tackles and improves issues of intentional or non-intentional adherence. MESH also addresses and provides support with hoarding and optimises medicine prescription and supply to prevent the re-occurance of these issues.
As part of its Out of Hospital programme and in response to a need to provide support and medicines education for people with complex needs who are prescribed multiple medications to manage their conditions, Bradford City and Districts CCGs undertook a procurement exercise to find the best provider and commissioned PSS to deliver the MESH from April 2017.
The main beneficiaries of the project are adults, registered with a Bradford GP, who live either in their own home or in care homes who are prescribed 10 or more medications. Other people eligible to receive a MESH review are those referred to start a Dosette box or those prescribed 4 medications or more, who have complicating factors e.g. have a non-compliance issue.
There are approx. 85,000 people in Bradford taking 4 or more medications.
There are approx. 21,000 people in Bradford taking 10 or more medications.
Carers and family members are also key beneficiaries because of the improved health, confidence and quality of life which is often experienced by patients following a MESH review.
In the first year of the project, MESH supported almost 6,000 people to review their medications. Through 9915 separate interventions, over 3,000 medications were stopped because they were no longer needed or were inappropriate for the person. By helping people who take multiple medications to better understand and be in control, MESH has reduced the risks of adverse reaction or poor concordance from polypharmacy for those patients, including A&E attendances and unplanned admissions to hospital. Individual reviews by MESH pharmacists has also delivered more cost effective use of medication and reduced waste through only stocking or prescribing the medications necessary to manage a patients condition(s).
