Increasing numbers of patients have multi-morbidities and polypharmacy is an increasing challenge. With up to 11% of unplanned hospital admissions being attributable to harm from medicines and over 70% of these being due to elderly patients on multiple medicines, there are significant opportunities to reduce this burden by timely and effective interventions.
A holistic polypharmacy review will often result in an element of de-prescribing, ensuring patients treatment is optimised to achieve their preferred outcomes and reducing inappropriate prescribing. The long term benefits include better patient compliance, less medication related side effects and reduced waste, generating cost savings.
Polypharmacy - Best Practice Guidelines were produced and provided as reference document to all healthcare professionals involved in medication reviews to aid in reviewing and reducing the number of inappropriately prescribed medicines.
Polypharmacy medication reviews are a key focus for the practice based pharmacist team for 2018-19, these reviews are associated with significant QIPP. These savings are due to better use of medicines in addition to reducing hospital admissions related to medicines. The local medication review guidelines were updated and a de-prescribing pack produced which included all the necessary tools, EMIS searches required to assist healthcare professionals to undertake a robust and effective medication review concentrating on reviewing and reducing the number of inappropriately prescribed medicines.
Patients, prescribers and the wider health economy will all benefit from the process of effective medication review and de-prescribing. This will mean that prescribers will no longer prescribe and patients no longer take medication that maybe causing harm or no longer providing benefit. This will reduce side effects associated from inappropriate polypharmacy, reducing risk and improving quality of life for patients. The health economy will benefit from medicines cost savings, reduced demand, an improvement in access to NHS services and a reduction in unnecessary admissions related to medicines.
From the suite of EMIS searches we have developed there are nearly 3000 patients aged over 65 who are currently prescribed 15 or more repeat medicines. The searches support our medicines optimisation delivery strategy by segmenting the population according to risk stratification. These searches and will help to further identify other groups of patients at increased risks associated with their medicines. It is envisaged that all 3000 patients including those at additional risk will have a detailed clinical medication review in the next 12 months ensuring long term medication is safe, effective, tolerated, cost effective and optimised for maximal benefit. The outcomes of these reviews will be reported and evaluated from the Pharmoutcomes reporting system.
