Problematic polypharmacy – when an individual’s multi-medication regime is not providing the intended benefit – can lead to adverse drug reactions and reduced quality of life. Problematic polypharmacy – when an individual’s multi-medication regime is not providing the intended benefit – can lead to adverse drug reactions and reduced quality of life.

The average older person admitted to hospital is prescribed 13 medicines and adherence is also poor resulting in significant waste of resources. Problematic polypharmacy is both a quality and patient safety issue. Recognising this problem, KSS AHSN carried out an two-phase programme, looking at problematic pharmacy in care homes.

As a result of the work it has developed a suite of resources to support organisations to develop a medication review service for citizens living in care homes. 

Phase one – An initial six-month trial in Brighton funded a pharmacist and pharmacy technician to perform Level 3 (holistic face to-face) medication reviews for patients at risk of medication related harm in care homes and their own homes. 

It showed that this approach can prevent hospital admissions, offers savings to Clinical Commissioning Group (CCG) prescribing budgets, and is well received by patients and carers.

Phase two – Building on those learnings, the KSS AHSN team worked with three CCGs and Sussex Community NHS Foundation Trust who were carrying out similar work, all at different stages, to aggregate data from a wider geographic area, test findings, and consolidate learnings. 

Resources – This work has resulted in the publication of a resource pack to support others looking to develop a similar approach, which includes: 

  • Phase 1 evaluation report
  • Three detailed case studies from phase 2 with accompanying analytic reports
  • A number of resources and templates that can be adapted for local use, including:
    • Metrics and a data collection spreadsheet
    • Guidance on how to run peer-to-peer training sessions

KSS AHSN will continue to support this work via the national AHSN Network medicines optimisation team, and by supporting discussions around the national polypharmacy programme. 

Find out more – lisa.devine5@nhs.net