Sustainability & Transformation Partnerships
Evidence has shown that pharmacists working with care homes and their residents results in improvements in quality of care and reduced risk of harm from medicines.
Better utilisation of pharmacists’ skills and expertise in care homes can bring significant benefits to care home residents, care home providers and the NHS as a whole.
There are over 400,000 elderly people in care homes and the average age of care home residents is 85. The average number of medicines taken by a care home resident is 8. These residents are generally frail; 76% of residents require assistance with mobility or are immobile and 78% have at least one form of mental impairment. Due to an aging population and policies to encourage elderly people to stay in their homes longer, the population of people in care homes is older, frailer and with more complex health needs than in previous years. The majority of people living in care homes are also suffering from dementia.
It has been demonstrated that pharmacists undertaking a medicines review with individual care home residents has a positive impact:
• Patients and / or their family members or carers have a better understanding of the medicines they are taking and why they are taking them. This leads to improved adherence
• Generally reduces the number of medicines prescribed per resident, deprescribing rates are between 12% and 20%
• Reduces the amount of medicines wasted
• Reduces staff time in administration of medicines
• Reduces the number of emergency hospital admissions
Research undertaken in 2009 estimated that medicines wastage in England cost £300 million each year. Of this, £24 million is medicines that are disposed of unused by care homes. Pharmacists and pharmacy teams in care homes can help reduce the amount of medicines wasted by ensuring safe and effective medicines policies are in place.
The extent of problems with medicines management in care homes has been known since a wide ranging study in 2009 that looked at the prevalence of medication errors received by 256 patients in 55 homes. Patients were prescribed an average of 8 medicines each and 69.5% of patients had at least one error. None of the improvements needed are, of themselves, difficult to achieve but require a new approach by all professionals involved in care at a local level. Professional leadership by pharmacists, as part of a multidisciplinary team, is the catalyst that is needed to make change happen.