OLDER PEOPLE
MOOP’S INNOVATIVE CARE PATHWAYS PRODUCING EXCELLENT RESULTS!
WITH UP TO ELEVEN PER CENT OF ALL UNPLANNED HOSPITAL ADMISSIONS ATTRIbUTAbLE TO MEDICINES-RELATED HARM, THE EUROPEAN UNION HAS IDENTIFIED THE REDUCTION OF AVOIDAbLE HARM IN HEALTHCARE AS A KEY PRIORITY. FORTUNATELY, MANY OF THE PROVINCE’S HEALTHCARE PROFESSIONALS ARE ALREADY MAKING GREAT STRIDES IN THIS AREA
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s the population ages and life expectancy increases, more and more people are living
with several long-term conditions that are being managed with an increasing number of medicines. Maintaining a careful balance in these medicines is becoming increasingly more difficult for people and health professionals, particularly since they are also trying to reduce health inequalities in the population.
Optimising a person's medicines is important to ensure a person is taking their medicines as intended and can support the management of long- term conditions, multi-morbidities and polypharmacy.
As far back as 2013, however, a report by The King’s Fund concluded that, while appropriate polypharmacy will extend life expectancy and improve quality of life, in problematic polypharmacy there can be an increased risk of drug interactions and adverse reactions, together with impaired adherence to medication and quality of life for patients.
10 - PHARMACY IN FOCUS
The report suggested that patients with multi-morbidity could have all their long-term conditions reviewed in one visit by a clinical team responsible for co-ordinating their care. between 2012 and 2014, the Western Health and Social Care Trust (WHSCT) developed and evaluated an intermediate care case management medicines optimisation patient care pathway. The aim was to develop, implement and evaluate a consultant pharmacist-led case management pharmaceutical care service for older patients admitted to intermediate care (IC) and continued back into the community care setting.
Since then, the pharmacy Medicines Optimisation in Older People (MOOP) project has gone from strength to strength, with the MOOP team now working in both SEHSCT IC beds (20 beds in a local community hospital) and IC beds within a private nursing home (29 beds).
All of the patients admitted into the consultant geriatrician-led IC units receive a high level of pharmaceutical
care from the MOOP IC team ensuring accurate medicines reconciliation on admission and discharge and referral to other teams and services where appropriate, for example to the osteoporosis team, medicines adherence and Falls Prevention services.
‘One of the primary roles of the team,’ says Medicines Optimisation for Older people (MOOP) Intermediate Care (IC) Team Pharmacy lead, Dr Karen Miller, ‘is to undertake evidence-based medicines reviews to optimise medication regimens and reduce inappropriate polypharmacy. The team attends the IC multidisciplinary team (MDT) meetings, assists with the discharge letters, discharge planning and the accurate transfer of pharmaceutical information on discharge to primary care.
‘Medication review is an integral part of the MOOP service by ensuring that patients are on appropriate medication based on their current clinical issues and past medical
history. Guidelines and evidence- based review tools are used to guide the process of medicine review by reducing inappropriate prescribing through stopping, or by changing potentially harmful medication. Addressing Inappropriate Polypharmacy through evidence- based medication review results in reduced medicine costs and costs associated with treating ADRs.
‘During the inpatient stay in the private nursing home, patients are also assessed for their ability to manage and administer their own medicine while staying in the home. This is part of the MDT approach to maintain and support a patient’s independence and to ensure a safe discharge home. This service will be rolled out to the other Trust IC beds in the next year.
‘The team also provides post- discharge care with follow-up phone calls to the patient to support them taking their medication at home and to help resolve any post-discharge problems they may have. This will often involve liaising with their GP >
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