Mary Aldred
Medication Review Technician,
North Eastern Derbyshire PCT
Tel: 01246 514940
Email: mary.aldred@nederbypct.nhs.uk
Summary:
The PCT Medication Review policy funded two pharmacy technicians to support GP practices with the compliance aspects of medication reviews for older people. This aimed to standardise the medication reviews, produce a tool that could be used across many settings and to involve patients in decision-making. Since it began, approximately 3,500 medication reviews have been carried out in 14 practices. 46% of all patients reviewed had at least one problem identified, the most common being not taking their medicines as prescribed, incorrect repeat prescription lists, side-effects or confusion over their medication. The service is highly valued by practices and patients.
Abstract:
The service aimed to standardise medication reviews for the over 75s; to cover the concordance/compliance aspects of medication usage; to produce a review tool that could be used and shared across many settings; and to involve patients in decision making regarding their medicines. To enable practices to fulfil their medication reviews more effectively meets the strategic aims of the NSF for Older People as wall as the local target of trying to reduce admissions to the acute hospital due to people not coping with their prescribed medicines.
This scheme was introduced following extensive consultation with relevant agencies, including Social Services, GPs, local acute and community hospitals and the PCT. Part of the original funding came from a Local Service Partnership award. A project lead was identified from within the Medicines Management Team and she ensured that the technicians were fully competent prior to commencement of the project.
After the initial 12 months, a comprehensive satisfaction survey was undertaken. Views were obtained from patients and practice staff. A database of all interventions is maintained and regularly examined to allow shared learning within the team.
This is a new role for pharmacy technicians nationally and one which was an exciting part of the professional development of pharmacy technicians. It was a new role for the PCT and the technicians were recruited specifically to initiate this service. Appropriate training was undertaken prior to the technicians commencing the project. The role is being developed further to promote an in-reach service to the community hospitals within the PCT, undertake medication reviews shortly after admission and pre-discharge counselling.The medication reviews are all entered onto a database that may be interrogated to identify to identify the numbers of patients involved, the proportion of patients requiring an intervention and the types of problem found. Questionnaires were sent to patients and to GP practices to ascertain qualitative data. From the first review of the service, it was found that 45% of all patients reviewed had at least one problem identified and 46% required at least one intervention.
Patient satisfaction surveys are undertaken periodically in additional to regular anecdotal feedback.
The medication review service is flexible to allow home visits in addition to the practice-based clinics. This recognises that many people over 75 taking several medicines are housebound. The two technicians have been involved in the PCT diversity training in order that they are equipped to have a more broad approach to their client group.
This project arose from the National Prescribing Centre Medicines Management collaborative initiative and progress and results has been shared within the NPC network. The LSP funding requires that regular feedback be given to support the effectiveness of the initiative. Presentations have also been given to the Royal Pharmaceutical Society and an article was published in the Pharmaceutical Journal.
This exciting new development to the role of the pharmacy technician has been fully embraced by the two post-holders and due to their enthusiasm and dedication the project won second place in the PCT Innovation in Healthcare Awards (Modernisation category) 2004. When some practices suggested that they incorporate BP monitoring into their service this was agreed and is now a fully integral part of the service. Patients and carers have benefited from the time spent specifically focussing on medication issues.
