Transcript Title to go here

Medicines Optimisation
Polypharmacy and Deprescribing
Clare Howard FFRPS FRPharmS
Clinical Lead Medicines Optimisation
Vicki Rowse Programme Manager
Medicines Optimisation
Why is this an issue?
Getting the most from medicines for both patients and the NHS is becoming
increasingly important.
It is estimated that:
• Between 30 and 50% of medicines prescribed for LTCs are not taken as
intended1
• 15 million people in England now have a LTC2
• 14% of people under 40 and 58% of people aged 60 and over have at
least one LTC2
• 2.9 million people will have multi-morbidity by 20182
• 25% of people over 60 report having two or more LTCs2
• Between 2003 and 2013 the average number of prescription items per
year for any one person increased from 13 to 193
Medication Safety
But we aren’t getting it right…
Evidence from primary care shows
• 1 in 20 prescription items has an error and 1 in 550 is
serious4
• In 2013 there were over 1 billion items dispensed in
England therefore this equates to 1.8 million serious
errors3
• Accounts for 1 in 25 hospital admissions5
• Over 50% were in 4 disease classes, antiplatelets,
NSAIDs, diuretics and anticoagulants5
Medication Safety
Secondary care not better.
EQUIP Study showed:6
Error rate of 7% of medication orders
52 errors per 100 admissions
24 errors per 1,000 patient days
Polypharmacy
• Kings Fund Poly Pharmacy and Medicines
Optimisation
• NICE MO short clinical guideline published 2015
What messages do they have?
Medicines Optimisation is defined as “a person-centered approach to safe and
effective medicines use, to ensure people obtain the best possible outcomes from
their medicines”1.
NICE GUIDANCE (NG5)
KING’S FUND
• Between 2003 and 2013 the
average number of prescriptions for
any one person per year in England
rose from 13 to 193
• In problematic
polypharmacy, there can
be increased risk of drug
interactions and ADRs,
impaired adherence and
QoL for patients10
 Better use of data
 Patient centered care
(including shared decision
making)
 Transfer of care
 Medication safety
NICE
% of Pharmacies conducting MUR
Workshop
We don’t have the answers!
You’ll hear from people working on this
We can agree where our efforts should focus
AHSN role in supporting spread
Patient video
http://www.leedswestccg.nhs.uk/news/leedscare-home-patients-benefit-medicationreview-service/
https://youtu.be/mjTFP7bIZ2o
Workshop
• 1. How has QOF affected polypharmacy and
how are you addressing this?
• 2. What is the role of the community
pharmacy?
• 3. How has your organisation addressed
polypharmacy?
• 4. How can we address polypharmacy when
patients move between care settings?