Transcript Screening and Medicine Management Plans in Practice

LTC Screening and
Medicine
Management Plans
in Practice
Claire Thrower
Unichem Bishopdale Pharmacy
Screening Patients
• Where can people be screened?
• Computer processor
• Pharmacist checking
• Patient contact; counter, phone, medico
• What we look out for?
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Unsynchronised medication.
Not collecting regularly ; supply lasting >3 months
Returning extra medications; build up at home
Not collecting repeats
• Can’t assess them at that time?
• List of patients to assess when you get a chance
Criteria: LTC who qualifies?
• Adherence Issues is KEY
• No adherence issues then they can not be LTC
• Multiple hospital admissions
• Is this due to medication issues???
• Has there been changes and need help to manage these
• Look at their health conditions, can they get > 20 points
• Can use eSCRV to help assess their eligibility
• NOTE Pack patient or complex medicine regime doesn’t mean
that they are automatically eligible for LTC
Medicines Management Plan (MMP)
• Discuss issues with patient and what they want to get from
this service.
• Formulate plan with patient
• Only need brief notes
• Record on MMP
• Action the plan
• Focus on one point at a time
• Document activities
• Diary note can be used, LTC document.
• Review Progress
Example: LTC diary note
Patient Engagement Ideas
• Opportunity whilst in the pharmacy
• Note in computer to discuss certain points with patient
• Phone call
• Medicines use Review (MUR)
Action Plan Ideas…
• Synchronisation
• Key particularly with CPSA stage 4
• Reconciliation
• Blister pack
• Weekly, monthly
• Lining up loose medications with packs (with dose pack)
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MUR
Monthly dispensing
Reminders; Repeats, new prescriptions
Yellow cards
Access addition services; medicine oversight
Patient ONE
Patient ONE
• 94 yrs old
• Recent hospital admission in March with medication changes
• Collects medicines regularly every 3 months
• Build up of some medication at home.
Patient ONE
• Medication build up
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Folic acid
Ferro Grad
Aspirin
Simvastatin
Pantoprazole
ISMN
Terazosin
Metoprolol
-0
- 14
- 68
- 73
-190
-5
-74
-176
MMP; Patient ONE
• Synchronisation of his medication with new script
• Monthly dispensing
• Yellow card
Patient TWO
Patient TWO
• 58 yrs old
• Not collecting repeats Dabigatran or Seretide
• Not collecting scripts regularly – medicines lasting 4 to 5
months
• Hospital admission Jan 13 with new diagnosis- new
medication started
MMP: Patient TWO
• MUR
• Blister packs monthly
• Return unused medicines at home
• Dabigatran and Seretide to go along side these.
• Yellow card
Patient THREE
Patient THREE
• 73 yrs old
• Recent hospital admission – fall
• Medication changes
• Post discharge unaware about whether to continue some
medication
• Family worried about her managing her medicines
MMP: Patient THREE
• Reconciliation
• Blister packs
• Yellow card
Communication with Medical
Centres
• Local Medical Centres write LTC on script
• Do this for patients they think should be LTC
• Verbal communication
• Faxing a list to Medical Practice of their LTC patients
EAR portal.
• Use of EAR portal for:
• If we are getting paid
• If not why? Looking at reason
• Exiting people that have not collected rx >120 days or are deceased
• Check it matches our records
• Checking the LTC review list
• Patients on this list won’t be paid for.
Points to take home
• MMP for patient is a “living document”
• build on the framework of original plan
• No formula for successful plan
• Every one is individual so their plans may all vary.
• Patients should be having at least monthly contact
• Document what you do, Diary notes
• All staff can do this