Law And Ethics- Medicines Optimisation And Information Lecs Flashcards
How does medicines optimisation differ to medicines management?
It focuses on OUTCOMES (rather than process)
Focuses on PATIENTS (rather than systems)
It is LED rather than delivered by a pharmacist.
It requires both patient and public engagement and inter- professional team working
What is medicines optimisation?
Ensuring that the right patients get the right choice of medicine at the right time
Medicines use is proven to be less than ideal.
This means people aren’t getting the most out of their medication. What does this lead to?
People are having to take MORE medicines to make up for the fact that some of their medication isn’t working as well as it should.
This needs to be put right especially in:
Older patient who are already on loads of medication
To prevent hospital admissions
To cut medicines waste
In primary care, almost ____ million pounds a year of medicines are wasted.
At least ___ % of emergency re-admissions into hospital are caused by avoidable adverse drug reactions as people aren’t taking their medicines propley!!
£300 million
6% avoidable
Therefore pharmacists can really make a difference to the UKs a&E departments!!
The QIPP agenda is a driver for medicines optimisation.
What is this?
QIPP stands for:
Quality, innovation, productivity and prevention.
Pharmacy can play a role
List a couple of things that are driving medicines Optimisation?
Economic- lots of money wasted due Wastage problems Adherence problems Safety problems Demographic changes in the population: elderly living longer QIPP
10 days after starting new medicines, ___% of patients are already non adherent
30%
Only ___% of patients who have been prescribed a new medicine are taking it as prescribed, experiencing no problems and receiving as much info as they need
16%
Tiny amount!!
What does the government document called “equity and excellence; Liberating the NHS” state we should do?
Put patient care at the heart of everything we do
Optimising medicines use is crucial to improving the quality of care and balancing the cost of healthcare (saving money’s)
Community pharmacists can be offered incentives to supply high quality services and improves costs of medication wastage etc.
They could do this by doing MURs and NMS
What’s the main gist of the paradigm shift?
We’re going from not that patient based at all focussing on systems and processes etc…
Too being completely patient based!!
Patients now need to be at the of everything!!
What are POOs?
Patient orientated outcomes
So things like reducing side effects, better services offered to patients, getting patients involved with their Own care abit more!
Professional standards on optimising patient outcomes from medicines give a broad framework which supports chief pharmacists and pharmacy teams to improve these services.
How is standard 1, “Patient centred”, implemented?
Patients and carers should be treated with respect by pharmacy staff
Give lots of clear information about meds to patients if they want it on ward rounds
Adherence: patients should be signposted to a community pharmacy for follow ups
MURs are being targeted to migraine patients
This is because we frequently hear “nothing works for me”
Pharmacist can offer some good solutions for a migraine
Treatment could be as simple as a large dose of aspirin (600-900mg) as this could abort an attack if taken at aura stage.
If nausea and vomiting becomes a problem, just pop in buccal Prochlorperazine
Note: for the use of triptans for migraines effectively patient counselling is a must do!
In the medicine pathway (history through to monitoring) when can a pharmacist chip in?
At ANY point!!
UKMi= UKs medicine information service
How to answer an enquiry:
1) understand the question
2) research the question
3) prepare your answer
4) feedback your answer
It’s important to document every stage of giving information out for an enquiry
This is so people can use this information in future to answer questions
What must we do as a medicines information pharmacist to understand the question?
1) what does the enquirer want to know, why?
2) get details on the dose, and indication for the medicine in Qu
3) get the patient patient medical history and drug history
4) look out for other problems the enquirer hasn’t spotted, e.g interactions!
When might it be inappropriate to answer an enquiry?
1) third party enquiries- outside sources
2) to protect the patients relationship with other professionals
3) illicit drugs (illegal)
4) complaints
How do we research a question?
Do a logical and structured search of reliable information sources Use 3-4 sources: Your own knowledge BNF, Martindale, EMC Specialist sources Literature search
How many sources should you try to find your answer in before you can be confident?
2 or 3 independent sources
This is so you can be confident in your answer
Where could you look to find reliable sources of information?
Use sources approved by a recognised body eg the UKMi essential resources lists
Where could you document answers to enquiries?
Patients PMR
Document who you fed back to, & when
Could keep files in MI office
