Medicines Optimisation Flashcards
What are the 4 principles of medicine optimisation
1 To understand the patient experience (Shared decisions)
2 Evidence based Prescribing
3 Safe medicine use (Regular follow up)
4 Making medicine optimisation routine
What are the 3 main element’s of The NICE 2015 Medicine Optimisation Guidelines
1 Focus on outcomes rather than process and systems
2 Optimising resource use getting better value from medicines
3 Encourage the patient to take ownership of their medicines
In 2012 how many people had one or more long term conditions and were on medications
A 6 million
B 9.4 million
C 15 million
C 15 million
In 2012 how many over the over 60 population had 2 or more long term conditions
A 25%
B 29%
C 35%
A 25%
In 2012 how many items were on the average prescription
A 3
B 9
C 19
C 19
What is the NHS Bill for medication
A £ 30Million
B £ 900Million
C £ 18Billion
C £ 18 Billion
What 3 categories would sub optimal prescribing fall into
A Medication (prescription error, suboptimal dose or not the best choice)
B Adminstration (Poor inhaler technique, taken at the wrong time of day or stopped early or continued unnecessarily)
C Outcomes (Adverse effects toxicity or experience)
W.H.O. in 2003 said how many medications prescribed for chronic conditions were not taken as prescribed
50% in fact a later study showed only 16 % of patient were taking medication as prescribed and they had all the information they needed
How many admissions to hospital are caused by avoidable A.D.R’s
A 2%
B 5%
C 6%
C 6% which is probably about 300,000 a year
Between 2005-10 500,000 incident’s were reported to the NPSA 80,000 involved harm to the patient.
What is the prescribing error rate in hospitals
A 0%
B 5%
C 9%
C 9%
In general practise there were 1.7 million errors in 2010 In the Nursing homes it was noted about 66% of clients were exposed to 1 or more errors
How does Medicine optimisation support National Targets and policies
Only some of the answers..
1 QUIPP quality, innovation productivity and prevention agenda led to improved quality but reduced waste cost and admissions
2 Equality and Excellence liberating the NHS (DoH2010)
improving NHS resources and shared decision making.
3 Making Shared Decision making a reality (Kings fund 2011) Shared decison making
What are the positive outcomes of Principle 1
A belief that preference and choices are understood that the patient is confident to share experiences of (not) taking the medication. Involved in and engaged with treatment better understanding of barriers to non adherence
What is the benefit of evidence based choices
Ensuring that it is the most effective clinical choice. That it is cost effective and it is informed by the best available evidence. It follows patient needs
Principle 3 discusses medication safety what is the total number of errors recorded in a year
a 2.3 Million
b 23 Million
c 230 Million
C the actual figure is 237 million and 28% were potentially harmful
Learning from safety incidents is a core facet of Medicine optimisation In 2014 NHS England issued an alert about poor adverse reporting. what percentage of reports did not discuss remedial actions in their reporting a 49% b 59% c 69% How many didn't disclose the cause of the incident a 49% b 59% c 69%
A 49% did not disclose actions to prevent reoccurrences
c 69% did not disclose cause of the incident
