Older people living with frailty are the fastest growing sub-group of our ageing population. This module looks at medicines use reviews (MURs) undertaken with the patient in his/her own home, including warden assisted or sheltered accommodation. This group of patients are the most vulnerable to adverse drug events (ADEs) and will benefit from domiciliary MURs for a number of reasons. 

Many are housebound, have difficulties accessing face-to-face pharmaceutical care and rely on others for medicines support, which can result in poor engagement with both the prescribers and dispensers. 

Multi-disciplinary team involvement, frequent hospital visits and care delivery via complex health and social care pathways are normal for this group – and that increases the risks of ADEs due to communication breakdown and poor transfer of information. Poor patient engagement and poor communication between various practitioners prescribing, dispensing or administering medicines can lead to errors, ADEs and non-adherence, especially during transfer of care or handover points.

Domiciliary MURs provide an opportunity to understand what is happening with the patient and their medicines, monitor medicines use, and detect and resolve any ADEs.