Medicines optimisation

Pharmacy teams have a responsibility to ensure medicines optimisation in care homes. Helping to optimise the use of medicines for people living in care homes is critical, as evidence shows that people living in care homes tend to have more comorbidity, take more medicines and are more at risk of harm from medicines than people who live in the community.²

The Care Homes’ Use of Medicines Study (CHUMS) report (2009) looked at 256 people living in 55 different care homes. In this group:²

• The mean age was 85
• People took a mean of eight medicines
• Seven out of 10 residents were exposed to at least one medication error (a mean of 1.9 errors/resident)
• The prevalence of prescribing errors in 8.3 per cent of medicines (39 per cent of residents)
• There were dispensing errors in 9.8 per cent of medicines (37 per cent of residents)
• There were administration errors in 8.4 per cent (22 per cent of residents).

The authors of the study concluded people who live in care homes:²

• Have ‘different’ needs from those that are usually seen in primary care services
• Experience a lack of access to specialist services
• Have multiple transitions in care
• Are supervised by staff who lack medicines training.

There are/is:

• Complex dispensing and ordering systems
• A fragmented system and poor communication between services
• A lack of standard procedures and documentation.

As a result of this research, in 2014 the NICE created its first social care guideline to marry the needs of health and social care to help health and social care professionals unite to support people living in care homes. NICE SC1 and QS 85 focus on managing medicines in care homes, which is generally known as ‘medicines management’.

In March 2015, NICE also produced a list of standards for the MDT to work towards.