What was the issue you were addressing or working on?
The increased number of older people living at home with one or more long term condition means there is increased risk of errors with medication. This has been identified as a risk for emergency admission to hospital. These older people are not a group who would routinely receive a review. Post Hospital Discharge a ‘transition’ time for many older people was originally targeted with the service now being available for all Care at Home clients.
Additional support to vulnerable older people to manage their medications can avoid emergency admission to hospital.
What you did?
The lead pharmacist analysed an audit of emergency admissions to hospital and identified that older people were being admitted due to preventable problems with medicine.
Additional support was offered to older people being discharged from hospital who received Care at Home Services. Post hospital discharge was deemed to be an appropriate time to target as there may have been changes to their medication or their ability to “manage” their medication and this may have been affected by their admission.
After referral the pharmacy technicians work with older people in their own home to increase their safety, understanding and concordance in relation to taking their medication. The Care at Home Team is integral to the process in that they work with the Pharmacy Team to assess the person’s ability to “adhere” to the medication regimen and their cognitive functioning to assess the need for “prompting”, and the use of compliance aids.
As well as the service to individuals, the Pharmacy Team is working closely with Care at Home to increase skills and knowledge around medicines and their administration.
The JIT supported the teams to carry out a “Contribution Analysis” of their work.
What were the outcomes - benefits or otherwise?
The Reablement Team have identified that 79% of older people who have been offered support are better able to manage their medication.
The service has been mainstreamed to cover all Care at Home clients.
Care at Home staff routinely ask for advice re medication e.g. inhaler administration. Community pharmacists report increased knowledge of conditions affecting older people e.g. Dementia, continence issues.
Contacts - to find out more
Pamela Macintyre, Pamela.Macintyre@ggc.scot.nhs.uk 01389 828293