Opinion

Supporting patients to make the best use of medicines

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This summer the NHS has come a step closer to the goal of ensuring medicines use is evidence based and cost effective with the release of the Medicines Optimisation Prototype Dashboard

Evidence from national and international research suggests that medicines use is “sub-optimal” and it’s estimated that as much as £300 million is wasted each year on medicines-related mishaps.

In the current era of austerity, NHS budget constraints have prompted a renewed evaluation of spending and waste across the NHS. Reducing that waste and maximising available funding is now essential and in May 2013 the Royal Pharmaceutical Society outlined how good practice in the area of medicines optimisation can achieve just that. To find out more search online for Medicines Optimisation: Helping patients to make the most out of medicines.

Medicines optimisation is primarily concerned with ensuring that patients get the right choice of medicines at the right time. The 2013 guidelines addressed four key principles to govern the practice of medicines optimisation with the goal of improving patient outcomes, ensuring patients take medicines correctly while avoiding taking unnecessary medicines, reducing medicines waste and improving medicines safety.

The four principles have been widely adopted and integrated into NHS culture. They are:

1. Aim to understand the patient’s experience.
2. Make evidence-based choices of medicines.
3. Ensure medicines use is as safe as possible.
4. Make medicines optimisation part of daily practice.

NHS England’s deputy chief pharmaceutical officer, Clare Howard, has said that as many as half of all prescribed medicines are not taken as intended. Medication related issues account for 5-8% of all hospital admissions (17% in over 65s) and carry and an obvious price tag. Better support for patients and a more efficient medicines approach overall could see substantial benefits to the patient and the NHS as a whole and ensure that the taxpayer is not left frustrated.

In the past the focus of medicines management has been on the cost and volume of drugs. It is hoped that through the application of the medicines management dashboard by CCGs, proper medicines use will finally be brought under stricter control.

The prototype dashboard has functions to record data on hospital admissions, patient experience indicators, medicines safety procedure and the utilisation of community pharmacy services.

Ms Howard said: 'We hope that the dashboard will help CCGs think carefully about how well their local population is supported in its use of medicines both in the community and during a stay in hospital and upon transfer back into the community setting.

'CCGs have access to expert pharmaceutical support. Historically, in some areas, this support has concentrated on driving down drug spend. Now, leading CCGs are recognising that there are greater efficiencies in using their pharmacists to lead medicines optimisation.'

Clinical Pocket Reference Practical Medicines Management contains useful data and best practice information on medicines to assist newly qualified nurses and students on clinical placement with medicines administration and optimisation. The new eBook version is fully optimised for smartphone.