Tackling inappropriate polypharmacy in NHS Scotland
|
|
- Marianna Griffin
- 5 years ago
- Views:
Transcription
1 Tackling inappropriate polypharmacy in NHS Scotland Francesca Aaen Lead Care Homes Pharmacist - NHS Lanarkshire Heather Harrison - Senior Prescribing Advisor/ Chronic Pain Primary Care Service Development Project Manager - NHS GGC
2 NHS Lanarkshire Care Homes Project NHS Lothian Polypharmacy review NHS GGC Polypharmacy LES
3
4
5 SPARRA=Scottish Patients At Risk of Readmission and Admission SPARRA is a risk prediction tool developed by Information Services Division (ISD), NHS Scotland predicts an individual's risk of being admitted to hospital as an emergency inpatient within the next year What is a SPARRA Score? SPARRA scores can range from 1 to 99% for patients in the 4.2m cohort Patients with a score of e.g. 50% are generally said to have a 1 in 2 chance of being admitted to hospital in the next 12 months What is the purpose of SPARRA? SPARRA data can help health care professionals to prioritise patients with complex care needs who are likely to benefit most from anticipatory health care. SPARRA data can also be used in a service planning capacity by locating groups of patients who would benefit from specific interventions or services.
6 Taking long term responsibility for prescribing in a care home NHS Lanarkshire GP enhanced service for care homes Care Homes Pharmacist Medication Reviews Community pharmacist independent prescribers
7 Pilot supporting care homes without GP enhanced service in one locality 2 care homes caseload of 168 residents 6 GP practices Reviews prioritised by high risk meds or by referral
8 Outcomes Case studies Positive feedback from Patients and families Carers GPs Practice staff Care Home staff Community pharmacy
9 CARE HOME A Hypnotics and anxiolytics Antipsychotics 35 CARE HOME B Hypnotics and Anxiolytics Antipsychotics
10 Average cost per patient (PIS data)
11 Next steps Expand the service 2 care homes in a second locality 102 patients 9 GP practices Develop a referral system Pharmacist as first point of contact for review Teach and Treat
12 Teach and Treat NHS Education for Scotland funded initiative Develop clinical capacity for IPs Each board delivering differently NHS Lanarkshire Polypharmacy and respiratory Pharmacists from any setting Intensive training programme Ongoing commitment to deliver clinics
13 NHS Lothian Polypharmacy review
14 NHS Lothian Polypharmacy Review Jan 2012 onwards: Aims and Outcomes Pilot project NHS Lothian Alpana Mair 2011 level 3 medication reviews for residents of two care homes with GP and care of the elderly consultant input involving optimising medications to minimise iatrogenic risk to elderly patients ADRs and drug-related hospital admissions and maximise benefit All 126 GP practices in NHS Lothian invited to participate in Service Level Agreements (SLA) Aims & Desired Outcomes To target priority patient groups - those most at risk of ADRs: care home residents, frail housebound, those on high-risk medications (either alone or in combination). To carry out systematic medication reviews to optimise medicines minimise medicines which may be harmful (particularly in those experiencing ADRs) or no longer appropriate, maximise benefit in line with NHS Lothian Polypharmacy Guidance for prescribing in frail adults (based on NHS Highland guidance, later Scottish guidance 1 st ed Oct 2012) To undertake joint review discussions GP/patient/pharmacist and implement changes
15 NHS Lothian Polypharmacy Review Jan 2012 onwards: Developments Ward rounds in care homes with Medicine of the Elderly Consultant/GP/pharmacist SurveyMonkey GP feedback questionnaire Peer review sessions for integrated care pharmacists Central database of patients who have had medication review
16 SUMMARY 2012/ / /15 to date patient cohort care home residents plus 24 patients per practice aged >75yrs on >10 repeat meds at least one of which high risk 24 patients per practice aged >75yrs with SPARRA score 40-60% having received meds from >10 BNF sections one of which high risk care home residents plus 24 patients per practice aged >75yrs with SPARRA score 40-60% having received meds from >10 BNF sections one of which high risk no. practices signed up to SLA/126 practices NHS Lothian no. patient medication reviews /4858 no. medicines stopped of which high risk medicines no. medicines with dose reduced no. medicines with dose increased no. medicines started no. medicines switched estimated medicines cost/patient/year saved ( ) 112 (1 st 368pts) 65 (1 st 602 patients 114 (random sample 20 patients per month
17 NHS Lothian Polypharmacy Review Jan 2012 onwards: Limitations Snapshot in time Face-to-face patient/pharmacist contact limited Prioritisation/scheduling of interventions GP time to implement interventions Documentation of outcomes so that shareable intra/inter profession Standardisation of review paperwork
18 Medicine is a science of uncertainty and an art of probability. William Osler
19 NHS GGC Polypharmacy LES enhanced polypharmacy review in a planned face to face consultation with a GP for patients considered priority for medication review. (1.5% weighted practice list) One GP from each practice to attend an external small group learning session and one internal practice learning session
20 Who is considered as prioirity?
21 Patients on 5 or more repeat medicines including an oral NSAID + ACE Inhibitor or Angiotensin 2 Receptor Antagonist + Diuretic + Warfarin + antiplatelet + age 65 years without PPI Patients on 5 or more repeat medicines including warfarin + Other antiplatelet(s) Patients aged 65 over on 5 or more repeat medicines including any combination of medicines that increases the risk of falls. (High and moderate falls list drugs include Antidepressants, Antimuscaririncs, Antipsychotics, Benzodiazepines, Z drugs, Dopamine agonists,,opiates, Anti-epileptics,, Alpha Blockers, Diuretics, ACEIs and Betablockers) Patients age 65 and over on 5 or more repeat medicines that equates to an Anticholinergic Risk Score of 3 or higher
22 Patients age 65 and over on 5 or more repeat medicines including a long acting sulphonylurea agent Patients on 5 or more repeat medicines including 2 or more antiplatelets for greater than 12 months Patients aged 65 years and over on 5 or more repeat medicines including an oral antipsychotic prescription (as a proxy of oral antipsychotic prescribing to older people with dementia) Patients on 5 or more repeat medicines including any current combination of Step 2 opioids (codeine, dihydrocodeine, dextropropoxyphene, tramadol or buprenorphine) Patients on 10 or more repeat or regular acute medicines (excluding dressings, emollients etc) The Polypharmacy EMIS/VISION Microsoft Access application tool has been modified so the practice can identify patients on 5 or more repeat medicines and other named drugs considered as a particular priority for review within the individual practice.
23 Evaluation Activity measures Percentage of practices opting in=99% (240/242) Numbers of patients reviewed= 32,316 Percentage of patients viewed compared with target= 114% No outcomes measures such as reduced hospitalisations or ADRs
24 221 GPs attended the sessions Average Pre Post Knowledge & Awareness of National Polypharmacy Guidance / 7 steps of polypharmacy review Knowledge & skills in applying a polypharmacy review How confident do you feel in delivering polypharmacy reviews
25 National Polypharmacy Guidance Supporting provision of Safe, Effective and Person-centred care (Prescription for Excellence) Describes a 7-step process: 1. Identify objectives of drug therapy 2. Identify essential drug therapy 3. Does the patient take unnecessary drug therapy? 4. Are therapeutic objectives being achieved? 5. Does the patient have ADR or is the patient at risk of ADR? 6. Is drug therapy cost-effective? 7. Is the patient willing and able to take the drug therapy as intended?
26 Each section then detailed E.g.: Safety Drugs poorly tolerated in frail adults See Gold National Framework on frailty o Antipsychotics (incl. phenothiazines) o NSAIDs (46) o Digoxin (doses? 250 mcg) (9) o Benzodiazipines (24) o Anticholinergics (incl. TCAs) (27) o Combination analgesics High-risk clinical scenarios See ADR table o Metformin + dehydration o ACEI/ARBs + dehydration o Diuretics + dehydration o NSAIDs + dehydration o NSAID + ACEI/ARB + diuretic o NSAID + CKD o NSAID + age >75 (without PPI) o NSAID + history of peptic ulcer o NSAID + antithrombotic o NSAID + CHF o Glitazone + CHF o TCA + CHF o Warfarin + macrolide/quinolone o?2 anticholinergics (see Anticholinergics)
Taking the harm out of Polypharmacy Step by step. Karen Reid and Claire Stein Lead Integrated Care Pharmacist NHS Lothian
Taking the harm out of Polypharmacy Step by step Karen Reid and Claire Stein Lead Integrated Care Pharmacist NHS Lothian Presentation: Polypharmacy Overview of the 2015 guidelines The Seven Steps Application
More informationCover images courtesy of jk1991 at FreeDigitalPhotos.net Infographics courtesy of SIMPATHY consortium
If using any content from this document, please acknowledge the Scottish Government Polypharmacy Model of Care Group, 2018. When referencing this document, please use the following format: Scottish Government
More informationPolypharmacy Strategy for NHS Fife
Polypharmacy Strategy for NHS Fife 2016-19 1 Introduction The purpose of this document is to describe the factors contributing to the issue of inappropriate polypharmacy as it relates to NHS Fife and proposes
More informationPolypharmacy: Guidance for Prescribing in Frail Adults
Polypharmacy: Guidance for Prescribing in Frail Adults Why is reviewing polypharmacy important? Medication is by far the most common form of medical intervention. Four out of five people aged over 75 years
More informationReshaping Care Pathways for Older People. Anne Hendry National Clinical Lead for Quality
Reshaping Care Pathways for Older People Anne Hendry National Clinical Lead for Quality Reshaping Care for Older People 10 Year Programme to 2021 300 million Change Fund to 2015 32 Partnerships between
More informationMedicines Optimisation the opportunities and challenges. Christina Short Medicines Optimisation Project Manager
Medicines Optimisation the opportunities and challenges Christina Short Medicines Optimisation Project Manager The remit:- Clinical Pharmacy input into the Locality Model Proposal: To contract a senior
More informationPrescribing Dilemmas. Sue Mulvenna Head of Pharmacy and CD Accountable Officer South Region SW 19 th May
Prescribing Dilemmas Sue Mulvenna Head of Pharmacy and CD Accountable Officer South Region SW 19 th May 2016 The four principles of medicines optimisation Aim to understand the patient s experience Evidence
More informationPolypharmacy in the Elderly
Polypharmacy in the Elderly Or How Scotland invented the Modern World Sir William Ferguson Anderson 1914-2001 Became the first Professor of Geriatrics in the world when he was appointed to the David Cargill
More informationOptimising prescribing in primary care in the face of multimorbidity and polypharmacy
University of Dundee School of Medicine Optimising prescribing in primary care in the face of multimorbidity and polypharmacy Bruce Guthrie Professor of Primary Care Medicine, University of Dundee NICE
More informationItem No: 10. Meeting Date: Wednesday 20 th September Glasgow City Integration Joint Board. Alex MacKenzie, Chief Officer, Operations
Item No: 10 Meeting Date: Wednesday 20 th September 2017 Glasgow City Integration Joint Board Report By: Contact: Alex MacKenzie, Chief Officer, Operations Anne Mitchell, Head of Older People & Primary
More informationNational Therapeutic Indicators and Additional Prescribing Measures 2017/18 - Early Release Document
National Therapeutic Indicators and Additional Prescribing Measures 2017/18 - Early Release Document 1 National Therapeutic Indicators 2017-18 National Therapeutic Indicators (NTIs) and Additional Prescribing
More informationPRESCRIBING IN THE ELDERLY. CARE HOME PHARMACY TEAM Bhavini Shah, Eleesha Pentiah & Puja Vyas
PRESCRIBING IN THE ELDERLY CARE HOME PHARMACY TEAM Bhavini Shah, Eleesha Pentiah & Puja Vyas LEARNING OUTCOMES Medicines Optimisation The effects of aging on health and medicines. Polypharmacy Acute Kidney
More informationIf using any content from this document, please acknowledge the Scottish Government Polypharmacy Model of Care Group, 2018.
3 rd Edition, 2018 If using any content from this document, please acknowledge the Scottish Government Polypharmacy Model of Care Group, 2018. When referencing this document, please use the following format:
More informationAlpana Mair, Deputy Chief Pharmaceutical Officer, Scottish Government (Chair)
Acknowledgements It has been a pleasure to chair the development of this Polypharmacy Guidance 2015 and work with a team that are committed to improving outcomes for patients. This document has been produced
More informationESSENTIAL CARE AFTER AN IN-PATIENT FALL
ESSENTIAL CARE AFTER AN IN-PATIENT FALL In line with the National Patient Safety Agency Rapid Response Report (NPSA/2011/RRR001): Essential care after an inpatient fall, in caring for a patient who has
More informationNSAIDs Change Package 2017/2018
NSAIDs Change Package 2017/2018 Aim: To Reduce harm to patients from Non-Steroidal Anti-inflammatory Drugs (NSAIDs) in primary care Background A key aim of the Safety in Practice programme is to reduce
More informationDeprescribing with Confidence Dr Sanjay Suman MD FRCP
Deprescribing with Confidence Dr Sanjay Suman MD FRCP Clinical Director Elderly Care and Stroke Medway NHS Foundation Trust Kent 45% of all medications prescribed for 65 years 1 1. Wynne et al Maturitas
More informationSPARRA Mental Disorder: Scottish Patients at Risk of Readmission and Admission (to psychiatric hospitals or units)
SPARRA Mental Disorder: Scottish Patients at Risk of Readmission and Admission (to psychiatric hospitals or units) A report on the work to identify patients at greatest risk of readmission and admission
More informationPolypharmacy Guidance
Polypharmacy Guidance October 2012 Developed by The Model of Care Polypharmacy Working Group Quality and Efficiency Support Team Scottish Government Health and Social Care Directorates - 2 - Acknowledgements
More informationKEY QUESTIONS What outcome do you want to achieve for mental health in Scotland? What specific steps can be taken to achieve change?
SCOTTISH GOVERNMENT: NEXT MENTAL HEALTH STRATEGY Background The current Mental Health Strategy covers the period 2012 to 2015. We are working on the development of the next strategy for Mental Health.
More informationScreening tools for elderly patients in primary care
Screening tools for elderly patients in primary care Cristín Ryan 1 Prof. Julia Kennedy 1 Dr. Denis O Mahony 2 Dr. Stephen Byrne 1 Co-Investigator: Dr. Paul Gallagher 2 1 Pharmaceutical Care Research Group,
More informationNational Prescribing Indicators Supporting Information for Prescribers
National Prescribing Indicators 2018 2019 Supporting Information for Prescribers February 2018 This report has been prepared by a multiprofessional collaborative group, with support from the All Wales
More informationCare homes: Good practice guide to prescribing and medication reviews
B112i. October 2015 Care homes: Good practice guide to prescribing and medication reviews The effective management of medicines in care homes requires robust systems to be in place as well as good communication
More informationBulletin Independent prescribing information for NHS Wales
Bulletin Independent prescribing information for NHS Wales July 2016 Optimising medicines use in care homes There are currently over 22 000 resident places in older adult care homes in Wales. 1 An ageing
More informationSTOPP and START criteria October 2011
# START and STOPP are newer criteria to identify potentially inappropriate medications in elderly, including drug drug and drug disease interactions, drugs which increase risk of falls and drugs which
More informationIatrogenesis in the frail elderly
Iatrogenesis in the frail elderly Professor Michael Dooley Director of Pharmacy Alfred Health Professor of Clinical Pharmacy Centre for Medicine Use and Safety Monash University Iatrogenesis in the frail
More informationDUMFRIES AND GALLOWAY ALCOHOL AND DRUG PARTNERSHIP; PRIORITY ACTIONS AND
DUMFRIES AND GALLOWAY ALCOHOL AND DRUG PARTNERSHIP; PRIORITY ACTIONS 2013-14 AND 2014-15 RECOMMENDATION/WORKPLAN CURRENT POSITION IN D & G PLAN 1. Annual Report 1.1 Develop robust reporting mechanisms
More informationREPORT TO CLINICAL COMMISSIONING GROUP
REPORT TO CLINICAL COMMISSIONING GROUP 12th December 2012 Agenda No. 6.2 Title of Document: Report Author/s: Lead Director/ Clinical Lead: Contact details: Commissioning Model for Dementia Care Dr Aryan
More informationDeconstructing Polypharmacy. Alan B. Douglass, M.D. Director
Deconstructing Polypharmacy Alan B. Douglass, M.D. Director Recognize this patient? Mrs. Brown- 82 years young Active Medical Problems Hypertension Hyperlipidemia Type 2 Diabetes Peripheral edema Osteoarthritis
More informationTest and Learn Community Frailty Service for frail housebound patients and those living in care homes in South Gloucestershire
Test and Learn Community Frailty Service for frail housebound patients and those living in care homes in South Gloucestershire Introduction This document introduces South Gloucestershire Clinical Commissioning
More informationNHS Greater Glasgow & Clyde. Managed Clinical Network for Diabetes. Annual Report
NHS Greater Glasgow & Clyde Managed Clinical Network for Diabetes Annual Report 2009 / 2010 1. Introduction This annual report of the NHS Greater Glasgow and Clyde (NHS GGC) Managed Clinical Network (MCN)
More information< = > less is more. De-diagnosing De-prescribing Non-testing
< = > less is more De-diagnosing De-prescribing Non-testing Who says? Overdiagnosis Polypharmacy False positives Too much medicine Risk aversion $$$ Sources Prof David Le Couteur, Clin Pharm and Aged Care
More informationMental Health Collaborative Dementia Summary of Activity
Mental Health Collaborative Dementia Summary of Activity October 2010 The following extracts provide either one example of a Board s dementia improvement activity or a brief summary of a Board s current
More informationMental Health Collaborative. Dementia Summary of Activity. April 2010
Mental Health Collaborative Dementia Summary of Activity April 2010 The following extracts provide either one example of a Board s dementia improvement activity or a brief summary of a Board s current
More informationEnhancing the Quality of Heart Failure Care
Enhancing the Quality of Heart Failure Care 2 Enhancing the quality of Heart Failure care Kent Surrey Sussex Academic Health Science Network 3 Contents 2 Heart failure care in the UK: Case for change 3
More informationDeprescribing: A Practical Guide
Deprescribing: A Practical Guide The information in this booklet should be used as a pragmatic decision aid, in conjunction with other relevant patient specific data. Useful resource links http://www.derbyshiremedicinesmanagement.nhs.uk/assets/clinical_guidelines/clinical_guidelines_fr
More informationAppropriate prescribing and deprescribing for older people getting it right. Alan Davis Northland District Health Board
Appropriate prescribing and deprescribing for older people getting it right Alan Davis Northland District Health Board Unused returns Potentially inappropriate medication use in the elderly 15% of older
More informationUse caution in the elderly: review of safe and effective medication use in older patients
Use caution in the elderly: review of safe and effective medication use in older patients John T. Holmes, PharmD, BCPS Assistant Professor of Family Medicine and Pharmacy Practice In support of improving
More informationPromoting Safer Use of High-Risk Pharmacotherapy: Impact of Pharmacist-Led Targeted Medication Reviews
Drugs - Real World Outcomes (2015) 2:261 271 DOI 10.1007/s40801-015-0031-8 ORIGINAL RESEARCH ARTICLE Promoting Safer Use of High-Risk Pharmacotherapy: Impact of Pharmacist-Led Targeted Medication Reviews
More informationNICE guideline Published: 21 September 2016 nice.org.uk/guidance/ng56
Multimorbidity: clinical assessment and management NICE guideline Published: 21 September 2016 nice.org.uk/guidance/ng56 NICE 2018. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and-conditions#notice-ofrights).
More informationDisclosures. Use caution in the elderly: review of safe and effective medication use in older patients. Institute of Medicine. Learning Objectives
Use caution in the elderly: review of safe and effective medication use in older patients Disclosures I have no disclosures or conflicts of interest related to this presentation John T. Holmes, PharmD,
More informationEnhancing the Quality of Heart Failure Care
Enhancing the Quality of Heart Failure Care 2 Enhancing the quality of Heart Failure care Contents 2 Heart failure care in the UK: Case for change Heart failure in the UK: Case for change Heart failure
More informationPolypharmacy and Deprescribing for Older People
Polypharmacy and Deprescribing for Older People Sarah Hilmer Head of Department, Clinical Pharmacology and Senior Staff Specialist Aged Care, RNSH Conjoint Professor of Geriatric Pharmacology, Sydney University
More information1000 Lives Key Components of Reliable, Evidence-Based Chronic Heart Failure Care how do we compare?
1000 Lives Key Components of Reliable, Evidence-Based Chronic Heart Failure Care how do we compare? Dr Nerys Davies, GPST Ms B. Davies, Specialist Nurse (Heart Failure) Dr J. Taylor, Consultant Cardiologist
More informationNICE Quality Standards and commissioning dementia care
NICE Quality Standards and commissioning dementia care 1 What is NICE? World leader in producing guidance and setting standards for high quality care and for promoting healthy living From April 2013 a
More informationPOLYPHARMACY. A practical approach to deprescribing in care homes. Care Home Pharmacy Team. Herts Valleys Clinical Commissioning Group
POLYPHARMACY A practical approach to deprescribing in care homes. Care Home Pharmacy Team Herts Valleys Clinical Commissioning Group Neeta Gulhane Specialist Pharmaceutical Advisor Care Homes The Care
More informationMEDICINE OPTIMISATION IN BERKSHIRE EAST CCGS
MEDICINE OPTIMISATION IN BERKSHIRE EAST CCGS Melody Chapman, Lead CCG Prescribing Support Pharmacist 23 rd July 2015 MEDICINES OPTIMISATION TEAM Team of pharmacists who work to get the best out of medicines
More informationGOVERNING BODY REPORT
GOVERNING BODY REPORT DATE OF MEETING: 20th September 2012 TITLE OF REPORT: KEY MESSAGES: NHS West Cheshire Clinical Commissioning Group has identified heart disease as one of its six strategic clinical
More informationNHS RightCare Frailty Pathway An optimal frailty system
NHS RightCare Frailty Pathway An optimal frailty system Martin Vernon National Clinical Director for Older People Adrian Hopper Consultant Physician & Frailty Pathway GiRFT Lead Alex Thompson Pathways
More informationIntelligent Polypharmacy. Professor Colin P Bradley Department of General Practice University College Cork
Intelligent Polypharmacy Professor Colin P Bradley Department of General Practice University College Cork Polypharmacy No standard definition 2005 review the use of medications that are not clinically
More informationPalliative Care, COPD and Falls QOF QiP Pathways GG&C ver
Palliative Care, COPD and Falls QOF QiP Pathways GG&C ver 6 17.10.11 1. Context 1.1 QoF QP for Unscheduled care required the development of three admissions pathways that were agreed between the Board
More informationImproving primary care prescribing safety using routine data for intervention and evaluation: four trials in 500+ practices
University of Dundee School of Medicine Improving primary care prescribing safety using routine data for intervention and evaluation: four trials in 500+ practices University of Dundee School of Medicine
More informationRational prescribing in the older adult. Assoc Prof Craig Whitehead
Rational prescribing in the older adult Assoc Prof Craig Whitehead Introduction Physioloical ageing and frailty Medication risks in older adults Drug Burden Anticholinergic and sedative drug burden Cascade
More informationRecommendations from the Devon Prisons Health Needs Assessment. HMP Exeter, HMP Channings Wood and HMP Dartmoor
from the Devon Prisons Health Needs Assessment HMP Exeter, HMP Channings Wood and HMP Dartmoor 2011-2012 In April 2006 the responsibility for prison healthcare transferred from HM Prison Service to the
More informationThe SIMPATHY economic analysis tool
The SIMPATHY economic analysis tool 1. Contents 1. Contents... 1 2. Introduction to SIMPATHY... 1 3. Introduction to the Economic Analysis Tool... 2 4. Assumptions and caveats... 3 5. How to use the tool...
More informationOptimising Safe & Appropriate Medicines Use and Deprescribing. Katie Smith, Director, East Anglia Medicines Information Service February 2014
Optimising Safe & Appropriate Medicines Use and Deprescribing Katie Smith, Director, East Anglia Medicines Information Service February 2014 Background Objectives How & why the OSAMU document was developed
More informationSCHEDULE 2 THE SERVICES. A. Service Specifications
SCHEDULE 2 THE SERVICES A. Service Specifications Service Specification 11J/0232 No. Service Enhanced Frailty Service (Christchurch MP and Farmhouse Surgery) Commissioner Lead Primary Care Team Provider
More informationSTOPP START Toolkit Supporting Medication Review in the Older Person
STOPP START Toolkit Supporting Medication Review in the Older Person STOPP: Screening Tool of Older People s potentially inappropriate Prescriptions START: Screening Tool to Alert doctors to Right (appropriate,
More informationMedicines Optimisation Annual Report Dr Emma Harris and Neil Hardy on behalf of the Medicines Management Team June 2016
Medicines Optimisation Annual Report 2015-2016 Dr Emma Harris and Neil Hardy on behalf of the Medicines Management Team June 2016 1 Clinical Objectives Improve the effective use of medicines Maximise health
More informationNursing in Scotland. Glasgow & Clyde Weight Management Service
Nursing in Scotland Glasgow & Clyde Weight Management Service Contact: Dr Marie L Prince Chartered Clinical Psychologist marie.prince@ggc.scot.nhs.uk GCWMS Ward 23 Surgical Block Glasgow Royal Infirmary
More informationReviewing Peer Working A New Way of Working in Mental Health
Reviewing Peer Working A New Way of Working in Mental Health A paper in the Experts by Experience series Scottish Recovery Network: July 2013 Introduction The Scottish Government s Mental Health Strategy
More informationStronger together - optimizing pharmacotherapy on geriatric wards?
Stronger together - optimizing pharmacotherapy on geriatric wards? Clinicamp FOD 27/4/2018 Dr. Jean-Claude Lemper ( Geriater UZ Brussel) Apr. Julie Hias (ziekenhuisapotheker UZ Leuven) Project College
More informationADHD Medication Prescribing in Scotland in 2016/17
ADHD Medication Prescribing in Scotland in 2016/17 Scottish ADHD Coalition Analysis March 2018 www.scottishadhdcoalition.org Notes on data sources Prescribing data was obtained through a data request to
More information23/11/2018. Tools to stratify patients for clinical pharmacy interventions
Tools to stratify patients for clinical pharmacy interventions Professor Mike Scott Director of the Regional Medicines Optimisation Innovation Centre (MOIC) 47 th ESCP Symposium, Belfast 24 th October
More informationPolypharmacy. A CPPE distance learning programme
A CPPE distance learning programme DLP 177 January 2016 Contents About CPPE distance learning programmes About this learning programme Glossary of key terms v vii ix Contents Section 1 The problem with
More informationPharmaceutical Care for Geriatrics
Continuing Professional Pharmacy Development Program Pharmaceutical Care for Geriatrics Presented by: Alla El-Awaisi; MPharm, MRPharmS, MSc Event Organizer: Dr. Nadir Kheir; PhD Disclaimer: PRESENTING
More informationBriefing Document on Medication use and Falls
Briefing Document on Medication use and Falls This document is intended as a briefing document and is not to be regarded as a document offering definitive legal advice in relation to the subject matter.
More informationPost MI LVSD Teach and Treat
Post MI LVSD Teach and Treat Scottish Heart Failure Nurse Forum GJNH, Sept 2017 Dr Clare Murphy Consultant Cardiologist Clinical Lead, National Heart Failure Hub Background to Post MI LVSD Teach and Treat
More informationCompleted audit cycle to explore the use of the STOPP/START toolkit to optimise medication in psychiatric in-patients with dementia
Completed audit cycle to explore the use of the STOPP/START toolkit to optimise medication in psychiatric in-patients with dementia Victor M. Aziz, Natalie Hill, Sugandha Kumar BJPsych Bulletin (08) 4,
More informationFRAILTY PATIENT FOCUS GROUP
FRAILTY PATIENT FOCUS GROUP Community House, Bromley 28 November 2016-10am to 12noon In attendance: 7 Patient and Healthwatch representatives: 4 CCG representatives: Dr Ruchira Paranjape went through the
More informationFALLS PREVENTION AND BONE HEALTH STRATEGY
FALLS PREVENTION AND BONE HEALTH STRATEGY 2011-2016 Unique ID: Category/Level/Type: Strategy Status: Date of Authorisation: Date added to Intranet: Key Words: Page 1 of 12 Author (s): Lynne Douglas Version:
More informationFrom medicines reconciliation to medicines review. Dr. Fatma Karapinar Hospital pharmacistepidemiologist
From medicines reconciliation to medicines review Dr. Fatma Karapinar Hospital pharmacistepidemiologist Conflict of interest Nothing to disclose Questions Medication review is more important than medicines
More informationPalliative care in long-term conditions Scottish Palliative Care Pharmacists Association
Palliative care in long-term conditions 2011 2012 Scottish Palliative Care Pharmacists Association Aims & Objectives To explore symptoms, general management principles and appropriate palliative treatment
More informationOlder People with Complex Health Needs: NIHR Workshop Delegate Agenda The Royal Society 6-9 Carlton House Terrace London SW1Y 5AG
Older People with Complex Health Needs: NIHR Workshop Delegate Agenda The Royal Society 6-9 Carlton House Terrace London SW1Y 5AG Wednesday 2 nd November 2016 A workshop to identify tractable research
More informationSupporting and Caring in Dementia
Supporting and Caring in Dementia Surrey and Sussex Healthcare, Delivering the National Dementia Strategy Strategy and Implementation Plan Final November 2011 1 National Strategy The National Dementia
More informationALCOHOL AND DRUGS PLANNING FRAMEWORK
ALCOHOL AND DRUGS PLANNING FRAMEWORK 1. NATIONAL CONTEXT 1.1 Scotland continues to have the highest alcohol and drug-related death rates in the UK with drug and alcohol problems particularly affecting
More informationWhat is Acute Oncology? Kay McCallum Acute Oncology Advanced Nurse Practitioner John Radcliffe Hospital Oxford September 2015
What is Acute Oncology? Kay McCallum Acute Oncology Advanced Nurse Practitioner John Radcliffe Hospital Oxford September 2015 What is Acute Oncology? Outline of Talk Concept of Acute Oncology Service (AOS)
More informationSUBJECT: HPV vaccination programme update
Meeting of Lanarkshire NHS Board Lanarkshire NHS Board 14 Beckford Street 29 February 2012 Hamilton ML3 0TA Telephone 01698 281313 Fax 01698 423134 www.nhslanarkshire.co.uk SUBJECT: HPV vaccination programme
More informationConflict of interest declaration and sources of funding
Potentially Inappropriate Prescribing immediately prior to Long-Term Care admission (PIP in LTC): Validation of tools for their future use across Ontario Bruyère CLRI Webinar March 24 th, 2016 and Bruyère
More informationSwitching Tramacet to paracetamol alone or paracetamol and codeine
Bulletin 62 February 2014 Community Interest Company Switching Tramacet to paracetamol alone or paracetamol and codeine This is one of a number of bulletins providing further information on medicines contained
More informationHA CONVENTION Effectiveness of Pharmacist-led Frail Elderly Medication Service in Acute Geriatric Ward
Effectiveness of Pharmacist-led Frail Elderly Medication Service in Acute Geriatric Ward HA CONVENTION 2017 Candis Chang Pharmacist Department of Pharmacy Ruttonjee and Tang Shiu Kin Hospitals Background
More informationNHS DUMFRIES & GALLOWAY Guidance for Prescribing for Frail Adults
NHS DUMFRIES & GALLOWAY Guidance for Prescribing for Frail Adults Guidance for Prescribing in Frail Adults Prescribing for frail adults should prioritise their comfort and quality of life. Unnecessary
More informationNew NICE Heart Failure Guidelines What do they mean for primary and secondary care, and patients?
New NICE Heart Failure Guidelines 2018 - What do they mean for primary and secondary care, and patients? Prof Ahmet Fuat PhD FRCGP FRCP PG Dip (Cardiology) GP & GPSI Cardiology Darlington Professor of
More informationAppropriate use of medicines in care of the elderly - Factors underlying inappropriateness, and impact of the clinical pharmacist
Appropriate use of medicines in care of the elderly - Factors underlying inappropriateness, and impact of the clinical pharmacist Anne Spinewine PhD thesis - Public defense 8 June 2006 A spoonful of sugar,
More informationDraft v1.3. Dementia Manifesto. London Borough of Barnet & Barnet Clinical. Autumn 2015
Dementia Manifesto for Barnet Draft v1.3 London Borough of Barnet & Barnet Clinical Commissioning Group 1 Autumn 2015 .it is estimated that by 2021 the number of people with dementia in Barnet will grow
More informationNew approaches to Polypharmacy: Oligopharmacy and Deprescribing
East & outh East England pecialist harmacy ervices East of England, London, outh Central & outh East Coast Medicines Use and afety New approaches to olypharmacy: Oligopharmacy and Deprescribing Nina Barnett,
More informationTargeted Deprescribing in Patients on Hemodialysis to Decrease Polypharmacy
Targeted Deprescribing in Patients on Hemodialysis to Decrease Polypharmacy Presentation Objectives Discuss Polypharmacy In HD patients Define Deprescribing Review results of the pilot study on deprescribing
More informationDementia Benchmarking Indicators Definitions and Data Sources Manual
Indicators Definitions and Data Sources Manual (September 2015) 1 Contents Page Number Dementia Indicators 3 Indicator Summary Tables 4 General Notes 22 Glossary 23 Appendix 1 Dementia Criteria 24 2 Indicators
More informationUse of anti-psychotic medication in care homes Response from the Royal Pharmaceutical Society in Wales
Use of anti-psychotic medication in care homes Response from the Royal Pharmaceutical Society in Wales About us The Royal Pharmaceutical Society (RPS) is the professional body for pharmacists in Great
More informationSCHEDULE 2 THE SERVICES. A. Service Specifications
SCHEDULE 2 THE SERVICES A. Service Specifications Service Specification No. 04/MSKT/0013 Service PAN DORSET FRACTURE LIAISON SERVICE Commissioner Lead CCP for Musculoskeletal & Trauma Provider Lead Deputy
More informationIntroduction of Early Supported Discharge to Intermediate Care Pathway for Hip Fracture
Introduction of Early Supported Discharge to Intermediate Care Pathway for Hip Fracture Neil Pendleton, Mark Brown, Heather Spence Salford Royal NHS Hospital Introduction of Early Supported Discharge to
More informationAim. Managing high risk medicines in primary care. Intended outcomes. Introduction. Risk associated with prescribing
Aim Managing high risk medicines in primary care To increase awareness of high risk medicines and combinations of medicines and to ensure the appropriate prescribing, supply or administration of such in
More information1/21/2016 UPDATE ON THE AMERICAN GERIATRICS SOCIETY 2015 BEERS CRITERIA DISCLOSURE OBJECTIVES AGING GOALS BEERS CRITERIA
UPDATE ON THE AMERICAN GERIATRICS SOCIETY 2015 BEERS CRITERIA DISCLOSURE I have no financial conflict of interest to disclose. Lacey Charbonneau, Pharm.D. PGY-1 Community Practice Resident Baptist Medical
More informationASPIRIN MISUSE AT HOME ACCORDING TO START AND STOPP IN FRAIL OLDER PERSONS
ASPIRIN MISUSE AT HOME ACCORDING TO START AND STOPP IN FRAIL OLDER PERSONS O. Dalleur 1,4, B. Boland 2,3, A. Spinewine 4-5 1 Pharmacy and 2 Geriatric Medicine, St-Luc university Hospital, 3 Institute of
More informationDeprescribing in CKD patients: Is less more? Speaker: Dr. Judith G. Marin, PharmD
2016 Deprescribing in CKD patients: Is less more? Speaker: Dr. Judith G. Marin, PharmD Case Mr. Kid Ney is a 75 y/o patient who has been on dialysis for the last 4 years (PD, then HD). PMHx: HTN, DM,
More informationPromoting Excellence: A framework for all health and social services staff working with people with Dementia, their families and carers
Promoting Excellence: A framework for all health and social services staff working with people with Dementia, their families and carers Mapped to the NHS Knowledge and Skills Framework () Background and
More information2010 National Audit of Dementia (Care in General Hospitals) Guy's and St Thomas' NHS Foundation Trust
Royal College of Psychiatrists 2010 National Audit of Dementia (Care in General Hospitals) Organisational checklist results and commentary for: Guy's and St Thomas' NHS Foundation Trust The 2010 national
More informationReviewing Medicines in at risk patients care homes
Reviewing Medicines in at risk patients care homes Clinical Medication Reviews by Pharmacists in Collaboration with GP Surgeries across Brighton and Hove CCG Liz Butterfield FRPharmS 19th April 2016 NICE:
More informationPopulation Health Analytics and Usage of the ACG System in the UK Stockholm, 13 th June, 2017 Alan Thompson, Director of User Support
Population Health Analytics and Usage of the ACG System in the UK Stockholm, 13 th June, 2017 Alan Thompson, Director of User Support athompson@hopkinsacg.org Content Summary of main uses of the ACG System
More information