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Patients Should Be Involved In Their Medical Decisions, According To A Team Of Pharmacists

A team of far-sighted pharmacists based at the Northumbria Healthcare NHS Foundation Trust (NHNFT) have recently created a service to optimise the use of medicines in care homes based on the decisions of residents of these facilities, alongside their families. Having become one of the six finalists selected in the 2014 annual Pharmaceutical Care Awards, the team then went on to win the award for ‘audience choice’ and to be recognised as the project which was most likely to be replicable in other environments.

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Thorough Approach to Success

According to the NHNFT’s senior clinical pharmacist, Steven Barrett, patient safety is improved when they are involved in their own healthcare decisions. It was this basic principle which led to the foundation of the project, seeking to empower residents to manage their own healthcare needs alongside the medical practitioners.

As part of the project, participating residents undertook a detailed review of their current medicine intake using information provided both by the care home and by their GP. This review was then assessed again at a later date by a multidisciplinary team, who then were able to agree any required changes to the medications. The multidisciplinary meetings were seen as an additional feature, working alongside regular work performed by GPs and care homes, in which three different strategies were employed. At some meetings, just the care home resident attended; at others, their family members were present, whilst in the third group both parties were invited or contacted after the meeting. Barratt said that this approach allowed for the flexibility required in handling each individual case, as well as allowing them to work with GP surgeries and their own practice requirements.

Quantitative Assessment

The data collected in the study looked at both the number of interventions made in medical prescriptions as well as their types, with information also recorded to capture the level of involvement from the resident. The views of the residents taking part were also gathered, including their overall opinions of the scheme. According to the report, of the 422 residents taking part in the projects, 1346 interventions took place. The majority involved a discontinuation of one or more of their medications. Medicines were withdrawn due to there being no current requirement for them, or because the resident asked for them to be stopped. In a very small number of cases, a medicine was stopped due to a risk of harm. The residents involved reported that they valued being included in the reviews, enabling them to feel like an active participant in their own care futures. 16% of the residents took full involvement in their medical decisions, whilst a total of 39% had the involvement of a family member.

Overall, it is hoped that this kind of discourse between care treatment teams and the individual residents will be able to open the doors to free discussion in which patients can raise their concerns or opinions and have these taken into account. This in turn creates good working relationships and enables residents to receive care with which they are totally satisfied.

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