Special Issue "Optimising Medicines in Care Homes"

A special issue of Pharmacy (ISSN 2226-4787).

Deadline for manuscript submissions: closed (30 April 2019)

Special Issue Editors

Guest Editor
Dr. Wasim Baqir

NHS England
E-Mail
Interests: prescribing and deprescribing in frailty and older people, living in care homes and their own homes; integrating services across the health and care system; quality improvement and using QI to make care better and safer
Guest Editor
Dr. Graham Stretch

Argyle Health Group & Ealing GP Federation, London W13 8ER, UK
E-Mail
Interests: prescribing and medicines optimisation in elderly care; medicines use in care homes; end-of-life care, dementia and anticholinergic burden in the elderly; pharmacy as part of integrated primary care teams; skill mix in general practice; education and development of pharmacy professionals

Special Issue Information

Dear Colleagues,

The scope of this Special Edition is to share learning on how Pharmacy teams are improving medicines optimisation in care homes.  A number of reports (e.g. CHUMS) have highlighted the suboptimal prescribing, dispensing and administration of medicines in care homes.  In the UK, we have seen many advances in medicines optimisation in care homes. Following on from the Care Home Vanguards, NHS England launched a medicines optimisation in care homes programme to share and spread learning across England. In Scotland the Realistic Medicines agenda and Polypharmacy Guidance is supporting medicines optimisation in care homes. Wales and Northern Ireland too, have initiatives supporting care homes and their residents.  With so much going on in this field, now is the time start sharing innovative and best practice.

We encourage teams working in care home settings to present your research, reviews and quality improvement work.  We are particularly interested in work related to quality improvement methods to develop clinical services, outcomes data, integrated working, shared decision making with residents, the role of the multidisciplinary team, skill mix (including the role of the pharmacy technician) and deprescribing. We hope that your work will help support clinical teams to develop their services.

Dr. Wasim Baqir
Dr. Graham Stretch
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All papers will be peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Pharmacy is an international peer-reviewed open access quarterly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 550 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • Medicines Optimisation
  • Deprescribing
  • Shared Decision Making
  • Care Homes
  • Integration
  • Pharmacy Skill Mix in Care Homes

Published Papers (2 papers)

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Research

Open AccessArticle
Pharmacy Technician Review of Oral Nutritional Supplements (ONS) within Care Homes
Received: 31 January 2019 / Revised: 28 February 2019 / Accepted: 1 March 2019 / Published: 6 March 2019
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Abstract
Up to 42% of patients admitted to care homes are at risk of malnutrition. Oral nutritional supplements (ONS) can be prescribed to increase nutritional intake when diet alone is insufficient to meet daily nutritional requirements. Where ONS are inappropriately initiated or continued beyond [...] Read more.
Up to 42% of patients admitted to care homes are at risk of malnutrition. Oral nutritional supplements (ONS) can be prescribed to increase nutritional intake when diet alone is insufficient to meet daily nutritional requirements. Where ONS are inappropriately initiated or continued beyond treatment goals this can contribute to significant waste and unnecessary costs. This study reviewed whether pharmacy technicians working in care home settings can support the cost-effective use of ONS. A quality improvement project using Plan-Do-Study-Act (PDSA) methodology was undertaken by pharmacy technicians working in care homes to review the prescribing and monitoring of ONS. A sample of 330 residents were reviewed across 5 care homes. 45 residents were prescribed ONS, 16 of whom were unknown to dietitians. In collaboration with the dietetic service an oral nutritional support flow chart was developed and tested. Thirteen of the 16 residents unknown to the dietetic team did not require ONS and could be considered for alternative dietary options. Through collaborative working with dietetic services, pharmacy technicians can support effective use and review of ONS for care home residents, reduce unnecessary prescribing, and ensure appropriate referral to dietitians where indicated. Full article
(This article belongs to the Special Issue Optimising Medicines in Care Homes)
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Open AccessFeature PaperArticle
Validation of a Drug-Related Problem Classification System for the Intermediate and Long-Term Care Setting in Singapore
Pharmacy 2018, 6(4), 109; https://doi.org/10.3390/pharmacy6040109
Received: 28 August 2018 / Revised: 19 September 2018 / Accepted: 28 September 2018 / Published: 3 October 2018
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Abstract
Background: This study aims to evaluate the inter-rater reliability and perceived usability of a newly developed drug-related problem (DRP) classification system for use by pharmacists in the intermediate and long-term care (ILTC) setting in Singapore. Methods: This was a cross-sectional survey study [...] Read more.
Background: This study aims to evaluate the inter-rater reliability and perceived usability of a newly developed drug-related problem (DRP) classification system for use by pharmacists in the intermediate and long-term care (ILTC) setting in Singapore. Methods: This was a cross-sectional survey study involving the use of a self-administered questionnaire. All 55 pharmacists affiliated to the Pharmaceutical Society of Singapore (PSS) ILTC Pharmacists Workgroup who were above 21 years old and not authors of the classification system were invited to participate. The inter-rater reliability of participants’ classification of 46 mock DRP cases using the new DRP classification system was determined using Fleiss’s kappa (κ). Participants’ perceived usability of the classification system was evaluated using six items with five-point Likert scales (1—“strongly disagree”, 5—“strongly agree”). Results: Thirty-three pharmacists responded to the survey. Overall inter-rater reliability was found to be substantial (κ = 0.614; 95% CI: 0.611–0.617). All usability items received positive ratings (“strongly agree” or “agree”) from at least 69% of participants. Conclusion: The new DRP classification system has substantial external validity and appears to be suitable for use by pharmacists to document and report DRPs in the ILTC setting in Singapore and facilitate evaluation of the impact of pharmaceutical care in the ILTC setting. Full article
(This article belongs to the Special Issue Optimising Medicines in Care Homes)
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