Medicines management is failing older people
Medicines management in the health service is failing older people, according to a report published last week.
Few patients over the age of 75 years who regularly take more than four
medicines are having their medicines reviewed every six months — missing
one of the key targets set down in the National Service Framework for
Older People when it was published five years ago, the report declares.
Some NHS trusts are failing to provide ward-based dispensing of drugs
when older people are discharged from hospital and there is little evidence
of community pharmacists helping older people manage their own medicines,
it says.
The report, “Living
well in later life”, was an assessment
by the Healthcare Commission, the Audit Commission and the Commission
for Social Care Inspection on progress made in the care of the elderly
following publication of the NSF in March 2001.
The report was based on the inspections of services for older people
provided by local authorities and the NHS in 10 districts in England
and concluded that medicines management for this patient group needs
to be addressed. It states: “None of the communities that were
inspected was fully meeting the standards set out in the NSF for the
management of medicines.”
Alison Blenkinsopp, professor of the practice of pharmacy at the department
of medicines management at Keele University, was author of the medicines
management guide for the NSF for Older People.
She said that although six monthly reviews of over 75s taking more than
four medicines were not common practice, the new report was more optimistic
about other medicines reviews of older people.
She said: “What I thought was quite positive from the report was
that most GPs are reviewing [older] people’s medicines annually
and that trusts are working with community pharmacists to carry out the
reviews.”
Professor Blenkinsopp also suggested that medicines use reviews being
carried out by pharmacists under the new pharmacy contract were not included
in the report. The report instead relied on data from GP practices, which
may have unfairly distorted the true picture of the number of reviews
taking place. She said: “I think there may be an issue around how
medicines use reviews that pharmacists are doing under the new contract
are being recorded.”
Barbara Parsons, head of pharmacy practice at the Pharmaceutical Services
Negotiating Committee, said: “The community pharmacy contract has
re-engineered services to include medicines use review and prescription
intervention which assists patients, including the elderly, to manage
their medicines better.” She added that the PSNC has worked with
other pharmacy organisations to produce a guide to the NSF for Older
People, which includes evidence of good pharmacy practice.
The “Living well in later life” report is the latest to level
criticism at the standards of medicines management for older people.
In February, a report by the Commission for Social Care Inspection painted
a grim and chaotic picture of the standards of medicines support being
offered in care homes in England (PJ, 11 February, p155 and
18 February, p198 PDF (80K)). |
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