Hospital Pharmacist
2008;15:135-137
April 2008

A career as … — a domiciliary pharmacist

By Sara Dilks, MRPharmS, and Ian Nash, MRPharmS

SUMMARY

Devon Primary Care Trust and Devon County Council have developed multidisciplinary health and social care teams for adults within primary care “clusters”. These complex care teams include domiciliary pharmacists, community matrons, occupational therapists, physiotherapists, community care workers, social workers, community mental health and voluntary sector representatives.

The complex care teams meet weekly at a “core group” to discuss individual patients, share information and take a proactive approach to managing adults at risk. A single telephone point of contact to the complex care team is available for GPs, hospital pharmacists, discharge and social care co-ordinators plus other health and social care professionals who wish to refer patients to the service. Following a call to a central telephone number, a cluster co-ordinator directs the referral to the appropriate team member.

The new service aims to improve management of patients with long term conditions or complex care needs in the community.

It has been estimated that medication problems are a major cause in at least 10 per cent of elderly care hospital admissions. Over half of the NHS drugs bill is spent on older people, but up to 50 per cent of elderly people may not be taking their medicines as recommended, thereby reducing their effectiveness. As people get older their use of medicines tends to increase; four in five people over the age of 75 take at least one prescribed medicine and 36 per cent take four or more medicines.

Recommendations from the National Service Framework for Older People suggest patients and their carers need support if they are to take their medicines as prescribed. Domiciliary pharmacists can provide support with medicines management, enabling older people to live independently in their own homes and avoid unnecessary hospital admissions.