Medicines Management
Issue no 2, pp18-19
March/April 2002
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Medicines Management |
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Features |
Development of a personal medication record card for elderly patients
The core goal of medication management is an improved outcome for the patient. Patients should gain maximum benefit from their medicines in order to maintain or improve their quality and duration of life. It is vital that patients do not suffer any additional illness from excessive, inappropriate or inadequate consumption of prescription medicines. This is best summed up in the phrase "Maximum benefit from minimum medicines", East Elmbridge and Mid Surrey PCG's medicines management mantra. How this ideal state is to be achieved will depend upon innovative ideas from the ground and the courage of the primary care organisations to support and implement them. All pharmacists are only too aware that they can no longer rely on dispensing fees to support them so it is incumbent upon us to grab the bull by the horns and come up with robust, sustainable programmes in support of NHS targets. Patient focus groups The new programme to implement the NSF for older people involves community and primary care pharmacists. A patient focus is not mere lip service in this PCG, and we have ensured that patient groups have been consulted throughout the developmental process. Pharmacists, doctors, nurses, dentists, social services and the voluntary sector, including Age Concern, have all contributed ideas that have shaped the current programme. Patient focus groups have been identified that will review all future medicine management programmes within this area of Surrey. These groups expressed concern that some health initiatives within the NHS were condescending to patients and their carers. All health care professionals would do well to remember that increasing age or disability is not necessarily associated with a loss of independent thought or the lack of desire to monitor one's own health. What is required is tools to enable patients to remain independent and in control of their health. This PCG, with a population of 270,000 patients, is endeavouring to provide some of these tools. The "Your medicine card" was developed as part of the programme. Although it is not a novel idea, it will allow patients and carers to keep track of their medicines, leading to a reduction in adverse events and wastage. Designed to be user-friendly with black type on yellow card, the medicine card has a Flesch Formula Score of 86.2 (meaning that 86 per cent of the population can read it easily). Two sizes are available: A4 and A5, which are folded for convenient storage. An A4 poster, displayed in GP surgeries as well as pharmacy windows, advertises the scheme. Dosage information is written on the card by the pharmacist or a member of the pharmacy staff. General advice on the safe use of medicines has been printed on each card and medical jargon and prescriptive language have been avoided. Space is available on the reverse side for the insertion of useful numbers and emergency contacts. Patient ownership The key to this health care initiative is that ownership is with the patient. Patients will be encouraged by their pharmacist to keep the card with them at all times and show it to other pharmacists, doctors, nurses and dentists when they seek advice or treatment. Over-the-counter medicines and herbal remedies will also be included on the card, ensuring a complete record of all products used. Alterations can be made by any health professional but only pharmacists will issue cards. The issuer stamps the card with the business name, telephone number and pharmacist's name. Any contractor in the scheme can update this portable record while new cards can be issued at the request of the patient. Development and printing costs have been met by the PCG and pharmacy contractors are paid up to £150 to complete simple audit forms. To keep the focus on the patient and carers, a sample of card holders are given a small questionnaire, which is returned directly to the project manager. Information gathered will be used in planning future programmes. Pharmacists have been more than happy to take part in the scheme. Completing the record takes a few minutes but local contractors recognise they are providing a unique service to their customers. The secondary aim of "Your medicine card" is to promote the profession. The slogan — Your pharmacist, the health professional you see most often ... — is repeated throughout the material. This reinforces the pharmacist as the medicines expert and reminds patients of the advice and support a local pharmacist can offer. A simple idea, born out of listening to patient's views and concerns, should lead to improved patient concordance. It is hoped that patients in East Elmbridge and Mid Surrey will experience positive outcomes and feel supported by health professionals who show a true commitment to placing the patient at the heart of medication management. Pharmacists wanting more information on "Your medication card" or details on medicines management in East Elmbridge and Mid Surrey PCG, can contact Gabrielle Clezy on 01342 892106.
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©The Pharmaceutical Journal
It
is not often that pharmacists win the battle to control funds when in
competition with doctors but pharmacists East Elmbridge and Mid Surrey
Primary Care Group, have achieved just that. Money from the NHS Primary
Care Incentive Scheme has been allocated to the PCG to allow pharmacists
to plan and implement a programme to reach the milestones contained in
the National Service Framework for Older People. Initially the programme
involves practice-based medication review services, but its development
has led to a medication record card to be distributed solely by local
pharmacy contractors.