Clinics for nursing home residents reduce emergency admissions

A project in Northern Ireland has demonstrated the value of a consultant pharmacist reviewing medicines for patients in nursing homes.

Nursing home residents were less likely to be admitted to A&E and more likely to be taking appropriate medicines following a review with a consultant pharmacist. The project team headed by Hilary McKee (pictured) was a finalist at the 2015 Care Awards

Nursing home residents were less likely to be admitted to accident and emergency departments and more likely to be taking appropriate medicines following a review with a consultant pharmacist, according to the results of a project from Antrim Area Hospital in Northern Ireland. The project team secured a place in the final of the 2015 Pharmaceutical Care Awards, which were organised by the Royal Pharmaceutical Society and The Pharmaceutical Journal and supported by GlaxoSmithKline, and took place at the Royal Society in London on 18 June.

The team, led by consultant pharmacist Hilary McKee, reviewed 727 patients in 16 nursing homes over the course of the two-year project. Presenting at the awards alongside head of pharmacy and medicines management Michael Scott, McKee said that the biggest obstacle was getting the local GPs on board. “We communicated by letter, because they were quite used to receiving letters from me,” she added.

As a result of the project, which was funded by the Department of Health, the average number of patients from the nursing homes visiting A&E dropped from 3.5 to 1.5 per month, with an estimated associated cost saving between £122,000 and £208,000 per year. Additionally, the drug cost savings for the two years was estimated at £213,000. The Medication Appropriateness Index (MAI) was used to measure the impact of the clinics on patients’ medicines — the project found that the MAI score was significantly lower in all nursing homes after the clinics, indicating that medicines were significantly more appropriate.

“We identified education needs within the home,” McKee also noted, adding: “We had one home that had a really excellent fruit and vegetable policy but nobody had developed any guidance about drug-food interactions so we had a whole interesting session on that.”

There are plans to replicate the project in another area of Northern Ireland.

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Citation
The Pharmaceutical Journal, PJ, 27 June/4 July 2015, Vol 294, No 7868/9;294(7868):DOI:10.1211/PJ.2015.20068806