Managing Medicines - What is it all about?
In 2001, we applied to take part in a Medicines Management Collaborative. We are now a pilot site looking at how patients can get the best out of their medicines and how we can reduce wastage of medicines that are no longer needed. Five of the GP practices in the PCT area are involved. Their details are below.
The PCT is now over six months into the Medicines Management Services (MMS) Collaborative project so it seemed like an ideal time to provide an update on our progress to date. The goal of the project is:
"To optimise prescribing, plus the experiences and outcomes for each patient, wherever medicines are involved."
When we began the project, we developed a vision for improving services. Our vision for Cheltenham and Tewkesbury is that 'all repeat prescribing and dispensing is safe, appropriate, cost-effective and convenient to our residents.'
The overall goal and the PCT's vision translates into four main aims:
a) Identifying and addressing unmet pharmaceutical need (eg identifying where patients are not getting the most effective treatment for their condition).
b) Helping patients get the best from their medicines and thereby delivering real improvements in healthcare.
c) Developing new and innovative medicine management approaches that have the patients' needs uppermost whilst also improving service efficiency and reducing waste.
d) Providing convenient access to a wide range of medicines management services in different environments through multi-disciplinary working that builds on the knowledge of pharmacists.
What's happened so far?
The collaborative approach involves a number of stages. Firstly it is about undertaking small cycles of change in the five participating practices. The practices then review and learn from their experiences. This information is then shared with the other practices in the PCT area and nationally, so that "best practice" can be rolled out across the PCT.
What changes have been made as a result?
Each practice is carrying out a monthly check on repeat prescriptions which have one or more items without complete dosage instructions. This has helped GPs to add specific instructions as necessary to repeat prescriptions to make sure that patients take their medication correctly.
- Appropriate dosage instructions have been added to the computer software for some commonly used products, including painkillers.
- A pharmacist working in the local community has been testing the theory that pharmacists can carry out medication reviews for patients in Nursing Homes and feedback any recommendations to the patient's GP.
- A monthly check of information provided by hospitals to GPs when patients are discharged is underway to identify ways of improving this process. It will help make sure that GPs are kept up to date on what medication their patient has been prescribed while they were in hospital.
What happens next?
There is much work still ongoing around medication reviews and the discharge process. The five participating practices will continue to test small changes over the next six months.
The second year of the project will concentrate on spreading good ideas generated during the first year throughout the PCT, to help us to achieve the NHS Plan objective that all PCTs will have Medicine Management systems in place by 2004.
