A specialist service that carries out enhanced medication reviews for frail patients admitted to hospital has been shortlisted for an award.

The multi-disciplinary team pathway was evaluated in a joint project between East Midlands Academic Health Science Network, Nottingham University Hospitals NHS Trust and the University of Nottingham. It has been shortlisted for the Health Service Journal’s (HSJs) Improving Safety in Medicines Management Award.

A specialist frailty multidisciplinary team was created at Nottingham University Hospitals NHS Trust, which included a specialist frailty pharmacist who carried out an enhanced medication review for each patient admitted to the service, to ensure that the combination of medicines being taken for different conditions was appropriate and safe.

The speciality frailty pharmacist also ensured communication with community and primary care services was completed to a high standard so that any changes could be continued when the patient left hospital.

The University of Nottingham evaluated the new pathway in comparison with standard care and found that, in the new pathway:

• Patients had less medicines prescribed at discharge
• Fewer new medications were initiated
• Discharge information was better quality
• Medication changes were more persistent in primary care at three months.  

EMAHSN Medical Director Gail Allsopp said: “We are delighted that the team has been shortlisted for the award. The pathway uses a multi-professional team approach, including an integrated specialist pharmacist to reduce inappropriate prescribing and the potential risk of harm associated for patients who are frail.”

“The evaluation of this model versus standard care demonstrated learnings for the hospital and for the wider health system in delivering safer use of medicines for this complex patient group. We are working with organisations across the East Midlands and nationally to share the learning widely.”

Vivian De Vittoris, Lead Pharmacist for Quality Improvement and Medicine Optimisation at NUH said: “While the majority of patients will be receiving multiple medicines due to specific or complex needs, sometimes polypharmacy can be problematic especially in the frail population, and in such cases, we need to ensure these patients are on the right medicines for the right amount of time.

My warmest congratulations to the team and all those involved in this work. It is a great example of how integrated medicine optimisation practice is essential to the delivery of high quality and safe care from medicines, both locally and across care pathways.”

Dr Matthew Boyd, Head of the Division of Pharmacy Practice and Policy at the University of Nottingham, who led the evaluation of the intervention said “The intervention has demonstrated the benefit of having a specialist frailty pharmacist both in the short term with improved medicines optimisation, but also sustained persistence of prescribing decisions once patients are transferred back into primary care. It has been a pleasure to evaluate such a positive improvement to the care of our older population.”

EMAHSN and NUH will be presenting their evaluation of the project at the Specialist Pharmacy Webinar on 14 July 2021. Find out more and book your place. 

The full list of finalists for the 2021 HSJ Patient Safety Awards can be found on https://awards.patientsafetycongress.co.uk/2021-shortlist. Winners will be selected ahead of the ceremony, which will take place as part of the Patient Safety Congress and Awards in Manchester in September 2021.