Lambeth CCG Integrated Pharmacy – “Medicines Plus” Service
Frail older people take many drugs and optimising medicines use in this patient group has a significant impact on their outcome, reducing adverse effects, reducing costs and reducing medicines waste. Complex and interconnecting factors including multi-morbidities, social vulnerabilities, functional and cognitive decline and organisational barriers impact on how older people access, adhere to and benefit from taking medicines.
Therefore standard interventions often fail to meet their needs. Fit for Frailty II publication recommend that medication reviews/assessments should result in a personalised shared care and support plan outlining treatment goals, management plans and what should happen if urgent care is needed
In view of this, the Lambeth Integrated Pharmacy - Medicines Plus service has been developed to commission two interdependent pharmacy services to work cohesively with primary, secondary and social care agencies to support patients with complex medicines needs in order to:
- Empower people to be in control of their health and wellbeing
- Offer holistic, personalised, co-ordinated care and support
- Be proactive, preventative and focused on better outcomes
In this service the Integrated Clinical Pharmacists (ICPs) undertakes holistic domiciliary medication assessments to identify and resolve complex Medicines Related Problems (MRPs) when frail older people are most vulnerable e.g. transfer of care. Once the initial MRPs are resolved and the patient is more stable, for patients who then require an on-going pharmaceutical support plan to maintain self-management and resilience, referred to here as a “Medicines Plus” plan are supported by the community pharmacist.
The community pharmacist will ensure that medicines use is optimised on an on-going basis as specified in the Medicines Plus plan and will liaise with the GPs as well as other health and social care practitioners regarding day-to-day aspects of medicines use.