Pharmacists based within care homes make them safer for residents

Published by  Communications

On 14th Feb 2023

An elderly man waiting at a care home pharmacy.
Getty images

Research involving the University of East Anglia has shown that basing pharmacists in care homes makes them safer for residents.  

The Care Home Independent Pharmacist Prescriber Study (CHIPPS) trialled onsite pharmacists in dozens of care homes across the UK, including in Norfolk. 

Evidence from the study, published today in the BMJ, shows that onsite pharmacists reduce the risk of potential harm to care home residents from medicine.  

According to the study, care home residents are routinely prescribed an average of eight or more medicines.  

Medicine use is considered to be one of the main areas of risk in care home settings by both the government and regulatory organisations.  

One study cited in the BMJ paper says that 70 per cent of care home residents experienced drug errors daily. 

The University of Leicester-led study says that there have been regular calls for interventions to help to improve the management of medicine in care homes.  

Dr James Desborough, from UEA’s School of Pharmacy, said: “Most care home residents have many long-term conditions with a lot of prescribed medication. Traditionally, residents are registered to a GP who overseas their health needs.   

“But we know that these medicines are not always managed effectively, which can result in errors and adverse effects for the residents.   

“Historically, one approach has been to ask a pharmacist to pop in and do a one-off review periodically of residents’ medication. They would make recommendations but ultimately the GP had to authorise almost all medication changes and these types of services have been shown to have limited clinical effectiveness. 

“We wanted to find out if pharmacists who are trained to prescribe medication in care homes, could ultimately help residents. 

“So, we set up a new way of doing things – where pharmacists prescribers became part of the healthcare team working with the care home. This generally resulted in once weekly sessions where pharmacists worked with care home residents, staff and the medical practice to identify and resolve issues associated with medication.”   

CHIPPS conducted a randomised controlled trial including 49 care homes across England, Scotland and Northern Ireland.  

The study also involved 25 care home trained pharmacist independent prescribers who were integrated into care homes to improve medicines management and safety.  

According to the study, independent monitoring of pharmacist activities and review of unexpected resident deaths and hospitalisations found no safety concerns.   

Interviews with GPs, care home managers, carers and residents identified a high level of satisfaction with the service provided by the pharmacist independent prescribers.  

Analysis of the primary outcome of falls did not show a significant reduction, potential future harm from medicines was significantly reduced.  

Dr Desborough said: “Our research shows that integrating pharmacists in to care homes is safe, reduces the drug burden for residents, and the risk of future adverse events.   

“Both care home staff and general practice teams valued the pharmacists’ expertise and support, suggesting this service could reduce GP workload. 

“The key to success was effective and regular communication with all parties which was a result of the integration into teams as opposed to a pharmacist just popping in, making recommendations, then leaving.” 

Prof David Wright, from the University of Leicester, said: “I am delighted that the culmination of this six-year programme of work, undertaken by an incredible group of researchers, clinicians and patient representatives has produced this result.   

“The CHIPPS model of care was very well received by all stakeholders. We believe that this was because both our training and model of delivery focused on the integration of the pharmacist independent prescribers into the medical practice and care home teams.  

“This approach was supported by our process evaluation, which found that the intervention appeared most effective when the pharmacists were embedded within their local general practice.  

“Furthermore, our pharmacist-led intervention was reported by some GPs to reduce their workload as they no longer had to routinely review and authorise large numbers of repeat medicines and the pharmacist prescribers assumed some of their care home responsibilities.  

“The results support expansion of the current pharmacist role in care homes, to include prescribing and frequent visits, as it reduces future harm from medicines and helps care homes to improve their management of medicines.” 

The study was led by the University of Leicester in collaboration with researchers at the University of East Anglia and Norwich Clinical Trials Unit, the University of Aberdeen, Queen’s University Belfast, and the University of Leeds.  

Latest News

 
Dr Naomi Wood pictured alongside her book titled 'This is Why We Can't Have Nice Things'
28 Sep 2023

Dr Naomi Wood wins the BBC National Short Story Awards

UEA Creative Writing lecturer and bestselling author, Dr Naomi Wood has been crowned the winner of the eighteenth BBC National Short Story Awards for her work...

Read more >
 
A woman in football kit
25 Sep 2023

From Psychology to the Canaries: UEA student on target for Norwich City Women’s Football Club

A University of East Anglia Psychology student has marked her fledgling Norwich City Women’s Football Club career with a quick-fire hat-trick in one of her first...

Read more >
 
A nurse interacting with a patient.
21 Sep 2023

Nurses worldwide rely on intuition to triage patients

Nurses around the world use intuition to work out how sick a patient is before triaging for treatment – according to new research from the University of East...

Read more >
 
Francessca Turrell
18 Sep 2023

UEA nursing apprentice’s sky-high dive for Alzheimer's and Dementia awareness

On Sunday 24 September, University of East Anglia (UEA) nursing apprentice Francessca Turrell will be taking part in a charity skydive for Alzheimer’s Society, a...

Read more >
Are you searching for something?
 
Francessca Turrell
18 Sep 2023

UEA nursing apprentice’s sky-high dive for Alzheimer's and Dementia awareness

On Sunday 24 September, University of East Anglia (UEA) nursing apprentice Francessca Turrell will be taking part in a charity skydive for Alzheimer’s Society, a...

Read more >
 
Logo Rewind's yellow book cover with black symbols
14 Sep 2023

New book to focus on Norwich’s medieval logos

‘Logo Rewind: Trademarks of Medieval Norwich’ is a new book from UEA Publishing Project, in collaboration with CreativeUEA and featuring the work of Darren...

Read more >
 
Ziggurats
13 Sep 2023

UEA students discover new room location following RAAC accommodation closures

Over 700 University of East Anglia (UEA) students have discovered where their new university homes will be located, following the closure of some accommodation...

Read more >
 
(L-R) Chris Law MP, Dr Martin Scott, Renu Mehta
13 Sep 2023

New report from UEA Academic asks whether UK Aid Match has been used for ‘charity washing’, ahead of Westminster event

A new report from the University of East Anglia’s Dr Martin Scott into the Government’s UK Aid Match (UKAM) scheme has led to concerns of ‘charity washing’, with...

Read more >
 
Claudio Barchiesi with his bike and a United Kingdom flag
12 Sep 2023

Pedalling with purpose: UEA student’s fundraising cycle from Italy to England

A student at the University of East Anglia (UEA) has completed a charity cycling trip from his hometown in Italy to his grandparent’s house in Suffolk, to raise...

Read more >
 
Student accommodation buildings
11 Sep 2023

University of East Anglia accommodation closes following Government RAAC guidance

Read more >
 
A gloved hand holding a petri dish
11 Sep 2023

The University of East Anglia is set to re-join Horizon Europe

Read more >