Why is this study needed?

Older care home residents often take many medicines at the same time to treat multiple new and long term conditions. Changes in health and aging mean that some medicines are no longer needed or cause side effects, but these medications are often continued. The NHS Long Term Plan recommended that clinical pharmacists should review the medication of care home residents to check it is still correct and needed.  Guidelines state that medication reviews should be person-centred and consider what matters to the patient and their family.  However, different stakeholders in the medication review process might have a different understanding of what a person-centred approach should look like.  This study aims to develop an understanding of what person-centred care means, and how it can be achieved in pharmacist medication reviews for older people living in care homes.

Introducing Betty

 As part of the study I have interviewed pharmacists reviewing medication in care homes, to find out what it means to them to be person-centred and what makes this easier or harder to achieve.  One pharmacist shared their experience of a medication review with an older lady we’ll call Betty who was living with dementia in a care home.  She used to be a head teacher and was described as flamboyant and arty with a love of painting. When the pharmacist visited Betty she commented that she could see that she was frustrated as she wasn’t able to go out much and was used to being active.  The pharmacist discussed Betty with her GP.  She wanted to reduce her antipsychotic medication however the care staff were concerned about the effects of this on Betty’s challenging behavior. The pharmacist, GP and care staff decided to try to get Betty involved in painting again and found that this helped to reduce her agitation.  They were then able to reduce her antipsychotic medication without any negative effects on her behavior.

What might person-centred medication reviews mean?

Betty I believe demonstrates what it might mean to be person centred and how a medication review extends much further than just reviewing the list of medicines, including co-ordination with and involvement of other stakeholders in Bettys care.   Through visiting Betty and gaining an understanding her life experiences, the pharmacist was able to optimize her medication.  And Betty was able to do what mattered most to her, to enjoy painting again.

What can care staff do?

Pharmacists interviewed shared that a lack of understanding of their role by care staff, residents and family representatives as a barrier to conducting medication reviews.  I would be interested in finding out from care staff any ideas of how they would like pharmacists to explain their role to care homes, residents and their family.

If you are interested in taking part in this study please contact me either by email: Please contact me via email rjl50@leicester.ac.uk  or on Twitter @RachJLewis

This study is funded by the NIHR Applied Research Collaboration East Midlands (ARC EM) The views expressed are those of the author and not necessarily those of the NIHR or the Department of Health and Social Care.