GPs fear that more than half of patients aged over 75 years are taking too many medicines and that many are not taking them as prescribed, new research has found, highlighting the urgent need for new procedures to improve treatment and compliance and thus boost care and save money.
The research, presented in Dispensing Health in Later Life and commissioned by Pharmacy Voice, shows that 79% of GPs are not confident their older patients, who are on more than four therapies, are still taking their drugs correctly six months after consultation, and that 50.3% of their patients in this group would benefit from taking fewer medicines.
Up to 40% of the 5.1 million people aged over 75 are now taking more than four medicines, and this number is expected to jump to 6.1 million by 2020 with the ageing population. In addition, the over 75s are thought to represent a significant chunk - at least 45% - of the NHS’ annual £8.9-billion prescription bill.
According to the report, regular, six-monthly medicines reviews for this age group, undertaken by community pharmacy teams, could reduce hospital admissions, save the NHS many millions of pounds, and help reduce medicines wastage, which is thought to cost £300 million a year. And it seems GPs are on board with the idea, as 92% responding to the survey said they would like more support from the community pharmacy teams to help patients take their medicines properly.
“Community pharmacy teams are well placed to undertake regular medicines use reviews, but the exact delivery must be worked through carefully with general practice colleagues to make sure our older patients aren’t sent round the houses, and are advised by the right health professional, at the right time, and in the right place,” said Michael Dixon, chair, NHS Alliance and a Devon GP.
Updating the SCR
Other recommendations include improving collaboration between general practice and pharmacy, and a greater commitment to information sharing, particularly with regard to the summary care record. Pharmacy Voice says the government’s plan to provide all community pharmacies read-only access to SCRs by autumn 2017 should be “rapidly followed by secure access to update records with written information, with patient consent”.
More than 96% of the population have an SCR, which provides key, up-to-date clinical information sourced from the GP record 24 hours a day, but can only by accessed by authorised healthcare professionals with the patient's consent to support and direct care.
The move to give pharmacists access came after a pilot scheme found that, in 92% of cases where the record was accessed by a pharmacist, patients did not need to be sent on elsewhere in the National Health Service. Also, in 18% of cases the risk of medication errors was avoided. But fears over data security and privacy remain.