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Medicines management in care homes

Al-Hamadani, Fadya 2018. Medicines management in care homes. PhD Thesis, Cardiff University.
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Abstract

There is an increasing demand on health and social care to provide high quality care to older adults in the UK as the population of this vulnerable group grows. These services should meet the needs of individuals who can have a range of acute and chronic conditions. The capacity for NHS services to meet these demands is limited and therefore care homes provide accommodation and health services to meet this unmet need. In the lay press, there have been concerns regarding medication management in care homes and there is evidence in the literature that this process is sub-optimal. The aim of this thesis therefore was to explore medicines management in care homes focusing on the areas of prescribing, administration and medicines waste. A retrospective analysis of anonymised medication administration records (MAR charts) and an audit of medicines waste was employed to achieve this aim. The analysis revealed that a significant number of residents (84%) were exposed to polypharmacy, potentially inappropriate medications (87%), anticholinergic burden (5% with an AEC score Ñ 5), and a significant number of administration errors (6 administration errors per resident per week). The study also demonstrated a significant volume of wasted medicines in care homes. As a consequence of these issues residents in care homes are potentially exposed to practices that may lead to harm and will likely increase the demand on health and social care resources. Careful consideration of prescribing practices is needed to reduce medicines burden and efforts should be made to embed a multidisciplinary approach to the care residents. In conclusion, further study of the clinical consequences of prescribing and medication errors in care homes should be explored as a matter of urgency and efforts should be made to maximise the therapeutic benefits of medications and reduce the cost of wasted medicines.

Item Type: Thesis (PhD)
Date Type: Completion
Status: Unpublished
Schools: Pharmacy
Subjects: R Medicine > RS Pharmacy and materia medica
Uncontrolled Keywords: Care Homes; Medicines Administration; Potentially Inappropriate; Prescribing; Geriatrics; Medicines Waste; MAR charts
Date of First Compliant Deposit: 12 June 2019
Last Modified: 31 Jan 2020 03:22
URI: https://orca.cardiff.ac.uk/id/eprint/123409

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