walsall healthcare nhs trust medicines management
TRANSCRIPT
Walsall Healthcare NHS Trust
Medicines Management
Medicines Management
ADVERSE DRUG REACTIONS (ADR)
British Medical Journal 2004:329:15 Pirmohamed et al
• 18,820 patients studied
• 1225 admissions related to an ADR
• a prevalence of 6.5%
• the ADR directly leading to the admission in 80% of cases.
• The median bed stay was eight days, accounting for 4% of the hospital bed capacity.
• The projected annual cost of such admissions to the NHS is £466m
• The overall fatality was 0.15%.
• Most reactions where definitely or possibly avoidable.
• Aspirin, NSAIDS, Diuretics, warfarin
World Health Organisation
• Unintended, harmful reactions to medicines (known as adverse drug reactions) are among the leading causes of death in many countries.
• The majority of adverse drug reactions (ADR) are preventable.
• People in every country of the world are affected by ADRs.
• In some countries ADR-related costs, such as hospitalization, surgery and lost productivity, exceed the cost of the medications.
• No medicine is risk free. Vigilant assessment of the risks and benefits of medicines promotes patient safety.
ADVERSE DRUG REACTIONS
Risk Factors
• Age (children and elderly)
• Multiple medications
• Multiple co-morbid conditions
• Inappropriate medication prescribing, use, or monitoring
• Organ dysfunction
• Altered physiology
• Prior history of ADRs
• Extent (dose) and duration of exposure
• Genetic predisposition
ADVERSE DRUG REACTIONS
Classification
MHRA
Type A - Augmented
Type B – (Bizarre) Idiosyncratic
Type C - Continuing
Type D - Delayed
Type E – End of treatment
Classification
NPSA
0 - Near Miss
1 – No Harm (116,622)
2 – Low Harm (14,453)
3 – Moderate Harm (3327)
4 – Severe Harm (234)
5 – Death (47)
NRLS – incident report
MEDICINES SAFETY – THE ROLE OF PHARMACY
• Part of the team
• At ward level
• In the community
• Education and training
• Patients
• Other healthcare professionals
• Analysis of medication errors
• Management of controlled drugs
• Checking and dispensing prescriptions
• Leadership for medicines management
• National Patient Safety Agency
• Local solutions to medication errors
• Audit (CQUIN)
• Governance
• Nationally –
• UKMI/NELM
• NPSG
• Quality Assurance
MEDICINES SAFETY – THE ROLE OF PATIENT
Understand your medications
• What are they for
• How often do I take them
• For how long
• What can I expect
Making every contact count
• Lists of medications
• What you aren't taking
• What you cant take
• What support you need
• Green bag
MEDICINES SAFETY – THE ROLE OF PATIENT
Report problems & concerns
• Pharmacist
• GP
Any Adverse drug event
Report problems & concerns
• Regulatory agencies
• Any new drug
• Type B – Unexpected
• Any ADR that has significantly impacted on activities of daily living
• Counterfeit products
SOURCES OF INFORMATION
Online
Form
Supporting the discharge process
Thank you for listening,any questions?
Good medicines management means that patients receive better, safer and more convenient care, it leads to better use of professional time and enables skilled practitioners to focus their skills where they are most needed, thus effective
medicines managements benefits everyone.