MCMW team consists of case managers, pharmacists, nurses, HCAS, social link workers working along side GPs to provide an integrated and whole systems approach to managing older adults, many of whom have complex comorbidities.
The Pharmacists currently undertake the following:
• Domiciliary visits to high risk patients requiring a structured medication review and
addressing of complex medicine needs and liaising with case managers and social care to ensure wider risks are managed.
• Level 21 Medication reviews (MR) for selected patients enrolled in the (MCMW) weekly Hub MDT and monthly Frailty MDT for GP surgeries within West London. A level 2 medication review is a review of all of the medicines with the patient’s clinical notes. The GP will discuss the review with the patient in person therefore resulting in the completion of a Structured Medication Review2 (SMR).
Between April 2022-March 2023 the following number of reviews were completed
• 88 Domiciliary reviews (Average number of interventions per patient = 7, net cost saving per patient £150.00)
• 3082 medication reviews for the MCMW Hub
• 682 medication reviews for patients seen at the Frailty Hub
The clinical significance of Pharmacist interventions for the domiciliary reviews were graded using a tool adapted from King College NHS Foundation trust. There were 7 interventions graded IV which prevented reversible harm/admission to hospital. The total cost saving for preventing 7 non-elective admissions is £21,392.
Stakeholder feedback shows:
• 26 (100%) agree the Pharmacist added value to patient care
• 26 (100%) agree the Pharmacists recommendations enhanced the quality and safety of prescribing
Through working with an integrated teams Pharmacists have demonstrated they have added value and improved patient care for hard to reach patients who may not have previously had access to a pharmacist led medication review.
