MEDICINES USE AND SAFETY NETWORK EVENT: MARCH 2019 WHO Medication - - PowerPoint PPT Presentation

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MEDICINES USE AND SAFETY NETWORK EVENT: MARCH 2019 WHO Medication - - PowerPoint PPT Presentation

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MEDICINES USE AND SAFETY NETWORK EVENT: MARCH 2019 WHO Medication Without Harm Challenge: Tackling medicines safety challenges in transfer of care and adherence Barry Jubraj Professor Nina Barnett Medicines Use & Safety Network,

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www.sps.nhs.uk

MEDICINES USE AND SAFETY NETWORK EVENT: MARCH 2019

WHO Medication Without Harm Challenge: Tackling medicines safety challenges in transfer of care and adherence Barry Jubraj Professor Nina Barnett Medicines Use & Safety Network, Specialist Pharmacy Services

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Upcoming MUS Events

WEBINARS: Wednesday 10 April End of Life Care with Sara Bernstein THURSDAY 9 May Frailty with Lelly Oboh and Jennifer Stevenson Wednesday 12 Jun Transitions of Care in Mental Health with Caroline Dada FACE TO FACE EVENTS (London) 23/24 October MUSN Meeting

The way we contact you will be changing so please register on our website: www.sps.nhs.uk; update your profile with your network choices from the Medicines Use & Safety Networks list; tick the box to opt in to receive updates and save your profile. Contact LNWH-tr.MUS-SpecialistPharmacyServices@nhs.net for any information about events or networks

14/03/2019

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9.30 Arrival, Registration and coffee 10:00 Welcome and Introductions and housekeeping Barry Jubraj Associate Director Medicines Use and Safety (MUS) 10.10 Medicines safety and non-adherence – making the link Barry Jubraj & Nina Barnett Consultant Pharmacist & MUS 10.25 Is it any better? The ongoing challenge of non-adherence Dr Christina Jackson King’s College London 11.10 Coffee and networking 11.40 Medicines safety and non-adherence workshop Barry Jubraj/Nina Barnett/ Christina Jackson 12.30 Lunch and networking – a sandwich lunch will be provided 13.30 Transfer of care (ToC) and medicines – Context setting & recent webinar Nina Barnett 13.35 ToC – A patient’s experience Nigel Westwood 14.00 ToC and care homes – the Sutton experience Hai To, Sutton CCG, Surrey 14.30 Break and networking 15.00 ToC in community paediatrics and insulin management (two presentations) Jacqui Ballantyne and Amy

  • Bradley. Northumbria

Healthcare 15.40 Panel Q&A All Presenters 16.15 Take away messages Barry Jubraj/Nina Barnett 16.30 SPS update and close Barry Jubraj

Welcome to:

  • Our

participants

  • Nina

Barnett

  • Our

speakers

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  • What we are trying to do
  • Why we think it is important
  • How this chat leads into the rest of the morning
  • Outcomes
  • Starting points:
  • What is medicines adherence?
  • What is medication safety?

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Session 1: Medicines safety and non-adherence – making the link A 15-MINUTE CHAT

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  • Medication safety is defined as freedom from

preventable harm with medication use

  • (Canadian Patient Safety Institute1).
  • So it’s more than just error reporting
  • Adherence to medicines is defined as the extent to which

the patient's action matches the agreed recommendations

  • (NICE2)
  • Christina’s talk (next) will give a fuller definition

1. Medication Safety. Canadian Patient Safety Institute: https://www.patientsafetyinstitute.ca/en/Topic/Pages/Medication-Safety.aspx (accessed 11.3.19) 2. Medicines adherence: involving patients in decisions about prescribed medicines and supporting adherence . NICE: https://www.nice.org.uk/guidance/cg76/chapter/introduction (accessed 11.3.19)

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Any evidence for a link between safety & non-adherence?

  • Brighton/King’s: The PRIME Study - develop a risk

prediction model that identifies older adults most at risk of experiencing medication-related harm after discharge from hospital:

  • Stevenson J, Parekh N, Ali K, Timeyin J, Bremner S, Van Der CammenT, et
  • al. Protocol for a Prospective (P) study to develop a model to stratify the risk

(RI) of medication (M) related harm in hospitalized elderly (E) patients in the UK (The PRIME study). BMC Geriatr 2016;16:22

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  • Recent meta-analysis: clear relationship between

mortality and polypharmacy:

  • Leelakanok N, Holcombe AL, Lund BC, Gu X, Schweizer ML. Association

between polypharmacy and death: A systematic review and meta-

  • analysis. J Am Pharm Assoc 2017;57:729–738
  • Sub-study of PRIME looked at this relationship – could it

be due to side effects? Or non-adherence?

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Findings:

  • 1280 patients recruited
  • 413 experienced medication-related harm (MRH)
  • 93 cases harm at least partly explained by non-adherence
  • Multivariable analysis: MRH due to non-adherence was

associated with one-year all-cause mortality. MRH due to ADR was not Harm from non-adherence to medications may explain the relationship between polypharmacy and mortality

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Questions for us all to think about:

  • 1. ‘Missed dose’ audits in hospitals are typically badged

under ‘medication safety’

  • But non-adherence generally isn’t. Why?
  • 2. When we start a medicine, we evaluate risks, e.g.

allergies, side effects, interactions

  • Do we evaluate the risk of non-adherence?
  • 3. We sometimes use a risk matrix to think about safety
  • Could this work with non-adherence?

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TWO PATIENT STORIES

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What we are trying to do

  • Get us thinking – starting today, about medicines non-

adherence in safety terms Why we think it is important

  • Non-adherence described as esoteric or somehow less

important than ‘medication safety’. It IS part of medication safety How this chat leads into the rest of the morning

  • Christina’s talk made the two of us sit up and think – so

we wanted you to hear it Outcomes

  • Workshop later, collect your thoughts, then publish

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SUMMARY THEN SESSION 2: OVER TO CHRISTINA

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SESSION 3

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Aim: To discuss the key questions from the first session How:

  • 1. Three groups of 30-ish go to different parts of the room
  • 2. Thirty becomes 3 x 10-ish
  • 3. Each group of 10 rotates round three flipcharts with the

earlier questions on each chart - 8 minutes per chart

  • 4. Use post it notes to discuss and put up thoughts
  • 5. Nina, Christina, Barry each buddy with a group of 30

then debrief

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Session 3: Medicines safety and non-adherence RAPID workshop

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Questions:

  • 1. ‘Missed dose’ audits in hospitals are typically badged

under ‘medication safety’

  • But non-adherence generally isn’t. Why?
  • 2. When we start a medicine, we evaluate risks, e.g.

allergies, side effects, interactions

  • Do we evaluate the risk of non-adherence?
  • 3. We sometimes use a risk matrix to think about safety
  • Could this work with non-adherence?

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9.30 Arrival, Registration and coffee 10:00 Welcome and Introductions and housekeeping Barry Jubraj Associate Director Medicines Use and Safety (MUS) 10.10 Medicines safety and non-adherence – making the link Barry Jubraj & Nina Barnett Consultant Pharmacist & MUS 10.25 Is it any better? The ongoing challenge of non-adherence Dr Christina Jackson King’s College London 11.10 Coffee and networking 11.40 Medicines safety and non-adherence workshop Barry Jubraj/Nina Barnett/ Christina Jackson 12.30 Lunch and networking – a sandwich lunch will be provided 13.30 Transfer of care (ToC) and medicines – Context setting & recent webinar Nina Barnett 13.35 ToC – A patient’s experience Nigel Westwood 14.00 ToC and care homes – the Sutton experience Hai To, Sutton CCG, Surrey 14.30 Break and networking 15.00 ToC in community paediatrics and insulin management (two presentations) Jacqui Ballantyne and Amy

  • Bradley. Northumbria

Healthcare 15.40 Panel Q&A All Presenters 16.15 Take away messages Barry Jubraj/Nina Barnett 16.30 SPS update and close Barry Jubraj

Review

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Upcoming MUS Events

WEBINARS: Wednesday 10 April End of Life Care with Sara Bernstein THURSDAY 9 May Frailty with Lelly Oboh and Jennifer Stevenson Wednesday 12 Jun Transitions of Care in Mental Health with Caroline Dada FACE TO FACE EVENTS (London) 23/24 October MUSN Meeting

The way we contact you will be changing so please register on our website: www.sps.nhs.uk; update your profile with your network choices from the Medicines Use & Safety Networks list; tick the box to opt in to receive updates and save your profile. Contact LNWH-tr.MUS-SpecialistPharmacyServices@nhs.net for any information about events or networks

14/03/2019