Too many Care Home residents are
not getting the best from their medicines
or are taking medicines which are
doing them more harm than good and may be reducing their quality of life.
Referral process for a medication review for a Care Home Resident
Primary care pharmacists, working in GP practices, are well placed to carry out a comprehensive medication review, if required, for residents. Pharmacists are experts in medicines, and working with the GP and the practice-based team they can ensure Care home residents receive the right medicines at the right time and in the right way to maximise the benefits from their medication.
Primary care pharmacists also have links with Medicine of the Elderly (MOE) consultants in secondary care and can seek expert opinion if required. The pharmacy team also have allocated sessions with MOE specialists specifically for collaborative working/reviewing medicines in this patient group.
It is important, where possible, that the resident (and/or their family members or carers, as appropriate, and in line with the resident’s wishes) and care home staff are involved in the medication review. The pharmacist, where possible, will explain the purpose of the medication review to the resident (and/or their family members or carers) and establish what their views and understanding of the medicines prescribed are.
Who should I refer?
The Royal Pharmaceutical Society believes “all residents should receive a review of their medication by a pharmacist when they first move into a care home in order to optimise their medication regime” (see Improving Medicines Use for Care Home Residents (March 2016). “Every care home resident should have a pharmacist led medicines review at least once a year or whenever a medicine is started, stopped or changed and when a resident moves between care settings” (see The Right Medicine: Improving Care in Care Homes (February 2016).
Referral for a medication review is recommended for residents who are:
- potentially on inappropriate medicines (polypharmacy).
- refusing to take their medicines or are “fed up taking tablets”
- finding it difficult to swallow their medicines
- sleeping a lot during the day/agitated during the day
- dizzy when they stand up
- at risk of falls
- becoming increasingly frail
- losing weight
or
- frequency or timing of administration of medication is causing problems
- concerned the resident may be experiencing side effects of their medication
- more specific medication information is required about some of the medication a resident is on
- medication changes are unclear post discharge from hospital
Please note this referral process is not suitable for any residents who become acutely unwell. In this instance seek medical/nursing support in the usual way.
A medication review may be appropriate after the acute episode has been resolved
How can I make a referral?
To refer a resident for a medication review please email the Primary Care Pharmacy team using one of the two methods below.
Email: PC.Prescribing@nhslothian.scot.nhs.uk. This generic mail box is checked Monday to Friday.
Methods of Referral
Secure Email
- Subject title: Request for medication review
- Information required within the email
- Resident’s name
- Date of birth
- Main text:
- Details of resident’s GP practice, the name of the care home and main point of contact at the care home in case further information is required
- A short explanation as to why you are referring the patient
- Your request will be sent to the pharmacist in the resident’s GP practice. The pharmacist will then liaise directly with you throughout the process of the medication review.
Non-Secure Email
Where a Care Homes does not have an NHS approved secure email you can email from your normal business email address – please DO NOT include any confidential or identifying resident information.
- Subject title: Request for medication review
- Information required within the email
- Name of the Care Home
- Contact telephone number
- The following statement:
“Please can you contact us on the number provided above as we have a resident who our team feel would benefit from a polypharmacy review.“
Please note that if the email contains patient confidential information
the email must be sent using a secure NHS email address
For more information on setting up a secure NHS email address
please see the secure email accounts page.
Useful links
Managing Multiple Medicines This combined mobile app and website aims to support healthcare professionals, patients and carers to make shared decisions and medicines based on the Scottish Government’s Polypharmacy Guidance Realistic Prescribing (2018, 3rd edition)
SPSP: Primary Care Medicines Sick Day Rules Card | Scottish Patient Safety Programme (SPSP) | ihub – Medicines Sick Day Rules Card
Guidance about medication, personal plans, review, monitoring and record keeping in residential care services:
Covert medication guidance and pathway:
Managing Multiple Medicines This combined mobile app and website aims to support healthcare professionals, patients and carers to make shared decisions and medicines based on the Scottish Government’s Polypharamcy.guidance.Realistic.Prescribing,3rd.edition
Further information
For information on information relating to Care Homes and pharmacy services and education please see the following webpages.
Pharmacy: Service and information
Pharmacy: Education – Medicines Management
