Journal of Medicines Optimisation - Mar 2019

Journal of Medicines Optimisation • Volume 5 • Issue 1 • March 2019 1 Editorial There have been many developments in roles for pharmacists. A key one has been the emergence of Antimicrobial Pharmacists, which has been particularly important given the extent of usage of these drugs and concern about the emergence of resistance. It is, however, most interesting to learn of the specific contribution that such a role can make to direct clinical care. The acquisition of an Independent Prescriber qualification is also a key component of such a development. The clinical area in question is that of foot care for patients with diabetes. The article sets out the significant adverse effects that can arise for a patient with diabetes, which may not be generally fully realised, and the benefit from close monitoring of their medications. Whilst an aim in improving patient care was achieved, the avoidance of unnecessary acute admissions and the facilitation of earlier discharge were also reported. This is a most enlightening article and it is hoped that it will encourage others responsible for the management of antibiotics to develop their role. It would be good to hear of such developments in the future. The communication of medicines information across the primary-secondary care interface is widely recognised as being a key factor in the continuity and optimisation of patient care but, in practice, it is often bedevilled by difficulties that mean it is not always fully effective. It is most important that such communication channels work well when patients are discharged from hospital and return home to the care of their GP, particularly when changes in treatment regimens have taken place during the inpatient stay. An article in this edition outlines a project to extend access to hospital ePrescribing data to clinicians, including GP practice pharmacists, in primary care. The system was readily adopted and well used and an evaluation showed favourable benefits, including an improvement in patient safety. There is much to commend such a development and it is surely an approach that will be of interest to those with a role in improving communication across the interface. The changing demographic of an increasing number of frail elderly provides a challenge in terms of clinical care and costs. Older people are being better supported to enable them to stay in their own homes and maintain independence for as long as possible. This does mean, however, that they are generally frailer when they enter a care home, more likely to be affected by multiple health problems and are often being treated with polypharmacy. The way this challenge is being met by the medicines optimisation team in a Commissioning Support Unit (CSU) supporting a Clinical Commissioning Group (CCG) for 31 care homes is outlined in the Patient Experience section. Benefits have been seen in improving the appropriateness of medications and reducing problematic polypharmacy through over 6,000 interventions in a four year period. The examples of information supplied to care homes and patients form a useful checklist for those with responsibility for such services. HYPERLINKS References and other resource material as appropriate can be accessed directly via hyperlinks in the Journal. SUBSCRIPTION The JoMO is free of charge to health professionals working for the NHS. To obtain a subscription, please go to an d click on the ‘PM Journals’ tab where subscription rates can be found. REGISTRATION To receive the JoMO, please go to , c lick on the ‘PM Journals’ tab and follow the process for registration. ADVERTISEMENTS/ADVERTORIALS Please contact the Advertising Editor (see end of journal) for more information. ACCREDITATION The JoMO has been Faculty accredited by the Royal Pharmaceutical Society. 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