RECENTLY I have been thinking about medicines optimisation – after all isn’t it just giving a new name to an old concept? But finally I decided it’s not. It encourages us to consider a golden thread from medicine to patient, where everything from evidence to safety is considered.
My work concentrates on care homes and predominantly dementia care. There I can clearly see that the four principles of medicines optimisation are needed on a daily basis. These describe how pharmacists can enable residents to improve their quality of life and outcomes from their medicines.
To say I love this work is an understatement – it is rewarding beyond words, and at the same time challenging, as it never reaches completion, but every small step can add value to individuals, their families and those who care for them.
As pharmacists we have the skills to assess the use of medicines, consider the side effects of medicines, and support individuals wherever possible in choices about their medicines, to nurture improvement around the safety of medicines and how to learn from incidents when things do go wrong.
However, the most important aspect that we do not yet seem to talk enough about in my opinion, the missing piece of this jigsaw, is the human face of pharmacy and the art of care.
We have much to offer in the support of patients and residents to manage their own medicines, to ensure we enable individuals and promote choice.
Although there are some pockets of excellent work, care home residents, in my view, are still not always involved in shared decision making in regards to pharmaceutical matters, nor do they always have access to the same level of pharmaceutical support that other sections of society do. Which, when you consider it, is bizarre, because they often are the most vulnerable and need it the most.
We, as a profession, should encourage and work with care providers to look at models of medication administration that move away from a mechanistic task focused approach to a more personalised, kinder, supportive, holistic pathways with the individuals always at the heart of care.
I have come to recognise that there is often dignity in small things in care, and simple interventions with medicines that may appear obvious to us pharmacists need to be encouraged and cultivated at the carer-giver, care-recipient interface. Likewise, we can learn much form patients and care givers who have a unique perspective on their own medicines.
This is really important in dementia care where the relationship between care giver and resident/patient can sometimes improve acceptance of medicines, many of which are needed to treat long term conditions, and if not managed successfully, can have significant impact on the health and wellbeing of individuals.
We must support care givers, whether formal or informal, in understanding the best way to use medicines effectively, as they are the final and very important section of that golden thread: here all the science and cost of care translates into a successful cost effective medicine outcome or a lost opportunity.
This is a time of change for us as a profession. But, as long as we face our patients, residents, individuals whom we support, and remember that all we do should add value to their outcome, our future as a profession aided by the new technologies and evidenced-based medicines will be anchored securely in our traditional past and the art of care.
Anne Child is Director of Pharmacy and Dementia Care at Avante Care
Follow Anne @