Birmingham polypharmacy review improves patient care and reduces costs

Our pharmacist-led polypharmacy review in Birmingham resulted in better patient care and cost improvements within its first year.

Background
Birmingham South Central Clinical Commissioning Group commissioned our pharmacist-led Polypharmacy Review Service to carry out a three-year polypharmacy review starting October 2016.

Action
Level 3 medication reviews for adult patients are delivered by a team of pharmacists with support from technicians and an administrator. EMIS searches in practices are risk-stratified to prioritise patients for review. An adapted version of the RIO tool is used to identify patients at risk of hospital admission.

Face-to-face reviews are carried out in the clinic or in the patient’s own home. Pharmacists then meet GPs to explain their recommendations and follow up patients as necessary.

The reviews:

• ensure each patient is prescribed safe and appropriate medicines
• assess any adverse drug reactions and drug interactions
• assess patient compliance and address any issues
• de-prescribe unnecessary or harmful medicines
• provide information and address patient concerns
• monitor drug therapy
• resolve interface issues, for example with secondary care
• produce a patient-specific pharmaceutical care plan.

Impact
By the end of the project’s first year (September 2017) numerous quality interventions and cost improvements had already been identified for all associated with it.

The Polypharmacy Review Service reduces avoidable harm and the potential risk of premature death, enhances the quality of life for people with long-term conditions, helps people recover from illness or injury, and improves patients’ experience of care.

The review team undertook evaluation surveys with GPs and patients. Of the 441 patient survey returns, 89 per cent of respondents found their reviews very helpful. Of the 30 GP practice returns, 87 per cent of respondents found the reviews and the scheme very useful.

From the first 1,539 patients reviewed, the estimated cost improvement resulting from potentially reduced hospital admissions, de-prescribing and reduced drug quantities is £320,537. The return on investment for year one is 1.65 (total output divided by cost of service).

I can’t emphasise enough how valuable the polypharmacy service was, I wish it was available annually. It is extremely useful.
Dr Iram Khattak, The Khattak Memorial Surgery, Birmingham

Hopefully this service will continue as it has been very useful for us & the patients.
GP responding to survey

Brilliant idea, great service.

Good service. Should be recommended to all patients.
Patients responding to survey