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May 7, 2018 - City Hospitals Sunderland. Background: The Frailty Lead Pharmacist is part of the frailty team that provides an in reach service to admissions ...
Age and Ageing 2017; 46: i1–i22 doi: 10.1093/ageing/afx055.80

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Clinical Quality 80

IMPACT OF FRAILTY LEAD PHARMACIST ON PRESCRIBING IN FRAIL PATIENTS ON ADMISSION WARDS

J Hindmarsh, H O’Neil, P Cranmer City Hospitals Sunderland Background: The Frailty Lead Pharmacist is part of the frailty team that provides an in reach service to admissions and a short stay ward at City Hospitals Sunderland. The aim of the frailty team is to provide a comprehensive geriatric assessment (CGA) to all frail patients that are admitted early evening and overnight. A comprehensive geriatric assessment is the gold standard for the management of frailty in older people (British Geriatric Society in association with RCGP and Age UK. Fit for frailty. BGC. London 2014). Objectives: To establish number and type of interventions made by the frailty pharmacist on the ward round • To identify the types of medications stopped and started on the ward round and the person initiating the change • To look at number of items prescribed by frailty pharmacist on the ward round

Method: Data was collected from a sample of 100 patients who were seen on the ward round by the frailty team Results: Items prescribed: 417 items (212 new items, 205 regular medications that were missing or incorrectly prescribed) Recommendations of medications to be stopped: 132 medications by the frailty pharmacist; 52 by the medical team. The top three reasons for stopping medication were rationalisation, nephrotoxic or hypotension. Medications recommended and commenced: • 125 by the pharmacist • 89 by the medical team. • The most common medications recommended were analgesia, actimel, dalteparin and laxatives. Conclusion: Since starting the service in December 2014 there have been no prescribing error incidents fed back due to pharmacist prescribing. This correlates with other data showing accurate pharmacist prescribing for example the article by Wasim Baqir et al. European Journal of Hospital Pharmacist 2014; 22: 79-82. By being on the ward round allows rapid medication reconciliation and review by the pharmacist. Suggestions are therefore made and actioned within 24 hours of admission.

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