Medication review

Transcript

Welcome to the CPPE medication review learning gateway.

As the population ages, more people live with multiple conditions. This often results in more medicines being prescribed to improve symptoms and outcomes for people. Polypharmacy isn’t always inappropriate but regular medication reviews can help to ensure that people are achieving their desired outcomes from their medicines. Medication reviews can also benefit people by reducing their medication burden and the risk of adverse effects. Reviews can be carried out in any setting. 

Medication review skills may be helpful for community pharmacists providing NMS consultations. While these services are focused on supporting adherence, better medication review skills will help you to identify medicines-related issues that need addressing. Working through the resources may help you identify people who would benefit from a medication review during the NMS consultation.

Pharmacy professionals working in hospital and general practice can use the resources to improve their knowledge and develop their skills. 

Good consultation skills are a fundamental part of medication review and so we’ve also signposted to the relevant CPPE resources to support you. 

This downloadable training enables pharmacists and pharmacy technicians to use communication and consultation skills and techniques required for person-centred care and shared decision making.

Learning Outcomes:

On completion of all aspects of this learning programme you should be able to:

• explain the concept of person-centred care
• describe the key communication and consultation skills and techniques required to conduct patient-centred care
• apply methods to assess your own practice and identify areas of improvement
• support patients, by using a patient-centred approach, to help them get the best from their medicines and/or in making healthy lifestyle choices
• further develop your practice by exploring tools and techniques, such as health coaching.

Pharmacy professionals, as an integral part of the NHS 10 Year Health Plan for England: Fit for the Future, are now routinely working in GP practices, care homes, secondary care, community and commissioning within a multi-disciplinary team. This growing infrastructure demands the need for effective communication between healthcare professionals working in different sectors. This programme will support you with documenting in patient clinical records to enable continuity of patient care in integrated local services.

Learning Outcomes:

On completion of all aspects of this learning programme you should be able to:

• summarise the legal and regulatory requirements for patient clinical records
• describe the information required for clear, concise and appropriate patient clinical records
• recognise the required structure expected when writing in patient clinical records
• document details of patient consultations and clinical interventions concisely and accurately in patient clinical records.

The overall aim of this course is to create a culture shift in practice by supporting pharmacy professionals to embed shared decision making as part of personalised care.

Learning Outcomes:

• define what is meant by shared decision making
• describe how shared decision making can improve a consultation from the perspective of a pharmacist and the person that they are consulting with
• demonstrate the use of the tools and techniques outlined in this course to support shared decision making*
• compare these different tools and techniques in order to select those that you will use in practice
• evaluate your ability to use shared decision making in practice.

* To fully meet this learning outcome as part of this programme you will need to arrange role play activities independently. Further details on how to do this are shared as part of the programme. If you are unable or choose not to arrange the role play activities you can achieve this learning outcome through experiential learning and applying what you have learnt from the programme to your practice.

This e-course has been developed for pharmacists and pharmacy technicians with an interest in structured medication reviews (SMRs).

It will support pharmacists working in all areas of practice to achieve the core learning needed to begin undertaking SMRs. It will enable pharmacy technicians to support pharmacists in the SMR process.

NHS England's guidance on Structured medication review and medicines optimisation states only appropriately trained clinicians working within their sphere of competence should undertake SMRs. 

To carry out SMRs, pharmacists need to have a prescribing qualification and advanced assessment and history taking skills, or be enrolled in a current training pathway to develop them. Pharmacists should also be able to take a holistic view of a patient’s medication. This e-course is only part of the training that will support you to gain the competence to carry out SMRs

Pharmacy technicians should not carry out full SMRs but may be involved in activities leading up to them. These could include supporting communication with patients in preparation for an SMR, or other approved activities in line with organisational policies.

Structure of this e-course

This e-course will support pharmacy professionals achieve the core learning needed in order to begin undertaking person-centred structured medication reviews in their practice. 

To facilitate your learning, we have structured the course into nine units. Some units are larger than others, but we estimate that you will need to commit an average of six hours of learning for each unit.

• Unit 1 - Understanding structured medication review
• Unit 2 - Consultation and communication skills
• Unit 3 - Interpreting laboratory data
• Unit 4 - Respiratory (COPD) focus
• Unit 5 - Mental health (focus on depression)
• Unit 6 - Cardiovascular disease
• Unit 7 - Anticoagulants and antiplatelets (focus on atrial fibrillation)
• Unit 8 - Type 2 diabetes
• Unit 9 - Multimorbidity and polypharmacy

Learning Outcomes:

On completion of all aspects of this learning programme you shoud be able to:

• describe the importance of shared decision-making and recognise its value in the structured medication review process 
• identify gaps in the information needed to undertake structured medication review 
• use evidence-based reference sources appropriately to support clinical decision-making 
• demonstrate clinical knowledge of the most commonly used medicines in the treatment of long-term conditions 
• develop an appropriate level of clinical judgment and skills to provide prioritised recommendations to a prescriber resulting from a structured medication review. 

This guideline covers safe and effective use of medicines in health and social care for people taking 1 or more medicines.

This guideline covers optimising care for adults with multimorbidity (multiple long-term conditions) by reducing treatment burden (polypharmacy and multiple appointments) and unplanned care.

This resource provides supports for healthcare professionals reviewing medication for adults with multimorbidity.

In this programme you will consider what is different about consulting with people with mental health problems. You will also recognise the impact of stigma and discrimination experienced by those with mental health problems and how to adapt your consultation style to address their needs and concerns.

Learning Outcomes:

• describe the mental health treatment gap and the importance of parity of esteem (valuing mental health equally with physical health)
• recognise the impact of stigma and discrimination experienced by those with mental health problems
• select the key national practice standards most applicable to pharmacy consultations with people with mental health problems
• reflect on your consultations with people experiencing mental health problems
• maximise the effectiveness of your consultations in this field by applying person-centred skills and behaviours
• identify possible risks in your consultations with people with mental health problems.

The aim of this workshop is to develop your knowledge and skills to enable you to take a shared approach to the safe and appropriate deprescribing of medicines.

A note about keycodes, and pathway and non-pathway event listings

After you select Choose an event, please be aware that workshop listings which require keycodes to access are for pharmacy professionals taking part in the Primary care pharmacy education pathway, while workshops that do not require a keycode are for all other pharmacy professionals who have identified this topic as a learning need.

Learning Outcomes:

On completion of all aspects of this learning programme you should be able to:

• describe the process of deprescribing and the involvement you can have within your role
• explain the importance of involving the person and the multidisciplinary team in the deprescribing process
• apply a person-centred and shared decision-making approach to deprescribing that considers the person’s perspective and experiences
• use a stepwise approach to the process of deprescribing, from identification through to reducing or stopping a medicine
• incorporate tools that can support the deprescribing process.

You can access the MR-CAT resource on the Consultations skills for pharmacy practice website.

In this web-based resource you can find information about the Medicines Related Consultation Assessment Tool (MR-CAT). The resource includes guidance on how you can use it for observed assessment as well as being able to self-assess your current practice.

You will also find guidance on how to gain feedback from people accessing your services using the Patient satisfaction questionnaire (PSQ).

This website resource also forms part of the Consultations skills – face to face and remote learning gateway. On this learning gateway page, you will find a range of learning resources which aim to increase your knowledge, skills, and confidence in relation to developing your consultation skills.

Learning Outcomes:

On completion of all aspects of this learning programme you should be able to:

• outline the purpose and structure of the MR-CAT
• describe how the MR-CAT can be used for both self-assessment and observed assessment
• explain how both peer and patient feedback can support professional development
• apply Pendleton's rules to support developmental feedback
• use the MR-CAT to critique practice through video observation

This page contains a selection of tools that health care professionals may find helpful when undertaking medication review

This guidance describes the 16 national medicines optimisation opportunities for the NHS in 2023/24, and signposts to resources to help with their implementation.