There are an estimated 431,500 elderly and disabled people in residential care, of whom over 95% are aged 65 or over. Due to an ageing population, as well as policies to encourage elderly people to stay in their own homes longer, care home residents are generally older and frailer.
In recent years pharmacists have become increasingly concerned about aspects of medicines safety in care homes. The 2009 Care Homes' Use of Medicines Study (CHUMS) - found that 70% of care home residents experienced at least one medication error which the report described as an unacceptable level. A four month trial in a care home in London where a pharmacist was given full responsibility for medicines management saw a 91% reduction in medication errors.
Many patients in care homes are on multiple medicines, with some on seven or more. The Royal Pharmaceutical Society has expressed concern about the amount of medicines patients take and in particular about the use of psychoactive and antipsychotic drugs, which can sometimes be prescribed inappropriately. Antipsychotics, the traditional treatment for dementia, is associated with 1,800 excess deaths per year.
Pharmacists should have an embedded role in care homes, with overall responsibility and accountability for medicines and their use. Better utilisation of pharmacists’ skills in care homes will bring significant benefits to care home residents, care homes providers and the NHS.
The RPS England report "The Right Medicine: Improving Care in Care Homes" shows that these interventions could save the NHS in England £135 million; £60 million savings in the medicine budget, and £75 million in avoided hospital admissions.