The RPS in Wales has called on Welsh Assembly Members to support greater investment in pharmacists to tackle increasing concerns about the use of antipsychotic medication to control the behavioural and psychological symptoms of dementia.
RPS Director for Wales, Mair Davies was joined by Wendy Davies, RPS Member and Mental Health Clinical Board Pharmacist at Llandough Hospital, to provide verbal evidence to the Committee’s inquiry into the use of antipsychotic medicines in care homes. The inquiry was instigated by the committee in response to calls from the Older People’s Commissioner for Wales and the RPS Wales policy, Improving Medicines Use for Care Home Residents.
The evidence session provided yet another opportunity for the RPS in Wales to outline where pharmacists add value to patient care by working as part of a multidisciplinary team, and through reviewing medication as patients migrate through the health and social care system.
During the evidence session Wendy stressed that pharmacists need to be more involved in the holistic assessment of a patient’s physical and psychological needs as well as taking responsibility for reviewing all of their medication. Attention was drawn to an example of a pharmacist intervention in care homes in a Cardiff locality that has recently resulted in a 70 per cent reduction in inappropriate antipsychotic prescribing. Greater collaboration between health professionals, patients and their carers was also called for, to ensure that where an antipsychotic medicine is used, it is appropriate and based on a thorough risk/benefit analysis.
Among the issues highlighted, the role of independent pharmacist prescribers in reviewing medicines and in de-prescribing was focused upon as a critical element of supporting care home residents. Mair Davies also called for improvements in training, calling for national standards for training and uniformity across Wales. The need for greater involvement of pharmacist expertise in care home inspections was also identified as needing attention to bring the inspection process in Wales in line that undertaken by the Care Quality Commission in England.
Commenting on this inquiry Wendy Davies said: “Pharmacists have a great deal of potential to improve the lives of people who have dementia and to be the guardians of the appropriate use of antipsychotics in care home settings. It is vital that the conditions are now created for pharmacists to work with other health professionals across the health and social care system to improve antipsychotic use. This includes the necessary IT infrastructure so all health professionals have read and write access to records in any setting to make clinical decisions when people with dementia are transferred between care settings. It also requires sufficient investment in the pharmacy team, harnessing the expertise of pharmacist independent prescribers, and upskilling pharmacy technicians to free up pharmacist time to consult directly with residents of care homes. I was delighted to be part of this important inquiry and look forward to the final recommendations of the Health Committee”.
To view the RPS written evidence submitted to the inquiry click here , or to view the video recording of the evidence session, click here.