Pharmacy in Scotland

Best Practice Case Study

Pharmacists supporting frailty prevention

Pharmacists in North Lanarkshire  were key in supporting the development of a multidisciplinary preventative approach for older adults at high risk of deterioration.  Three General Practices with a population of around 16,000 are benefiting from access to this service.

The area has significant urban deprivation and has the lowest GPs to patient ratio in Scotland, meaning access for vulnerable people can sometimes be harder.  This approach was developed to try and ensure equity of access for those who need it.

Communities with older adults at high risk of deterioration were identified, and pharmacy teams assessed patients to prioritise home visits, remote consultations or in person appointments.

Advanced pharmacists carried out comprehensive geriatric assessments in patients' homes.

Pharmacy teams also undertook polypharmacy reviews with patients who were identified as needing support. In total,  72 patients were reviewed with a median age of 85 years.  They were assessed and a Clinical Frailty Score was determined for each patient to give an indication of their level of risk.

As a result of the polypharmacy reviews undertaken, 90 medications were stopped, 40 started, 5 increased and 52 doses reduced; with an overall cost saving of over £100 per patient per year. 

Medication reviews also  resulted in a 31% reduction of the overall anticholinergic burden, , reducing the risk of unintended impairment in patients affected.

Positive feedback was  received from patients and the model has now been adopted by other GP practices in Lanarkshire. 

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