LIMOS provides in-home support to patients managing long-term conditions and medicines. They target patients with hospital admissions or readmissions related to medicines, adherence problems, mental health issues, or who are housebound. LIMOS pharmacists visit patients at home or in the hospital to support medicines management, improve adherence, address barriers, and communicate with other healthcare providers. They assess patients' needs and create individualized care plans. LIMOS offers three levels of community support services depending on a patient's needs for assistance with ordering, collecting, opening containers, or total medication management. Common barriers to adherence include mobility, dexterity, cognition, literacy, and ability to manage daily tasks that LIMOS works to overcome through

1. Medicines Support Solutions
Jo Kiangala
LIMOS Pharmacist
July 2015

2. Supporting People to get
the most from their
medicines
Patient centred approach

3. Limos Model of Care

4. Which patients does LIMOS target?
Have admission / readmissions to hospital
- ? meds related
Adherence problems - intentional or non-intentional
Social Care Package for medicines support
Mental Health Issues
Housebound

5. What we do
Visit patient in own home or in hospital:
• Support patients with LTCs to manage their medicines
enabling them to stay in their own homes
• Improve access to personalised support for medication
use
• Address adherence issues – intentional & unintentional
• Support carers - assist / administer meds
• Follow up patient across the interface if required
Communicate with all those involved in agreed patient centred
pharmaceutical care plan

6. Medicines adherence
• Failure to fill or refill a prescription
• Taking the incorrect medication
• Omitting one or multiple doses
• Taking more medicines than prescribed
• Inappropriate use of devices such as inhalers or
eye drops
• Prematurely taking or discontinuing medicines
• Taking medicines that have expired , damaged or
stored improperly

7. Categories of community support services
• Level 1: requires help ordering and collecting
prescriptions and advice on safe storage
• Level 2:all level 1 +supervision with self
medication or assistance to open containers
and remind to take medicines
• Level 3:requires total medication
management. The care worker has full
responsibility

8. Barriers to medicines adherence
• Following education, motivation and support these barriers can be
overcome
What are the barriers
Mobility
Manual dexterity
Physical co-ordination
Speech, hearing or eyesight
Memory
Literacy skills
Cognitive impairment
Ability to lift, carry or move everyday objects

9. Medicines Support Assessment
Tool
• Access Issues
• Compliance and Day to Day Management
issues
• Unintentional & Intentional
• Clinical Issues
• Action Plan
• Re-assessment and follow up.

10. Referral Form
Has the patient (or patient’s representative) agreed to the referral, and share the information detailed in
this form with LIMOS? YES NO
Where consent is obtained, LIMOS will access the patient’s clinical record (GP/hospital where appropriate) to view information related
to medicines to help support care. Please indicate if this has been discussed and consent to access information obtained. NOT
DISCUSSED YES NO
Note, if consent to access information is not discussed or not given, a referral can still be made. E.g. referrers from social care, community pharmacy
may prefer LIMOS to have this discussion with the patient. LIMOS will contact patient before proceeding.

11. Scenarios
• Patient with MS and lives alone.
• He is finding it difficult to get his tablets out
of their blister pack and using his eye drops
• He wants to remain independent

12. Scenarios
• Patient has significant visual impairment . He
is able to take care of all his personal needs
and would like to remain independent with his
medicines

13. Examples of strategies to assist with common causes
of medicines non-adherence
• Dexterity
 Remove tablets for the patients or suggest a device to aid
removal
 Supply screw caps
 Supply device to aid medication e.g. aid for instilling eye
drops, haleraid etc.
 Supply 20ml measuring cup instead of 5ml spoon
• Vision impairment
 Use larger fonts
 Symbols
 Rubber bands
 Magnifying lens

14. Any questions