The Health Innovation Network Polypharmacy programme is working with healthcare professionals to address problematic polypharmacy by supporting easier identification of patients at potential risk from harm from multiple medications. Our evidence-based polypharmacy Action Learning Sets (ALS) are being rolled out across England to support GPs, pharmacists and other healthcare professionals who undertake prescribing or medication reviews to understand the complex issues around stopping inappropriate medicines safely. To drive and accelerate changes in practice, delegates complete a quality improvement project to address problematic polypharmacy in their workplace. This poster summary, To evaluate the benefits of Structured Medication Reviews in elderly Chinese patients, can be viewed here. For more information about the polypharmacy programme, please visit https://thehealthinnovationnetwork.co.uk/programmes/medicines/polypharmacy/

1. To Evaluate the Benefits of Structured Medication Reviews in
Elderly Chinese Patients.
Lisa Sheau Sing Loh, Rachel Vincent
The Newcastle upon Tyne Hospitals NHS Foundation Trust
Measurement for Improvement
Measurements included patient survey and data collection (which
includes medication interventions, any referrals and follow-up).
This is an ongoing study. Based on the initial 12 patients (9 female
and 3 male, mean age 77 years [range 65 to 96]) who had SMRs,
the preliminary results showed that all patients were not aware of
the SMR service. They all found the SMRs beneficial and agreed
the pharmacist was able to address their concerns.
• 22 medication interventions were recorded, representing a mean
of 1.8 interventions per patient.
• 58% of patients (n = 7) were referred for blood tests. 67% (n = 8)
had BP monitored.
• 25% (n = 3) were referred to GPs. 10 referrals were also made to
other healthcare professionals and social worker. 92% (n = 11)
had follow-up with the pharmacist.
Effects of Changes
This study also identified factors such as barriers for Chinese
patients in accessing health services, including language (83% of
patients are non-English speaker), understanding of health system
and health beliefs. 50% of patients (n = 6) were taking Chinese
medicines and 33% (n = 4) had incorrect health records. The
Chinese pharmacist was able to address these issues.
.
Intervention
A Chinese Pharmacist Prescriber who is fluent in Mandarin and
Cantonese conducted face-to-face/telephone SMRs with elderly
Chinese patients in their native language to improve engagement.
Strategy for Change
The Clinical Pharmacist aims to provide a holistic care via SMRs. If
required, patients were referred for any appropriate investigations, to
the relevant healthcare professionals and to the “Search Newcastle”
charity social worker who supports the local Chinese community.
Context
This preliminary study aims to evaluate the benefits of pharmacist-led
structured medication reviews (SMRs) in a group of elderly Chinese
patients, aged 65 years and above, living in the area covered by GP
practices in the Newcastle Inner West Primary Care Network (PCN).
Problem
For patients, the benefits of SMRs include improving experience,
quality of care and reducing risk of harm from medicines1. However,
a Department of Health & Social Care document has raised
concerns that if SMR is not adequately supported, it may widen
health inequalities2.
Previous research has shown that ethnic minority communities have
problems accessing healthcare and engaging in SMRs due to
various issues including language or cultural barriers2,3,4.
Currently, there is a lack of published studies exploring the use of
SMRs in the elderly Chinese population. This study aims to address
these issues.
Assessment of Problem
The practice team have identified Chinese patients who haven’t had
their SMRs and/or annual health reviews or were experiencing
difficulties with their medications. The situation is further complicated
by a lack of Chinese interpreters.
References
1. NHS England. Structured medication reviews and medicines optimisation. https://www.england.nhs.uk/primary-care/pharmacy/smr/
(accessed 11th March 2023)
2. Department of Health & Social Care. Good for you, good for us, good for everybody: A plan to reduce overprescribing to make patient care
better and safer, support the NHS and reduce carbon emissions. Good for you, good for us, good for everybody: a plan to reduce
overprescribing to make patient care better and safer, support the NHS, and reduce carbon emissions (publishing.service.gov.uk) (accessed 11th
March 2023)
3. Robinson A. et al. ‘He or she maybe doesn’t know there is such a thing as a review’: A qualitative investigations exploring barriers and
facilitators to accessing medication reviews from the perspective of people from ethnic minority communities. Health Expect. 2022; 25(4):1432-
1443.
4. Oluwatosin A. A perspective on health inequalities in BAME communities and how to improve access to primary care. Future Healthcare
Journal. 2021. Vol 8, No1:36-9
Conclusions
This study demonstrates the benefits of SMRs in elderly Chinese
patients in improving their quality of care and experiences.
Responses from patients have been positive. This service has helped to
bridge the gaps in their care.
Positive feedback from patients indicates the potential for this service to
roll out to other practices, to other age groups and extrapolate to other
ethnic minority communities.
Medication Stopped
41%
Medication Started
27%
Dose Changes
32%
Contact: lisa.loh@nhs.net