Comment

04.08.17

A centre for medicines optimisation research and education

Source: NHE Jul/Aug 2017

Dr Yogini Jani, a consultant pharmacist at University College London Hospitals NHS FT (UCLH), discusses a collaboration with UCL School of Pharmacy that aims to transform patient care by making medicines safer and easier to take.

Left to right: Professor David Lomas, UCL’s vice-provost (health); Professor Ian Wong, CMORE’s co-director; Dr Yogini Jani, CMORE’s director; and Professor Marcel Levi, UCLH’s chief executive

Established in May, the Centre for Medicines Optimisation Research and Education (CMORE) will combine the two partners’ experience and expertise in the effective use of medicines, medication safety and pharmaceutical science and build on education and training initiatives. 

Medicines are the most frequently used intervention in healthcare. Modern medicines are effective but also more complex. With the growing number of patients with long-term conditions and an associated increase in the number of prescription items per patient per year, there is also recognition that nearly 30-50% of medicines for long-term conditions are not taken as prescribed. The issues of multimorbidity and polypharmacy were highlighted in a King’s Fund report published in 2013, and ways of optimising the use of medicines by the Royal Pharmaceutical Society in the same year. In 2015, NICE guidance for medicines optimisation identified key priorities for implementation to enable the best possible outcomes from the safe and effective use of medicines. 

Patient safety concerns in relation to medicines due to adverse events, mistakes and communication breakdown during transfers of care between hospital and other care settings are also well recognised. National initiatives, such as the MHRA yellow card reporting system, the NHS Medication Safety Thermometer and a national alert requiring designated Medication Safety Officers, exist to enable reporting and learning to improve safety. However, there is global acknowledgement through the recent announcement of the WHO’s third global patient safety challenge that “unsafe medication practices and medication errors are a leading cause of injury and avoidable harm in healthcare systems across the world”.  

Medicines optimisation is an umbrella term often used to encapsulate a range of principles and activities to help healthcare professionals and patients to get the best from medicines. These include understanding the patient’s experience of medicines and enabling involvement in their own care, ensuring medicines use is as safe and effective as possible, and having systems for identifying, reporting and learning from medication-related patient safety incidents. Medicines optimisation continues to be an important component of improving health service provision as identified in the Carter report. 

CMORE combines the clinical knowledge and experience of the pharmacy department at UCLH with the academic expertise from UCL School of Pharmacy in areas of medicines use and optimisation, pharmacoepidemiology and medication safety, and age-related medicines development and use.  

Research areas and focus 

The centre will focus on informing design, safety and effective and optimal use of medicines through leading research, improvement initiatives and educational development. 

One example of CMORE activities is a research project to explore ways in which specialist medicines can be administered close to home for cancer patients. The work has been funded by the BOPA-PRUK Research Award for developing research capability of pharmacists. The project will benefit patients by providing deeper insights into the barriers and enablers based on patients’ views and opinions, as well as GP perspectives. Depending on the findings, there is potential for better patient experience and less travelling time, and the opportunity to review and redesign cancer services. 

Another research area is improving the use of antibiotics in patients with penicillin allergy. Nearly 10% of the general population claim to have a penicillin allergy, which will affect the choice of antibiotic they may receive. The project has been funded by the Health Foundation through an Improvement Science Fellowship. It aims to develop, test and implement strategies for improvement by studying how well and what information relating to penicillin allergies is recorded, how healthcare professionals choose antibiotics based on the recorded information, and how this might impact on patient safety and clinical outcomes. Outputs will be disseminated and spread via the National Medication Safety Officer Network for wider patient benefit. 

The educational stream of CMORE builds on the Berwick report recommendations to build training and capacity for quality and patient safety sciences. The centre provides placement and research opportunities for undergraduate and postgraduate students from UCL School of Pharmacy, thus bridging the gap between ‘knowing’ and ‘doing’. Going forward, CMORE will provide training and support in research methods and quality improvement approaches to pharmacists and pharmacy staff, and opportunities for inter-professional learning with doctors and nurses. 

Ultimately, CMORE is based on the premise that medicines are fundamental to modern healthcare and require collaboration between patients and healthcare professionals to study, understand, identify and improve so that we can make the most of the medicines that we have.

FOR MORE INFORMATION

W: www.uclh.nhs.uk

Comments

There are no comments. Why not be the first?

Add your comment

 

national health executive tv

more videos >

latest healthcare news

Lord Kerslake quits as trust chair in protest against NHS underfunding

11/12/2017Lord Kerslake quits as trust chair in protest against NHS underfunding

Lord Kerslake has resigned as the chairman of a major hospital trust in London in protest against historic underfunding in the NHS. The respect... more >
CQC praises ‘proactive’ Hartlepool services in care integration review

08/12/2017CQC praises ‘proactive’ Hartlepool services in care integration review

The CQC had praise for the health and care system in Hartlepool as it continued its programme of 20 targeted reviews of integrated care. The... more >
Government launches inquiry into Ian Paterson case

08/12/2017Government launches inquiry into Ian Paterson case

A national inquiry has been launched into the malpractice of Ian Paterson. Earlier this year the breast surgeon was sentenced to 20 years in pri... more >
681 149x260 NHE Subscribe button

the scalpel's daily blog

Ten lessons to support new care models locally

29/11/2017Ten lessons to support new care models locally

Anna Starling, policy fellow at the Health Foundation, offers the top 10 lessons for local leaders seeking to make systematic improvements across services, all based on first-hand accounts from vanguard officials. Redesigning health and social care services across traditional boundaries is not easy. Making change in complex environments, with differing professional viewpoints and varying organisational priorities while getting on with t... more >
read more blog posts from 'the scalpel' >

interviews

Cutting through the fake news

22/11/2017Cutting through the fake news

In an era of so-called ‘fake news’ growing alongside a renewed focus on reducing stigma around mental health, Paul Farmer, chief exec... more >
Tackling infection prevention locally

04/10/2017Tackling infection prevention locally

Dr Emma Burnett, a lecturer and researcher in infection prevention at the University of Dundee’s School of Nursing and Midwifery and a boar... more >
Scan4Safety: benefits across the whole supply chain

02/10/2017Scan4Safety: benefits across the whole supply chain

NHE interviews Gillian Fox, head of eProcurement (Scan4Safety) programme at NHS Supply Chain. How has the Scan4Safety initiative evolved sin... more >
Simon Stevens: A hunger for innovation

25/09/2017Simon Stevens: A hunger for innovation

Simon Stevens, chief executive of NHS England, knows that the health service is already a world leader when it comes to medical advances – ... more >

last word

The Refugee Doctor Initiative

The Refugee Doctor Initiative

Terry John, co-chair of the BMA & BDA Refugee Doctors and Dentists Liaison Group and chair of the union’s international committee, talks about a brilliant initiative that is proving mut... more > more last word articles >

editor's comment

25/09/2017A hotbed of innovation

This edition of NHE comes hot on the heels of this year’s NHS Expo which, once again, proved to be a huge success at Manchester Central. A number of announcements were made during the event, with the health secretary naming the second wave of NHS digital pioneers, or ‘fast followers’, which follow the initial global digital e... read more >

health service focus

Release full market value against surplus and decommissioned assets

28/11/2017Release full market value against surplus and decommissioned assets

Advertisement feature: Oliver Pearson, sal... more >
Operation Barcode: selecting technology to succeed

22/11/2017Operation Barcode: selecting technology to succeed

The benefits of Scan4Safety have been widely ... more >