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Tackling Inappropriate Medication


Reduced prescribing for nursing home residents

Reduced prescribing of inappropriate medication in nursing home residents through a pharmacy intervention

Professor Hughes’ ground-breaking work has highlighted the fact that the prescription of medications for older people in nursing homes has been inappropriate, with the overuse of medicines that are not clinically indicated. Professor Hughes’ work started when she undertook a year of study in the USA as the first pharmacist to be awarded a Harkness Fellowship in health care policy by the Commonwealth Fund of New York. 

It had been widely documented that medication was being used to sedate and subdue older people as a way of controlling them as well as countering a lack of staffing. In collaboration with colleagues in the USA, she developed and implemented the Fleetwood Model, a pharmacy intervention service, as part of a trial in 22 nursing homes.  The intervention service led to a reduction in this inappropriate prescribing of psychoactive medications (anti-psychotics, hypnotics and anxiolytics) which can cause sedation and other side-effects. Pharmacists worked closely with GPs to help and advise on drug prescription with the outcome being a reduction in drugs being inappropriately prescribed. In additional the research has shown the intervention to be cost-effective. This research has informed health policy and practice in Northern Ireland.

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