28th July 2009
In July 2009 the document ‘Getting the Medicines Right: Medicines Management in Adult and Older Adult Acute Mental Health Wards’ was published to support the role of medicines management in acute mental health settings. The work was commissioned by the National Mental Health Development Unit (NMHDU, formerly the National Institute for Mental Health in England, or NIMHE).
In 2007, the Healthcare Commission published Talking about medicines: The management of medicines in trusts providing mental health services, which made a number of recommendations to mental health Trusts within ten priority areas for medicines management. These 10 priority areas were:
- Involving people in decisions and management of their medicines
- Ensuring appropriate and effective use of medicines in people’s care
- Efficiently and effectively providing and administering medicines
- Promoting multi-disciplinary team working to provide seamless care
- Coordinating care with other service providers
- Governing use of medicines
- Choosing and prescribing medicines
- Ensuring staff are competent to work with medicines
- Accurately recording and reporting on use of medicines
- Supplying and managing medicines in the Trust
Little work has been done to explore what elements of medicines management schemes (such as medicines reconciliation, the use of patient’s own drugs, self-administration of medicines, and enhancing clinical pharmacy), work best on adult and older adult acute mental health wards in England. For this reason the NMHDU commissioned a project to evaluate such schemes.
The document ‘Getting the Medicines Right: Medicines Management in Adult and Older Adult Acute Mental Health Wards’ aims to assist those involved in the planning, implementation, design and commissioning of medicines management systems in adult and older adult acute mental health wards. The document states that over half of hospital re-admissions are related to problems with adherence. Therefore, although the document considers medicines management processes on wards, most of the findings are also applicable to community services.
The document provides:
- An evaluation of specific pharmacy led medicines management schemes proposed for adult and older adult acute mental health wards.
- Recommendations about the suitability of those medicines management schemes for adult and older adult acute mental health wards.
- Key messages from service users and carers arising from the consultation, and a 5-stage model framework for getting medicines management right on acute mental health wards.
What does this mean to medicines management?
Many examples of successful medicines management initiatives in recent years have been focused in acute hospital Trusts, sometimes making it difficult to see how they could apply in a mental health setting. However, the principles of good medicines management are the same in any care setting. This document promotes the positive contribution that medicines management can have in acute mental health settings and makes recommendations to support the better use of activities such as: medicines reconciliation, use of patient’s own drugs, one stop dispensing, self-administration of medicines, medicines education, short-term leave medicines, discharge counseling/ advice on medicines, automation, medicines review, and clinical pharmacy.
The 5-stage model framework proposed in the document will help Trusts to assess where they are regarding the development of medicines management in their acute mental health wards and will also help them to plan and prioritise what aspects of medicines management could be further developed.
The authors suggest that the document will be of use to all staff involved in reviewing, commissioning and providing medicines management services to local acute mental health ward services for adults and older adults. Nursing staff may find this document of particular benefit as they frequently take a lead role in many aspects of medicines management at ward level.
How does this relate to other publications or evidence?
This document may be used in conjunction with the medicines management self-assessment tool kit developed by Care Services Improvement Partnership (2008). Further information on the toolkit is available in the NPC rapid review published on 7th May 2008.