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Falls Prevention & Inhaler Service Update Training
Claire Thomas
Agenda7.15pm Introduction7.20pm Falls Prevention Service
Evaluation7.30pm Practice Scenarios8.10pm Feedback and Q&A Session
8.20pm Inhaler Check Service Evaluation 8.30pm Practice Scenarios 9.10pm Feedback and Q&A Session9.20pm Summary & Close
Falls Service Experiences so far Please write down 3 things/key
words you would like to share/address regarding your experiences so far of delivering the falls prevention service.
Falls Prevention Service Evaluation Background Service description Aims & objectives
Setting and MethodsSetting: 23 community
pharmacies across Doncaster.Methods: Audit of 414
consultations, analysis of 353 patient satisfaction questionnaires & a face-to-face meeting with a Falls Co-ordinator. Analysis involved descriptive statistics & qualitative comments a thematic approach.
Results
High
Risk Med
icin
e (n
=41
4)
Side
Effec
ts (n
=41
3)
Afrai
d of
Fal
ling
(n=41
3)
Balan
ce/g
ait P
robl
em (n
=41
1)
Visio
n Pr
oble
m (n
=41
3)
Urinar
y Con
tinen
ce P
robl
em (n
=41
2)
Fall in
last
12
mon
ths (n
=41
2)
94.9
31.517.4 22.6 22 22.1 21.8
Risk Factors Identified
Percentage of Patients
Results
High-risk medicine Side effects Afraid of falling Balance/gait problem Vision problem Continence problem
22.3
31
65.3
42.9
27.8 27.6
Risk Factors and Falls
Percentage of patients who have fallen in the last 12 months
Results>50% of patients who had
suffered a fragility fracture were not prescribed bone-sparing medication
37% reported compliance problems
Majority of consultations resulted in interventions provided by the pharmacist
Feedback from patients & Falls Co-ordinator was positive
Future Service Development
Extend service to include domiciliary consultations
Referral of patients presenting at A&E following a fall into the service
Introduce an element to the service to try & reduce the number of medicines being taken by patients
Develop a community pharmacy osteoporosis screening service
Evaluation ConclusionPharmacists can successfully identify patients at risk, provide patient education and make appropriate referrals to the specialist falls clinic.
This new and unique service should continue. Patient satisfaction with the service is high, it is supported by the specialist falls service and it is accessing patients who are not accessing other services.
Practice Scenario4 questions to discuss in groups5 mins to agree group answer5 mins for debate
Feedback and Q&A“Support was amazing after poor service from DRI A&E. The pharmacy has done more to support my falls and reduce readmission to A&E which is for me a step in the right direction” Falls Service Patient“The service is beneficial, it is accessing a group of patients that might not be accessing other services”. Falls Co-ordinator SFS
Additional ResourcesConsultation skills for pharmacy practice:
taking a patient-centered approach. CPPEFalls: assessment and prevention in older
people. NICE guideline 161 available at: http://www.nice.org.uk/guidance/cg161
Medicines and Falls in Hospital: Guidance Sheet available at: https://www.rcplondon.ac.uk/sites/default/files/documents/medicines-and-falls2.pdf
Age UK www.ageuk.org.uk
Inhaler Service Experiences so far Please write down 3 things/key
words you would like to share/address regarding your experiences so far of delivering the falls prevention service.
Inhaler Check Service Evaluation Background Service description Aims & Objectives
Setting and MethodsSetting: 29 community
pharmacies across Doncaster.Methods: Audit of 616
consultations and analysis of 577 patient satisfaction questionnaires. Audit and questionnaire results were analysed using descriptive statistics, qualitative comments using a thematic approach.
ResultsCost: £7561.50 8.6% of patients unsure of their
diagnosisMajority of patients prescribed a
MDI400 patients had an initial IR out of
the target range for their deviceOver 98% of patients achieved
target range by the end of their consultation
MDI Inspiration rate Results
MDI Use & Previous Instruction
Results cont.Condition Control: high reports of
regular preventer use. Almost half of patients needed to use their reliever inhaler once or twice daily or more.
Interventions: Most common intervention was inhaler instruction. Little need to contact the GP/practice nurse
Patient feedback: Extremely positive
Future Service Development
Supply of spacers with/without masks
Include full assessment of condition control (ACT/CAT)
Follow-up consultations to monitor performance and outcomes
See patients after asthma attacks/exacerbations ?referral from A&E
COPD exacerbation management
Evaluation ConclusionResults demonstrate the need for
regular inhaler technique checks Community pharmacists have a key
role in improving inhaler technique, complying with current guidelines
The service is beneficial to patients & the NHS; improving inhaler use can improve condition control improving quality of life, reducing hospital admissions & even deaths, funding should continue
Practice Scenarios4 questions to discuss in groups5 mins to agree group answer5 mins for debate
Feedback and Q&A
“Thought I was good using inhalers but learnt a lot from the pharmacist that will help me” Inhaler Check Service Patient
“Pharmacist was exceptionally helpful and explained everything in detail. This made me feel more confident” Inhaler Check Service Patient
Additional Resources Inhaler technique videos available at:
https://wessexhiecpartnership.org.uk/wires/video-series/inhaler-technique/
COPD guidelines available at: http://www.nice.org.uk/guidance/CG101
COPD learning resources available at: http://www.thelearningpharmacy.com/content/learningtopics.asp
Asthma guidelines available at:https://www.brit-thoracic.org.uk/guidelines-and-quality-standards/asthma-guideline/
National review of asthma deaths available at: https://www.rcplondon.ac.uk/projects/national-review-asthma-deaths