Domiciliary Care

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Domiciliary Care Medicines Management

• Hannah Blight
• Lead Pharmacist Medicine
• Mid-Staffs NHS foundation trust

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Introduction

• Hospital admission What do hospitals need?
• Medication following Discharge understanding
  the discharge letter
• Medication issues Medication timing, swallowing
  difficulties and falls.
• Questions?

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Hospital Admission

• List of Medications Most recent, up-to-date,
  printed MAR chart.
• Allergy information.
• Copies of other relevant charts e.g. warfarin
  charts or Insulin charts.
• May be asked to bring in patient own medication.

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Discharge Medication

• Every patient leaving hospital should have a
  discharge letter.
• List of medications on discharge.
• Information about changes to medication.
• At least 2 weeks supply of medication for newly
  prescribed / changed medications.
• Communication of changes.

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The Discharge Letter
Patient details
Admission information
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The Discharge Letter continued
Allergies / sensitivities
Course Length
Discharge Medication
Supply Information PH Home PL Locker
Supply made at time of
discharge
Medication Changes
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Medication Issues

• Medications where timing is critical.
• Medication administration for patients with
  swallowing difficulties and / or enteral tubes.
• Medication and Falls.

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Medications where timing is critical

• Parkinson's medication.
• Insulin.
• Antibiotics.
• Antiepileptic medication.

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Swallowing difficulties / Enteral tubes

• May need converting to liquids / patches.
• Not all medication is available as a liquid.
• Not all solid oral dosage forms are suitable to
  be crushed.
• Modified Release MR / SR / XL

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Swallowing Difficulties / Enteral tubes continued
..

• Film or enteric coated.
• May need dosage adjustment.
• Advice needs to be obtained before crushing or
  dispersing in water.
• Licensed and unlicensed routes of administration.

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Medication and Falls

• 4 or more medicines
• High risk medications Benzodiazepines, Alcohol,
  Antidepressants, Laxatives, Diuretics,
  Salbutamol, Beta blockers, vasodilators,
  antihypertensives, Antiarrythmics Anticoagulants,
  Urinary incontinence abdominal cramps and Eye
  preps.

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Any Questions?