Ahead of World Patient Safety Day 2022, Jan Scott, Patient Safety Programme Manager, discusses how the West of England AHSN Polypharmacy Community of Practice (CoP) is tackling the challenge to reduce severe avoidable medication related harm. The AHSN held its first CoP in August 2022 with the second scheduled for November.
Polypharmacy simply means many medicines. As more people live longer with multiple long-term conditions, the number of medicines they often take increases. This can have a significant burden on the person managing and trying to adhere to multiple medicines regimes and can also be harmful. Medication-related harm from polypharmacy has long been recognised as problematic and despite increasing awareness and evidence, the negative impact on patients remains a challenge. Adverse drug reactions contribute to an increased number of hospital admissions with one study attributing this to as many as 16.9% of admissions[i].
The World Health Organisation has sought widespread engagement and commitment at a global level; the Global Patient Safety Challenge: Medication Without Harm was launched in 2017 and includes polypharmacy as a key area for action. The challenge remains as significant today as it was then and the National Overprescribing Review Report titled Good for you, good for us, good for everybody led by Dr Keith Ridge, published in September 2021, found that overprescribing has grown dramatically over the last 25 years. The focus of World Patient Safety Day 2022, 17 September is on Medication Safety and polypharmacy, at its heart about medicines safety, is now the focus of a AHSN Network national programme.
Having joined the AHSN in April 2022, with a nursing background, predominantly in critical care, governance, and assurance, I am linked into professional learning communities and alive to the power of collaboration and working towards a common vision or goal. The term CoP was however, new to me and although there is a common purpose and agenda, a CoP can be a much less structured meeting. Regional CoPs underpin the three pillars upon which the national polypharmacy programme is based: population health management; education and training and public behaviour change. The value of the CoP approach lies in allowing rich discussion and shared information from a range of individuals from varied backgrounds across organisations and experts by experience to focus on the problem or issue.
Having previously worked in the Royal Air Force Medical Services, and as expected in the NHS, there is a time and place for a regimented approach where immediate decisive action and response is critical. I however found it refreshing to experience a creative approach to problem solving and to hear how something shared in a CoP can have a positive impact elsewhere. It offers a space for people to share their experiences, successes, and what they have learned from practice. A single action or solution that has worked for one area may not be the best approach for all and it is the diversity of thought that can really add value.
We held our first polypharmacy CoP on 31 August 2022 and the breadth of experience and expertise at event really was inspiring with thought-provoking discussions on initiatives and work being undertaken locally. Rosie Marchant, our guest speaker, presented on the valuable work and pilot project being completed on the North Bristol Care Home Interface Project (N-CHIP). The impact of the work was hugely exciting and encouraging demonstrating a positive impact on residents as well as reductions in ambulance callouts and conveyances to hospital. I look forward to seeing the full evaluation when it is released.
Working across the region with three integrated care systems, allows the West of England AHSN the opportunity to bring together clinicians, specialists, guest speakers and patients from different systems to explore how practices, approaches and experiences vary. Bringing successes and challenges to the group allows for rich discussion and a support network that is difficult to replicate in a more formal approach. The CoP encourages open participation and communication and provides a ‘safe space’ to exchange ideas. We’re looking to expand the CoP as we progress, so as many ideas and experiences as possible are heard and shared.
As part of the AHSN Polypharmacy Programme: getting the balance right, the West of England AHSN are supporting health care professionals to identify patients at potential risk from polypharmacy and to support better conversations about medicines.
Find out more about the work we are doing to address the effects of polypharmacy.
The next Polypharmacy CoP will be on 17 November 2022. If you are interested in hearing more about the CoP events, get in touch with Jan at janet.scott26@nhs.net
[i] Osanlou, R, Walker, L, Hughes, DA, Burnside G and Pirmohamed, M. 4 Jul 2022 Adverse drug reactions, multimorbidity and polypharmacy: a prospective analysis of 1 month of medical admissions. BMJ Open. Accessed 1 Sep 2022. e055551.full.pdf (bmj.com)
Posted on September 2, 2022 by Jan Scott, Patient Safety Programme Manager
