Home › Research › Health systems and care delivery
65 Improving Medicines Safety for Care Homes Residents
U Okoli, June Gooch Kent, Sanket R. Gadhia. Age and Ageing, 2020-02-01
Topic: Risk, prevention and care in population studies
Abstract Introduction Care home residents often have multiple, chronic conditions and are receiving complex treatment regimes, yet 30–50% of prescribed medicines are not taken as recommended [1]. Polypharmacy and medication errors are common. Evidence suggests that there is a linear increase in medication errors with the number of medications a patient is prescribed. This paper describes an approach to identity and address inappropriate polypharmacy and safety concerns in Buckinghamshire care homes. The workforce used was: primary care and care home pharmacists, technicians and geriatricians. Methods A successful business proposal enabled a new interdisciplinary model of care to be established. This was delivered in 2768 Buckinghamshire care home beds (63% of Bucks ICS bed capacity). The CCG pharmacists, GPs and pharmacy technicians reviewed medication for all residents followed by a medication and clinical review by a geriatrician for the most complex individuals. Other community specialist teams were included as part of a Multidisciplinary team as needed. Data on reviews, medicines stopped and safety were collected from 2013–2018. Results Overall 2134 medications were stopped for 1268 residents of 2102 reviewed, with 505 interventions to reduce falls risk. 942 safety issues were identified and resolved. Total savings on medicines optimisation, waste and non-elective admission prevented was £619,000. System wide safety included: community psychiatric nurse to support dementia diagnosis, specialist enteral feeding nurse reinstated and a new website to share and disseminate good practice standards. Conclusions Future direction of this work focuses on system wide improvements to promote multi-organisational interdisciplinary healthcare and social services professionals work in care homes. NHSE Pharmacy integrated funding has provided extra pharmacists and technicians to support the 37% of the care home beds not yet covered by March 2020. Reference 1. Horne R, Weinman J, Elliot R, et al. 2005, NHS National Coordinating Centre for service delivery and organisation report.
Key findings
- Evidence suggests that there is a linear increase in medication errors with the number of medications a patient is prescribed.
- Results Overall 2134 medications were stopped for 1268 residents of 2102 reviewed, with 505 interventions to reduce falls risk. 942 safety issues were identified and resolved.
Why it matters
This paper describes a Buckinghamshire programme in which pharmacists, technicians and geriatricians reviewed medications for care home residents, stopping 2134 medications and resolving 942 safety issues. It addresses medicines safety and polypharmacy in care homes, not the treatment, cure or prevention of Alzheimer's disease.
Study details
- Evidence strengthLow
How this study scored 29/100
Published in a peer-reviewed journal. Scored zero for study design, sample size, effect reported, studied in people and randomised / blinded because the record does not state it. We have no data on institution's track record, so that was left out: it earned 28 of the 97 points we could judge it on, which is 29 out of 100.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Age and Ageing) |
| Journal's citation record | 2 / 4 | Age and Ageing: journal h-index 231 (OpenAlex, 2026-10-29) |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 1 / 5 | Rated “low” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 2 / 5 | 2020 — within 10 year(s) of the newest study here |
| Sample size | 0 / 4 | Participant count not stated — scores zero (not stated in the record — scored 0) |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 0 / 3 | Not stated whether this was studied in people — scores zero (not stated in the record — scored 0) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 1 / 7 | Cited 2 times (OpenAlex, 2026-10-10) |
| Citations per year | 0 / 5 | 0.2 citations a year over 8 year(s) since 2020 |
| Impact for its field and year | 1 / 6 | Cited 0.2× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 0 / 6 | No other study in this library cites it |
| Still being cited | 0 / 4 | Cited 0 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 1 / 4 | Last-listed author Sanket R. Gadhia: h-index 10 (OpenAlex, whole career) |
| Institution's track record | — / 3 | No institution listed in OpenAlex — left out of this score |
| Multi-centre collaboration | 0 / 3 | OpenAlex lists 0 institution(s) in 0 countries — scores zero (affiliation lists can be incomplete) |
| Indexed in PubMed | 1 / 2 | Not in PubMed, but has a DOI |
| Free to read | 2 / 2 | Free to read |
| Points | 28 / 97 | Scored on 19 of 20 parts. We have no data for the rest, so they are left out: 28 of the 97 points we could judge it on is 29 out of 100. |
| Total | 29 / 100 | — |
What each of these 20 components measures, and what this score is not →
Read the original
Full text: free to read — OpenAlex lists this copy as free to read: the link above (checked 6 Feb 1020).
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. Check the citation against the original before you use it.
APA 7th
Okoli, U., Kent, J. G., & Gadhia, S. R. (2020). 65 Improving Medicines Safety for Care Homes Residents. Age and Ageing. https://doi.org/10.1093/ageing/afz187.06
Vancouver
Okoli U, Kent JG, Gadhia SR. 65 Improving Medicines Safety for Care Homes Residents. Age and Ageing. 2020. doi:10.1093/ageing/afz187.06.
BibTeX
@article{okoli2020-06e6a89b,
author = {Okoli, U and Kent, June Gooch and Gadhia, Sanket R.},
title = {{65 Improving Medicines Safety for Care Homes Residents}},
journal = {Age and Ageing},
year = {2020},
doi = {10.1093/ageing/afz187.06},
url = {https://doi.org/10.1093/ageing/afz187.06}
}
Related studies in Health systems and care delivery
Also in Health systems and care delivery
172 studies in the library are filed under Health systems and care delivery with no topic tag they share with another; these are this study's neighbours in a fixed tour of them. The Health systems and care delivery hub.