A collaborative study has revealed that having pharmacists integrated into care home teams enables better prescribing regimes to improve care for residents and reduces the risk of future adverse events from medicines.

Research conducted with support from the University of Aberdeen into onsite pharmacists for care home residents has found that this service in care homes is safer for residents and well received by all involved.

A randomised controlled trial was conducted over six years, with 49 care homes across England, Scotland and Northern Ireland. The study also included 25 care home trained independent prescribing pharmacists, who were integrated into care homes to improve medicines management and safety.

The Care Home Independent Pharmacist Prescriber Study (CHIPPS) trialled the service across the UK, interviewing GPs, residents, carers and care home managers to understand the reception of onsite independent prescribers.

Led by the University of Leicester, experts from the University of Aberdeen, Queen’s University Belfast, University of East Anglia, University of Leeds, and Norwich Clinical Trials were all involved in this research.

Professor Christine Bond, who co-led the main trial and was the Aberdeen project lead, said:

“Pharmacists are increasingly taking on more roles including as prescribers. It is important these new services are underpinned by evidence of effectiveness and safety.

“This study showed that pharmacists could safely optimise prescribing regimens for care home residents, reducing their drug burden and risk of future adverse events. The service was highly valued by general practitioners and their teams who appreciated the expertise of the pharmacists and the reductions in their workload.”

Professor Bond added that staff in the care homes also responded positively to the initiative, as they valued pharmacists’ input and support.

Care home residents are routinely prescribed around eight or more different medicines, according to this collaborative study. Its findings revealed that having pharmacist prescribers within care homes reduces the risk of potential harm to care home residents from medicines.

Medicine use is considered a major risk in care home settings by both government and regulatory organisations, with the researchers citing a previous study which found that 70% of care home residents experienced daily drug errors.

While their analysis did not show a significant reduction in falls among residents – another one of the main risks facing care home residents – the potential future harm from medicines was ‘significantly’ reduced.

Project leader, Professor of Health Services Research and Head of School of Healthcare University of Leicester, David Wright said:

“I am delighted that the culmination of this six-year programme of work, undertaken by an incredible group of researchers, clinicians and patient representatives has produced this result. 

“The CHIPPS model of care was very well received by all stakeholders. We believe that this was because both our training and model of delivery focused on the integration of the pharmacist independent prescribers into the medical practice and care home teams.”

Professor Wright explained that this approach to delivery was supported in the study’s evaluation, noting that intervention was most effective when pharmacists working in care homes were embedded within local general practice.

He added that the service may also lower the workload burden for GPs:

“Furthermore, our pharmacist-led intervention was reported by some GPs to reduce their workload as they no longer had to routinely review and authorise large numbers of repeat medicines and the pharmacist prescribers assumed some of their care home responsibilities.”

Professor Wright hopes to see the current role of pharmacists in care homes expanded to include prescribing and frequent visits given the results of this work outline that it reduces harm and improves medicines management.

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