It is essential that a holistic approach is taken to medicines management, rather than the present, fragmented, sector-specific system. In Northern Ireland, an Integrated Medicines Management (IMM) project was undertaken, aiming at medicines optimisation. This project achieved significant patient benefits, including reduced length of stay in hospital, reduced re-admission rate, a more accurate medicine history and an improved discharge process.
The IMM highlighted that the lack of integrated product use was a significant deficiency in the existing medicines management processes due primarily to different choices of agents within a therapeutic class and different generics and parallel imports being used in primary care. This inevitably leads to confusion with regard to medicines that patients should be taking, and can result in omission of products or indeed duplication of product use with potentially far reaching consequences.
IMM was originally a project run in United Hospitals Trust. By targeting the work of pharmacy staff, the team at United demonstrated significant improvements in patient care. These included:
- Reduction in length of stay by an average of 2 days
- Reduction in re-admission rates of 20%
- Reduction in drug costs
- Improved communication with primary care
- Improved utilisation of staff time.