Abstract
Introduction: The Acute Frailty Team (AFT) review all acute admissions referred to Medicine for the Elderly within our organisation. Our team is comprised of a consultant, AHPs and a specialist clinical pharmacist. The Clinical Frailty Scale Score (CFS) was used to quantify frailty within our patient population. Recognising that older patients are at increased risk of medicine related harm, medication reviews are undertaken as part of the comprehensive geriatric assessment. The aim of this project was to determine the number of documented Level 3 medication reviews on discharge including number of medication interventions and determine any correlation with CFS.
Methods: For a 5 month period, all patients reviewed by AFT (Monday to Friday) had a documented CFS score on admission. A retrospective review was then undertaken with data collected on CFS score, patient demographics and number of Level 3 medication reviews documented on discharge. Data was then collated to indicate medication interventions and the most common medication changes.
Results: 212 patients were reviewed during the study period. Range of CFS score was 2 to 8 and 81.2% were classified as CFS ≥5. 101 patients had a documented Level 3 medication review accounting for 380 medication interventions; 210 medications were stopped and 82 medications were started. 36.6% of the patient group were deceased within 1 year of review.
Conclusion(s):
In order to optimise effective prescribing and minimise harm in older, frail people, this data will be used locally to promote the importance of medication reviews during an acute admission and ensure this is reliably communicated on discharge. Deprescribing accounted for 55.3% of changes. Since 1/3 of patients are deceased within one year, a targeted medication review is essential and should influence our prescribing practice going forward.