5 minute read
Medicines initiative supporting patients
iSIMPATHY project supports patients to ensure best use of medicines
Four senior clinical pharmacists have been successfully delivering medicine reviews as part of the iSIMPATHY (implementing Stimulating Innovation in the Management of Polypharmacy and Adherence Through the Years) project
The project is operating in nine GP practices in Donegal, Sligo, Cavan, Monaghan and Louth since February 2021 and in a 10th practice in Leitrim since January 2022. Over 1,000 patient medicines reviews have been completed to date as part of the project.
The pharmacists carry out a face-to- face, phone or video consultation with each patient, focusing on their needs and wants as well as clinical and safety considerations. The pharmacists liaise with the GP who actions the changes to their medication as necessary.
The iSIMPATHY project aims to support patients to be part of shared decision making and ensure the best use of medicines for them.
Health Ministers from the three project jurisdictions - Minister for Health Stephen Donnelly; Health Minister Robin Swann, Northern Ireland; and Cabinet Secretary for Patient James Howard from Health and Sport Scotland Jeane Freeman - Kingscourt, Co Cavan. joined health professionals including Dr Colm Henry, HSE Chief Clinical O cer, and Joe Ryan, HSE National Director, to announce the project launch at a virtual event in November 2020. polypharmacy, optimise medicines use and reduce medication-
The project addresses the challenges posed by polypharmacy related harm, in line with the HSE’s Patient Safety Strategy (HSE, (use of multiple medicines) and adherence (being able and willing 2019) and the National Service Plan (HSE, 2021). to take medicines) through the provision of medicines reviews. The reviews give people a personalised assessment of their Taking multiple medicines may be the most appropriate action, medication and enable them to be part of shared prescribing but there can be an increased risk of harm from interactions decisions, using a seven steps approach which asks ‘What matters between drugs or between drugs and diseases which outweigh the to you? The reviews result in appropriate polypharmacy, intended benefits. encompassing the person’s wishes and concerns about their
The medicine reviews aim to improve patient adherence and medicines, together with clinical, quality, safety and costunderstanding of their medicines, reduce inappropriate e ectiveness considerations.
HSE project lead Ciara Kirke explains that the iSIMPATHY project is enabling the delivery of a brand new model of quality, clinical care in border counties.
“For the first time in the Republic of Ireland, outside of a research setting, we are delivering comprehensive medicine reviews to people who most benefit from them. Over 1,000 patient medicines reviews have been completed,” said Ciara.
“These reviews are person-centred and holistic, delivered by project pharmacists working in primary care, within GP practices, engaging directly with patients and working in collaboration with GPs. We are seeing a reduction in the risk of medication-related harm, improvements in patient quality of life, a greater understanding of medicines through patient education and considerable savings as a result of reviews. Further evaluation is under way.”
The Project Pharmacists taking part in the iSIMPATHY project are Leon O’Hagan in Co Louth; Clare Kinahan in Cavan/ Monaghan; Jacqueline Treacy in Sligo/Leitrim; and Emma-Jane Coyle in Donegal.
Patient James Howard from Kingscourt, Co Cavan described his experience of having a medicine review with Clare Kinahan, senior iSIMPATHY pharmacist. “When I was out walking I used to get quite dizzy and I was then taken o a couple of tablets and now I feel great again. I think it is a great thing to have a review for these things. I benefited from the review because the lady in question [Project Pharmacist] was very patient and very good at explaining it. I think everyone should have a review,” said James.
Participating GP, Dr Conor Mitchell, from Ballyshannon said, “iSIMPATHY has been very helpful and I am delighted to have Emma as part of the team. Yes, it is extra work but this is the nature of the beast when it comes to polypharmacy. It is time well spent. For the more complex patients, patients with 30 plus items on their prescription, iSIMPATHY has given a starting point to approach the patient medication record of these patients, optimise prescribing and remove expired items from the patient medication record.”
GP Dr Grace Kenny, from Dundalk who also took part, said, “From my point of view, project pharmacist Leon’s work and input are invaluable. His approach is patient-centred, encouraging, and empathetic. I have had only positive feedback from the patients, who are willing to either take, cut down, change, or cut out certain medication.
“His suggestions of change are always backed by guidelines, which he presents in typed format, making the changes easy to understand and comply with. I know I now find myself much more aware of polypharmacy and non-compliance, and I am putting some of what Leon has suggested into practice so it's a win-win situation for both doctors and patients. And I would imagine that the cost-e ectiveness of the project will be evident, very soon.”
Emma Jane Coyle, Senior iSIMPATHY pharmacist in Ballyshannon/ Bundoran, said, “Patient uptake and reported experience has been very positive so far. Patients are extremely satisfied with the level of attention and detail that is paid to their care, as are my colleagues within the practice. Addressing appropriate polypharmacy is heavily dependent on a multidisciplinary team approach. The role of the iSIMPATHY pharmacist is complementary to the care that GPs, nurses and community pharmacists already deliver in primary care. iSIMPATHY has given patients an opportunity to voice concerns relating to their medications and be involved in future planning to overcome issues. Appropriately pitched patient education has been a large part of the discussion with patients.”
POLYPHARMACY TRAINING COURSE FOR HEALTHCARE PROFESSIONALS A new online Polypharmacy training course will be available this year.The aim of the course is to prepare healthcare professionals including doctors, nurses and pharmacists to undertake comprehensive person-centred medicines reviews.
More information can be found at www.iSimpathy.eu.
For further information contact the iSIMPATHY HSE Project Manager: Celine Croarkin Celine.croarkin@hse.ie
