ethical Excess medicines (sometimes inappropriate) Lack of structured review Communication issues: most patients were unaware of what treatment they were on Long medication rounds and timing not patient -centred Service costs funded by Shine include Clinical Pharmacist support (0.5WTE; approx £32,000 p.a.). Other costs (e.g. POAS, GP time) to be determined Progress to date 91 patients reviewed 300 interventions 62 patients (68%) ≥1 med stopped 28 patients (31%) referred to POAS Our objectives …ensuring that residents or their family are fully involved in any decisions around prescribing and de-prescribing of medicines 800 700 600 500 400 300 200 100 0 made me think, involving the family is a really good idea. I n=718 n=592 suspect a lot of them don’t mind the changes you have made but it is very positive to have them involved. I think it helped to improve the relationships with the care home. GP involved in a SHINE Care Home Review Before Review After Review Next steps Continue review; target 326 patients in 12 care homes Patient involvement in decisions Review £169 per patient reviewed Having done the SHINE I think it is an excellent model. It really 17.5% reduction Methods • Medicines Screen & review by Shine Pharmacy Team • Discussion with GP £15,368 Qualitative data being collected from key stakeholders, patients and families 142 medicines stopped; 16 started Optimise medicines use in care home residents… Annualised savings from stopping 142 & starting 16 medicines MDT • MDT discussion (nurse, GP, pharmacist) • Referral to POAS Teams • Patient, family & carers involved in decisions Follow up • Hotline for urgent advice • Structured follow up Patient 1:1, 17 Data missing, 37 Shared Decisions None, 3 Family Telephone, 21 Family No changes, 7 Letter , 1 Detailed qualitative data Family 1:1, 6 Commission service, post-Shine Our Team Wasim Baqir, Julian Hughes, Peter Derrington, Nisha Desai, Steven Barrett, Jo Mackintosh, Yvonne Storey, Joan Lowerson, Aileen Beatty, Richard Copeland, Jane Riddle, David Campbell, Annie Laverty, Sandra Gray.