Medicines Projects
Improving assessment of medicine adherence
Medicines are an effective and common treatment for many illnesses and have improved the lives of many people. Not taking medicines as instructed by the prescriber can be a key reason why an illness is not successfully treated or why symptoms of disease continue. For many people with long-standing illnesses, such as asthma and epilepsy, it is known that disease control is worse in those who do not take their medicines and this can result in more GP visits, times in hospital, or even early death.
In NHS Greater Glasgow and Clyde, we have developed a report that helps hospital doctors determine whether patients coming to their outpatient clinics have been regularly collecting their medicines from community pharmacies as expected. If the report suggests that medicines have not been taken regularly there is advice on how the doctor and patient can discuss the underlying reasons for this and recommendations on what could be done to make this better.
This project is designed to identify whether making the report available in asthma and epilepsy outpatient clinics has led to any improvement in how patients take their medicines and whether there are any other important improvements in disease control.
Lead Investigator: Dr Sean MacBride-Stewart
Burden and cost of drug-drug interactions polypharmacy
Adverse drug reactions (ADR) from drug–drug interactions (DDI) are a major public health problem worldwide. The risk of DDI increases with the number of drugs co-prescribed and may be pharmacological or facilitated by pharmacogenomic interactions, that is the interactions between an individual’s genetic characteristics and medicines.
This study aims to ascertain the burden and cost of DDIs in polypharmacy, patients on multiple medications, in NHSGGC by investigating hospital and emergency department (ED) admissions over a 6-month window and calculating the number of DDIs from prescriptions of each patient. DDIs will be based on drug-drug and drug-gene interaction tables.
The prevalence of DDIs and their impact on admissions and mortality and associated healthcare costs will drive measures to improve safer prescribing and medicines reconciliation that will have direct patient benefit as well as reducing financial burden on the NHS.