Outcome Recording All visits were documented on the VW by the VW-MMT and interventions made ‘sharepoint’ were categorised the following headings: Medicines optimisation (eg regimen simplification, dose optimisation) Medicines education/counselling Medicines adherence advice Inhaler technique check / advice Compliance aid initiation including blister packs Patient education (eg understanding medical conditions, disease management, lifestyle advice) Waste medication Controlled Drug issues Critical incidents Signposting to other members of VW MDT Hospital admission avoidance To assess the potential clinical impact of interventions made during the project all interventions were collated and reviewed by a panel of 2 CCG pharmacists, 2 hospital pharmacists, 2 hospital doctors and 2 GPs. Twenty interventions were circulated to the panel by email and Delphi methodology used to arrive at consensus. The Delphi process is a group judgement technique in which contributors individually respond to survey questions and submit the results to a central coordinator [21]. The coordinator processes the contributions and results are then fed back to the respondents. The respondents are then asked to resubmit their views, assisted by the input provided by the coordinator. This process continues until the coordinator sees that a consensus has formed. For the purposes of this evaluation, consensus was defined as 75% agreement between participants’ scores [22]. In addition, consensus can also be achieved when stability of the distribution of scores occurs; for example if variation between rounds is less than 15%, a state of stability is said to exist [21,23,24]. This process resulted in each intervention being assigned a value according to the Eadon-ScHARR scoring criteria (Table 1) [25,26]. 1: Eadon Scoring System Intervention type Score ScHARR Cost Avoidance (£) Intervention which is detrimental to the patients well-being 1 0 Intervention is of no significance to patient care 2 0 Intervention is significant but does not lead to an improvement 3 0-6 in patient care Intervention is significant and results in an improvement in the 4 65-150 standard of care Intervention is very significant and prevents a major organ 5 713-1484 failure or adverse reaction of similar importance Intervention is potentially life-saving 6 1085-2120
Outcome Recording All visits were documented on the VW ‘sharepoint’ by the VW-MMT and interventions made were categorised the following headings: Medicines optimisation (eg regimen simplification, dose optimisation) Medicines education/counselling Medicines adherence advice Inhaler technique check / advice Compliance aid initiation including blister packs Patient education (eg understanding medical conditions, disease management, lifestyle advice) Waste medication Controlled Drug issues Critical incidents Signposting to other members of VW MDT Hospital admission avoidance To assess the potential clinical impact of interventions made during the project all interventions were collated and reviewed by a panel of 2 CCG pharmacists, 2 hospital pharmacists, 2 hospital doctors and 2 GPs. Twenty interventions were circulated to the panel by email and Delphi methodology used to arrive at consensus. The Delphi process is a group judgement technique in which contributors individually respond to survey questions and submit the results to a central coordinator [21]. The coordinator processes the contributions and results are then fed back to the respondents. The respondents are then asked to resubmit their views, assisted by the input provided by the coordinator. This process continues until the coordinator sees that a consensus has formed. For the purposes of this evaluation, consensus was defined as 75% agreement between participants’ scores [22]. In addition, consensus can also be achieved when stability of the distribution of scores occurs; for example if variation between rounds is less than 15%, a state of stability is said to exist [21,23,24]. This process resulted in each intervention being assigned a value according to the Eadon-ScHARR scoring criteria (Table 1) [25,26]. 1: Eadon Scoring System Intervention type Score ScHARR Cost Avoidance (£) Intervention which is detrimental to the patients well-being 1 0 Intervention is of no significance to patient care 2 0 Intervention is significant but does not lead to an improvement in patient care 3 0-6 Intervention is significant and results in an improvement in the standard of care 4 65-150 Intervention is very significant and prevents a major organ failure or adverse reaction of similar importance 5 713-1484 Intervention is potentially life-saving 6 1085-2120
sf-foi-50105-appendix-2-domiciliary-medication-review-services.docx