GPs told to draw up care home prescribing plans

GPs will be told to draw up more robust plans to manage prescriptions for care home residents in a bid to stamp out 'common' medication errors in these patients, under planned guidance from NICE.

Four in 10 care home residents face prescribing errors

NICE will call on GPs to check medical records when prescribing drugs to care home residents and keep better records of treatment changes.

Practices should have ‘a clear written process’ for prescribing and issuing prescriptions for their care home residents and forge better links with care home providers so medical records and care plans are kept up to date, NICE said.

Almost 40% of care home residents experience one prescribing error each year, according to DH-commissioned research into care home medicines management.

The 2009 Care Home Use of Medicines Study found the most common errors were incomplete information on the prescription, unnecessary drugs prescribed, dosing errors and omissions.

In response, NICE has launched a consultation on draft guidance to improve the management of medicines in care homes.

It said there was evidence that some doctors do not always check GP patient medical records when signing a prescription.

There is also ‘a lack of procedures for GP practice receptionists to generate prescriptions for GPs to sign when requested by care home staff’, NICE said.

In addition, hand-written prescriptions issued in care homes are often not recorded on GP medical records.

NICE’s guidance advises that all prescriptions must be issued ‘in line with patient medical records’.

Medical records and residents’ care plans must be updated with changes to any prescribed medicines as soon as possible, including when medicines are prescribed at a care home.

This should include ‘clear instructions on the use, duration and indication for the prescribed medicine’. It also urged GPs to ensure prescribed drug quantities fit the 28-day supply cycle.

Practices should also ensure ‘effective communication and collaborative working’ with care home providers and community pharmacies when medicines are started, stopped or changed.

NICE’s wide-ranging review also calls on practices, pharmacies and care homes to improve coordination of medication reviews.

Professor Mark Baker, director of the centre for clinical practice at NICE, said: ‘Despite existing guidance and standards on managing medicines in care homes, recent studies have found evidence that medication errors are commonplace.

‘Sadly, the high profile cases that make it into the news are just the tip of the iceberg. It’s therefore very important that there are clear, documented, systems and processes in place for managing medicines in care homes which use the best available evidence.’

The consultation will end on 16 December 2013 at 5pm.

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