Oral health; the gateway to hydration, nutrition, and medication

Yasmin Allen @missdiplom and Nikki Patel @NikkiPatel_

Yasmin is currently working as a clinical fellow in leadership and management in the HEE, her work includes promoting collaboration between health care professionals and the dental team, unscheduled dental care and improving oral health for older people in community and hospital settings. Yasmin also works clinically in the out of hours emergency dental care service on weekends.

Nikki is a community dental officer who looks after the oral health of dependant elderly or medically compromised individuals. She is currently pursuing her Fellowship in Clinical Leadership at Health Education England in London, where she is involved with projects and strategies to overall improve the oral health of the population and develop new and improved ways of working.


Toothbrush_20050716_004Cast your mind back to when you opened your eyes this morning. Then think of how your mouth felt at that time; I bet it was dry, uncomfortable, had a horrible taste and you most likely felt some plaque roughening the surfaces of your teeth. Now think about how your mouth would feel if you hadn’t brushed your teeth after waking up. Or you didn’t brush them for a week after, or even a few weeks after. Your mouth and teeth will now almost certainly feel dirty, odorous, uncomfortable and in turn it may affect your confidence and well being. This is what happens to dependant elderly people far too regularly than we would like to admit. These are the people whose personal care, including their hair care, foot care, nails care and continence care is being delivered as part of their overall support. Yet there is often one part of personal care which is frequently overlooked- the mouth. Continue reading

Better medicine reviews in care homes – a no brainer?

fotolia-8532456-m(7)Wasim Baqir is a Research & Development Pharmacist at Northumbria Healthcare NHS Foundation Trust.

There are currently 405,000 care home residents in the UK aged over 65 taking an average of seven medicines, with some taking double or treble this amount. Research shows at any one time 70% of them have an error with their medication which can occur during prescribing, dispensing or administration. That’s a lot of errors.

I’m a clinical pharmacist working in Northumbria and although these figures are quite well known, they are still pretty shocking.

Medicines use in care homes is problematic: over-prescribing, lack of structured review and little or no resident involvement in decisions are common themes. Despite the evidence (think CHUMS report) and guidance (think NICE guidelines) medicines use in care homes remains generally poor. That’s why I’m backing a new campaign from the Royal Pharmaceutical Society to improve the situation.

Continue reading

Which drugs to stop in which older patients?

Tischa van der Cammen is a Consultant Geriatrician and Carolyn Sterkeis a public health researcher. Both are based at the Erasmus University Medical Center in Rotterdam, Netherlands and have recently published a paper in Age and Ageing journal.polypharmacy

Drug treatment has brought many benefits for older patients. For example, the treatment of hypertension in patients aged over 80 led to a major reduction in stroke and mortality, as was shown in the HYVET study.

As people age, diseases may accumulate, and hence older patients usually are prescribed several drugs at the same time. It is ‘rule rather than exception’ that patients above age 75 use 4 or more drugs, this is called polypharmacy. There are a variety of definitions for polypharmacy – in the UK it is generally 4 or more prescribed medicines – as specified by Department of health and Rollason.

Inappropriate poly-pharmacy in older patients may lead to negative health impacts Continue reading

Passport to improve patient experience

Kandarp Thakkar is a member of the ImPE Supergroup at the CLAHRC for NWL and the Deputy Chief Pharmacist for Clinical Services at The Royal National Orthopaedic Hospital NHS Trust. He tweets  @KandarpThakkar and is on Linkedinpassport1

My Medication Passport is a small, easy-to-read document for patients to show clinicians and carry a record of the medications they are taking. It is designed to help patients get more involved in their care. An initial report on this was featured by the HSJ in August 2012.

The passport was initially developed as part of a joint NIHR CLAHRC NWL (hosted by Chelsea and Westminster Hospital) and Imperial College Healthcare NHS Trust initiative to improve prescribing for the elderly. It is now being delivered in collaboration with AstraZeneca through a joint working agreement. Continue reading

Improving compliance through dosing aids

Dr Henk-Frans Kwint is A Care Community Pharmacist at Stevenshof Pharmacy affiliated with the SIR Institute for Pharmacy Practice and Policy.dosing aids1

A recent Dutch study on older patients receiving their drugs via a sophisticated dosing aid, called multidose drug dispensing, has shown a higher self-reported medication adherence compared to patients receiving manually-dispensed drugs, despite a lower knowledge and lower cognitive function among patients receiving these dosing aids. The research is published in Age and Ageing. Continue reading