Harnessing innovation to deliver medicines optimisation at scale
In this case study, Meera Parkash, Clinical Facilitator, Population Health Management at Optum UK, discusses how medicines optimisation can help free up pharmacy capacity and deliver key improvements to population health management.
At a time when the health system is urgently seeking new ways to cut costs, improve outcomes and reduce health inequalities, there are three areas where medicines optimisation can make an important contribution.
The first is non-adherence to medicines. It is estimated that half of all patients are non-adherent to their prescribed medication, costing the NHS £500m every year. The second concerns over-ordering and over-prescribing. About £300m worth of medicines go unused each year, and around half of this cost is believed to be recoverable. The third and final relates to adverse drug events (ADEs) in primary care, leading to hospital admissions. An estimated 72 per cent of ADEs are avoidable, costing the NHS £100m every year.
Traditionally, clinicians have had to manually search for patients who may need changes to their medication approach. This is extremely time-consuming and may not always be accurate if the data being used is out of date.
Population360® changes this. By integrating fully with clinical systems, it automatically finds and presents opportunities to improve medication safety, non-adherence and cost-effectiveness all in one place – transforming the speed, accuracy and scale of these processes.
Other prescribing decision support tools focus mainly on acute prescriptions and can only process them one patient at a time, whereas Population360 can proactively manage an entire patient population for an ICS at once. It does this by providing safety and adherence alerts for high-risk cases while surfacing lists of patients who may benefit from medication changes.
In light of resourcing pressures on pharmacy teams – which limit the number of structured medication reviews, programme switches, or high-risk drugs monitoring they can undertake using traditional methods – Population360 frees up capacity and helps them cover more ground. This demonstrates that it can be an important enabler for delivering medicines optimisation strategies at scale.
Evidence of success
Working with a GP practice covering 10,000 patients, Population360 flagged opportunities to save £82,376 through simple medication switches and recommended 1,171 patients for an adherence or safety intervention over a three-month period.
Based on these, a single pharmacy technician successfully reviewed 16 patients in less than 30 minutes, actively booking tests for 14 patients and initiating a patient consultation and de-prescribe for another.
Another pharmacist reviewed all female patients prescribed sodium valproate based on a targeted clinical rule. The pharmacist contacted patients, reminding them to follow up with their consultant to ensure Annual Risk Acknowledgement Forms were up to date (most of which were not) and contraception was in place.
Both examples demonstrate clinicians working proactively, supporting structured medication reviews, and closing important gaps in care.
The lead pharmacist at the GP surgery said: “It (Population360) gives us these patients very, very quickly and we can review them and take appropriate action – some of these patients are hard to reach people which is also an advantage.”
To see how Optum advances medicines optimisation (MO) and to learn more about proactive prescribing at scale, please click here.
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