Integrated Medicines Management (IMM) In Northern Ireland

This project achieved significant patient benefits, including reduced length of stay in hospital, reduced re-admission rate, a more accurate medicine history and an improved discharge process. The IMM highlighted that the lack of integrated product use was a significant deficiency in the existing medicines management processes due primarily to:
  • Different choices of agents within a therapeutic class
  • Different generics and parallel imports being used in primary care.

This inevitably leads to confusion with regard to medicines that patients should be taking, and can result in omission of products or indeed duplication of product use with potentially far reaching consequences.

There was a lack of integration between the procurement processes in primary and secondary care in terms of product use, with resultant problems for patients in not only obtaining optimal benefit from their therapy, but also increased use of medicine-related adverse effects. This product mismatch mitigates against the development and maintenance of a robust quality joint formulary, which is actively promoted as a system to enhance high quality, safe and effective patient care.

Integrated Medicines Management (IMM) was originally a project run in United Hospitals Trust. By targeting the work of pharmacy staff, the team at United demonstrated significant improvements in patient care. These included:

  • Reduction in length of stay by an average of 2 days
  • Reduction in re-admission rates of 20%
  • Reduction in drug costs
  • Improved communication with primary care
  • Improved utilisation of staff time.

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References

Claire Scullin PhD,Michael G. Scott PhD,Anita Hogg BSc and James C. McElnay PhD. An innovative approach to integrated medicines management. Journal of Evaluation in Clinical Practice 13 (2007) 781–788.

Scott M, Timoney M, Mairs J, Crealey G, Al Abaddi I, Brenninkmeijer R, Janknegt R, McElnay J. Safe Therapeutic Economic Pharmaceutical Selection (STEPS): development, introduction and use in Northern Ireland. Expert Opin Pharmacother. 2007 Oct;8 Suppl 1:S57-63.

Pharmaceutical Clinical Effectiveness (PCE) programme: a suite of initiatives designed to improve quality and safety of medicines management services with resulting health gains and efficiencies.

Integrated Medicines Management (IMM): a randomized controlled study to access the impact of a multidisciplinary cross-sector process designed to improve the effectiveness of medicines use.