Intermediate Care for the Elderly

North West London
Published Date: 25 Feb 2014

Method
The STOPIT proforma was used to collect data prospectively over a period of five months (September 2012–February 2013). Forms were not completed for patients where drug treatment was initiated and subsequently optimised on the EHRU. For patients transferred from CWFT, “step 1” of the form was not completed, since this will have been undertaken during the acute admission to hospital. “Step 2”, the medication review, was undertaken during the weekly ward round and typically involved the consultant and registrar for older people, a pharmacist and a nurse. 
Changes were documented on the STOPIT form and results were tabulated on an Excel spreadsheet. Basic descriptive statistics were used in the analysis. 

Results
During the study period, EHRU provided rehabilitation for 36 patients. 15 rehabilitation patients (42%) had a STOPIT form completed. Table 1 outlines the source of referral and medication changes recorded on STOPIT forms for some of these patients.
The study population presented with a typical spectrum of medical conditions as well as a variety of medicines that are to be expected in elderly patients. In each case, patients and primary care physicians were informed of medication changes and a medication adherence assessment was conducted and the findings acted upon, in order to try and maximise the benefit of using the STOPIT tool.

Conclusion
This small study explores the potential to optimise medicines in a rehabilitation environment. We have reviewed a variety of medicines in a diverse patient population with a range of referral sources. It was beyond the scope of our project to look at cost savings but we believe that this type of work in rehabilitation settings can successfully contribute to the QIPP agenda that continues to have a high profile in the UK health economy.11

Contact 
Mudhar Abdul-Saheb