Swansea University academics are calling for policy makers, regulators and healthcare professionals to adopt a structured medicine monitoring system, after research showed a positive impact on the care of people living in care homes and taking mental health medicines.

Professor Sue Jordan from the University’s College of Human and Health Sciences led the research, which is newly published in the PLOS ONE journal. The study showed how care home residents’ adverse side-effects were picked up more effectively by their nurses and carers when a structured monitoring system was used alongside the administration of mental health medicines.

The overuse of mental health medicines in care homes has long been a cause for concern, and insufficient patient monitoring has been seen as an important cause of medicine-related harm.

The new study examined the nurse-led medicines’ monitoring system known as the Adverse Drug Reaction (ADRe) Profile, which identifies and addresses the adverse effects that mental health medicines can have on patients.

This study worked with ten care homes caring for people prescribed mental health medicines to investigate the clinical impact of ADRe; how to ensure the routine and continued use of ADRe in care homes; and how ADRe might enhance pharmacists’ medication reviews.

The study found that nurses using ADRe picked up issues which resulted in nursing care being changed for 27 of 30 residents and medication for 17 patients being reviewed.

The research team also interviewed key people such as prescribers, pharmacists, nurses and care staff in the homes, residents, service users and relatives as well as policy makers and a care homes inspector. The responses were mainly favourable because, without ADRe, treatable problems might be left unattended to; but healthcare professionals said that time, understaffing and work demands were potential barriers to regularly using ADRe. However, patients and service users said continued monitoring was needed to avoid people becoming ill, their conditions deteriorating, mistakes being made or valuable information about a patient’s condition not being picked up.

The study concluded that, when ADRe is used routinely, it improves the lives of patients, helps to identify problems quickly, and results in better care and medication reviews. It also shows that as ADRe fully records a list signs and symptoms, it makes reviews by pharmacists easier and helps them make better decisions when changing, reducing or stopping medicines.

Professor Sue Jordan said: “Our study shows how simply checking patients for the signs and symptoms of possible adverse drug reactions improves the lives of the most vulnerable in society. It also shows that bringing patients’ perspectives into medicines optimisation is complex, and the very complexity means that professionals may shy away from this potentially difficult task. The positive impact on patients’ lives should persuade managers, service leaders and guideline developers to adopt ADRe.”

www.swansea.ac.uk/adre