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304 IMPLEMENTING A FRAILTY SPECIFIC PHARMACY PRIORITISATION TOOLKIT IN AN OLDER PERSONS’ REHABILITATION UNIT


 
 
 Standardised identification of patients for medication review using nurse-delivered, frailty-specific pharmacy prioritisation toolkits should maximise effective use of limited pharmacy resources. A frailty-specific pharmacy prioritisation toolkit was introduced in a 21 bed older persons’ rehabilitation unit to standardise pharmacy referrals and categorise the interventions made.
 
 
 
 The frailty-specific pharmacy prioritisation toolkit was applied to consecutive patients by upskilled rehabilitation nurses to identify patients for weekly senior pharmacist review over a 5-month period from 18th Jan 2022 to 24th May 2022. Regular use of high-risk medication, greater than 10 medications, patients with specific pharmaceutical concerns such as a desire to reduce their medication burden, acute or chronic kidney injury and admission potentially related to medications or admission with non-mechanical falls are included in this toolkit. Pharmacist interventions included recommendations on medications to be weaned or stopped, dose-adjusted, started or restarted and identification of prescribing errors. Age, gender and interventions were recorded onto Excel and data was analysed using descriptive statistics.
 
 
 
 The total number of patients screened was 82. Eighty five percent (n=70) fulfilled criteria for a medication review. Mean age (SD) was 77(10.9) years. Female:male ratio was 1.5:1. Review was completed in 50% (n=35) of these cases. In total there were 228 interventions, with a mean (SD) of 6.5 (2.4) per patient. Eighty-four recommendations were made to wean or stop medication and thirty to dose adjust, of which 60% (n=18) were proton pump inhibitor dose reduction. Thirty-eight were to start or restart a medication, 34% (n=13) of which were for bone protection. Eleven prescribing errors were identified.
 
 
 
 The pharmacy prioritisation toolkit applied by existing rehabilitation nurses successfully identified patients for medication review. The review rate reflects a need for a twice-weekly senior pharmacy resource.
