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Objectives: With 70% of care home residents experiencing a medication error every day in the UK, better multi-professional working between medical practitioners, pharmacists and care homes was recommended. The aim of this study was to determine the effectiveness (falls reduction) and cost-effectiveness, of a multi-professional medication review (MPMR) service in care homes for older people., Method: A total of care homes in the East of England were cluster randomised to 'usual care' or two multi-professional (General practitioner, clinical pharmacist and care homes staff) medication reviews during the 12-month trial period. Target recruitment was 900 residents with 10% assumed loss to follow-up. Co-primary outcome measures were number of falls and potentially inappropriate prescribing assessed by the Screening Tool of Older Persons Prescriptions., Key Findings: A total of 826 care home residents were recruited with 324 lost to follow-up for at least one primary outcome measure. The mean number of falls per resident per annum was 3.3 for intervention and 3.0 for control (P = 0.947). Each resident was found to be prescribed 0.69 (intervention) and 0.85 (control) potentially inappropriate medicines after 12 months (P = 0.046). No significant difference identified in emergency hospital admissions or deaths. Estimated unadjusted incremental mean cost per resident was £374.26 higher in the intervention group., Conclusions: In line with other medication review based interventions in care homes, two MPMRs improved medication appropriateness but failed to demonstrate improvements in clinical outcomes. From a health system perspective costs where estimated to increase overall and therefore a different model of medicines management is required., (© 2020 The Authors. International Journal of Pharmacy Practice published by John Wiley & Sons Ltd on behalf of Royal Pharmaceutical Society.)

Objective: Problem-based learning (PBL) was introduced into the first 3 years of the undergraduate degree course at the University of East Anglia (UEA) to both enhance the student learning experience and to enable it to meet external course accreditation criteria. Evidence to support both of these assertions is required. The objective was to determine student opinions on the value of PBL and the PBL learning process at one UK school of pharmacy., Method: Utilising the professional accreditation criteria for UK schools of pharmacy a questionnaire was devised and piloted before being given to all UEA undergraduate pharmacy students for self-completion. The most appropriate method of dissemination was determined from a student-led focus group., Key Findings: A total of 201/329 (61.1%) students responded. The majority of students agreed that PBL improved their team working (83.1%), oral communication (89.1%) and problem-solving skills (61.7%). Additionally PBL improved students' ability to identify and address ethical dilemmas (74.5%) as well as enhancing their ability to manage their own learning (67.6%). Male students and those with a stated preference for team working were found to prefer PBL., Conclusion: Students generally believe that PBL develops a number of key skills and consequently inclusion of PBL alongside traditional teaching methods enables the school to meet a number of degree accreditation criteria. Male students, those who enjoyed team working and working with their current group were more positive about PBL. Further work is required to improve the experience for all students., (© 2013 Royal Pharmaceutical Society.)

Objectives: The aim of this project was to conduct an economic evaluation of the Norfolk Medicines Support Service (NMSS), a pharmacist-led medication review service for patients identified in primary care as non-adherent., Methods: The cost-consequences analysis was based on a before and after evaluation of the NMSS. Participants completed a self-reported adherence and health-related quality of life questionnaire prior to the review, at 6 weeks and 6 months. Service provision, prescribing and secondary care costs were considered and the mean cost before and after the intervention was calculated., Key Findings: One-hundred and seventeen patients were included in the evaluation. The mean cost per patient of prescribing and hospital admissions in the 6 months prior to the intervention was £2190 and in the 6 months after intervention £1883. This equates to a mean cost saving of £307 per patient (parametric 95% confidence interval: £1269 to £655). The intervention reduced emergency hospital admissions and increased medication adherence but no significant change in health-related quality of life was observed., Conclusion: The costs of providing this medication review service were offset by the reduction in emergency hospital admissions and savings in medication cost, assuming the findings of the evaluation were real and the regression to the mean phenomenon was not involved. This cost-consequences approach provides a transparent descriptive summary for decision-makers to use as the basis for resource allocation decisions., (© 2011 The Authors. IJPP © 2011 Royal Pharmaceutical Society.)