Medicines optimisation : a pharmacist's contribution to delivery and education

This thesis describes the author’s publication history from 2001 to 2019, and relates this to their key career milestones from registration as a pharmacist in 1991. From a career output of over 80 items published in a variety of media, eleven key publications form the basis of four publication themes, which the author has related to the concept of medicines optimisation. An exemplar case is used to illustrate these publication themes, arranged into four chapters: a) improving the patient experience and supporting medication adherence b) providing safe care: medication review, polypharmacy and deprescribing c) making medicines optimisation part of routine practice through clinical education, and d) supporting safe practice through professional and personal development of healthcare staff. Following Chapter 1 (introduction), the second chapter discusses the author’s contribution to the medication adherence agenda which closely relates to their outputs encouraging the development of pharmacists’ consultation skills, particularly with patients who have a learning disability. The third chapter discusses the author’s published outputs in the areas of medication review, polypharmacy and deprescribing, the success of which they outline as contingent on the improved communication skills and person-centred approach described in Chapter 2. Chapters four and five discuss the author’s wide-ranging contribution as a clinical educator with a focus on developing others, which the author contends is an essential underpinning of the mission to deliver the benefits of medicines optimisation. The exemplar case from the introduction is briefly revisited to illustrate that the author’s publications directly relate to the challenges of the patient’s medication regime which in turn relate to three of the four Royal Pharmaceutical Society principles of medicines optimisation. The conclusion of this thesis includes a summary of the methodologies used in the key publications, and summarises the author’s belief that their career activity, leading to their publications, broadly align to the concept of medicines optimisation. Moreover, a recommendation can be made that education of all stakeholders should be explicitly mentioned in any future refinements of its definition.