Dementia Project Outcomes

Author: admin / Date: 25-05-2015 /

Supporting Development

At the 2013 LPC Conference, Pinnacle Health awarded a grant of £5,000 as part of a competitive proposal to LPCs encouraging them to think about dementia and how community pharmacy could play a bigger role in the care, support and early diagnosis of patients with dementia.

Avon LPC was the successful winner with a project whose stated aims were:

  1. Pharmacies will become more dementia aware and increase awareness and understanding of dementia in their communities. They will provide a range of information materials and signposting to local support services helping sufferers, carers and families to live well with dementia.
  2. Pharmacy interventions will improve early identification of dementia.
  3. Pharmacist medication interventions will optimise treatment for dementia sufferers.

All other entrants were given the opportunity to utilise a free license on PharmOutcomes to deliver their envisaged services.

The Service

Locally in North Somerset it was estimated that in April 2013 only 45% of people predicted by the Dementia Prevalence Calculator had a diagnosis of dementia recorded in GP records. The National target by 2015 is to diagnose 66.6% of people predicted with dementia.

Using two lead questions:

  • “Have you noticed a change in your memory which is affecting your daily life?”; and
  • “Have you already discussed this with your GP?"

the pharmacists then utilised a 3-tier service:

Tier 1 -­‐ patient engagement using two screening questions above;
Tier 2 -­‐ Mini-COG assessment with appropriate GP referral, and patient and carer information;
and Tier 3 -­‐ a medication review intervention to identify possible culprit drugs and any problems with adherence.

At each level reassurance that not all memory problems are caused by dementia, information and local signposting was offered. All patients were followed-up 4 to 8 weeks later to find the views about the service acceptability and quality. All the intervention and follow-up data was entered onto PharmOutcomes.

Project Outcomes

The service evaluation was completed in April 2015 and demonstrated that community pharmacists can:

  • Use their clinical skills in partnership with GPs to improve patient care;
  • Identify people not previously known to be concerned about memory problems;
  • Provide reassurance that not all memory problems are caused by dementia;
  • Raised awareness of drugs that can contribute to memory problems; and
  • Improved:
    • Awareness of dementia within the participating pharmacies and their local communities
    • Access to information
    • Access to local support services

In total, 17 pharmacies recorded 152 Mini-COG results with a 21.6% hit rate for potential dementia.

A full service evaluation was written up by Avon LPC and financially, the service demonstrated that the savings to the NHS from early diagnosis and subsequent treatment are significant. A report by Alzheimer's Disease International indicates that the cost of early identification of one patient was approximately US$4000 from the results of a universal primary care screening and diagnosis program of all attendees aged 65 years and over. This community pharmacy service was ten times more cost-effective than that screening cost.

A poster outlining the identification and actions to support people with cognitive impairment in one pharmacy in Banwell Village by Community Pharmacists won an award at the Clinical Pharmacy Congress 2015 and our congratulations go to Margaret Hook MRPharmS.