3221 Collaborative care: enhancing frailty management and patient safety through nurse-pharmacist partnerships

Abstract

Introduction Frailty presents significant challenges to healthcare systems, particularly in Thurrock, Essex, where 14% of residents are aged 65 or older. This demographic shift, combined with socioeconomic factors, underscores the need for patient-centred, clinically effective, and tailored healthcare services that prioritise patient safety. Aim To improve frailty management for elderly patients in Thurrock by integrating pharmacist support within a nurse-led service, focusing on medication management, reducing workload pressures, providing holistic, patient-centred care, and ensuring patient safety to enhance outcomes and reduce hospital admissions. Method A 12-week pilot involved patients aged 65+ undergoing joint reviews with a frailty nurse and pharmacist. Participants had a Rockwood Frailty Score of 5–7 and at least one long-term condition. Reviews included evaluations of medication, functional and falls risks, nutritional status, fracture risk, and blood tests. The management phase focused on deprescribing, dose adjustments, and addressing health metrics such as postural hypotension, bone protection, and falls risk. Regular follow-ups ensured coordinated care with a focus on patient-centred outcomes and patient safety. Results From April 4 to June 28, 2024, 37 patients (mean age: 84) participated. Comprehensive assessments led to 155 interventions (averaging 4.07 per patient). Medication management improved significantly, with 88 drugs deprescribed, including 55 Falls Risk Increasing Drgs (FRIDs), resulting in a 14.39% reduction in FRIDs and a 23.03% reduction in polypharmacy. These interventions led to £6252.18 in annual drug savings and a 974.09 kg reduction in CO2 emissions. Key outcomes included 57 health and social interventions. Financial analysis suggested savings of £63,450 from preventable hospital admissions, with a return on investment (ROI) of 1655.4%. Conclusion The pilot demonstrated the clinical effectiveness of pharmacist-nurse collaboration in improving medication management, chronic condition control, reducing falls risk, and preventing hospital admissions. It emphasises the importance of patient-centred care, safety, and skill mixing to enhance clinical outcomes.