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27 results on '"Alldred, David Phillip"'

2. The Care Home Independent Pharmacist Prescriber Study (CHIPPS): development and implementation of an RCT to estimate safety, effectiveness and cost-effectiveness

Author

Wright, David, primary, Holland, Richard, additional, Alldred, David Phillip, additional, Bond, Christine, additional, Hughes, Carmel, additional, Barton, Garry, additional, Poland, Fiona, additional, Shepstone, Lee, additional, Arthur, Antony, additional, Birt, Linda, additional, Blacklock, Jeanette, additional, Blyth, Annie, additional, Cheilari, Stamatina, additional, Daffu-O’Reilly, Amrit, additional, Dalgarno, Lindsay, additional, Desborough, James, additional, Ford, Joanna, additional, Grant, Kelly, additional, Gray, Janet, additional, Handford, Christine, additional, Harry, Bronwen, additional, Hill, Helen, additional, Inch, Jacqueline, additional, Myint, Phyo Kyaw, additional, Norris, Nigel, additional, Spargo, Maureen, additional, Maskrey, Vivienne, additional, Turner, David, additional, Watts, Laura, additional, and Zermansky, Arnold, additional

Published
2023
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4. CompreHensive geriAtRician-led MEdication Review (CHARMER): protocol for a feasibility study of a hospital deprescribing behaviour change intervention

Author

Scott, Sion, primary, Atkins, Bethany, additional, Martin-Kerry, Jacqueline M, additional, Pritchard, Megan, additional, Alldred, David Phillip, additional, Clark, Allan B, additional, Colles, Antony, additional, Hammond, Amber, additional, Murphy, Katherine, additional, Keevil, Victoria L, additional, Kellar, Ian, additional, Patel, Martyn, additional, Sims, Erika, additional, Taylor, Johanna, additional, Turner, David, additional, Witham, Miles, additional, Wright, David, additional, and Bhattacharya, Debi, additional

Published
2023
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5. The impact of pharmacist conducted clinical medication review for older people in care homes

Author

Alldred, David Phillip

Subjects
615.140846
Abstract

Older people living in care homes have high levels of morbidity and are prescribed multiple medicines. Inappropriate prescribing (for example of antipsychotics), suboptimal management of long term conditions and a lack of medication review have been identified in this setting. It was hypothesised that a pharmacist could review the medicines of care home residents leading to potentially beneficial outcomes.

Published
2008

7. Developing a core outcome set for hospital deprescribing trials for older people under the care of a geriatrician

Author

Martin-Kerry, Jacqueline, primary, Taylor, Jo, additional, Scott, Sion, additional, Patel, Martyn, additional, Wright, David, additional, Clark, Allan, additional, Turner, David, additional, Alldred, David Phillip, additional, Murphy, Katherine, additional, Keevil, Victoria, additional, Witham, Miles D, additional, Kellar, Ian, additional, and Bhattacharya, Debi, additional

Published
2022
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9. Pharmacist-independent prescriber deprescribing in UK care homes: Contextual factors associated with increased activity.

Author

Alharthi, Mohammed, Scott, Sion, Alldred, David Phillip, Holland, Richard, Hughes, Carmel, Birt, Linda, Blacklock, Jeanette, Bond, Christine, Clark, Allan, and Wright, David

Subjects
DEPRESCRIBING, BOOKSTORES, MEDICAL practice, LONG-term care facilities, REGRESSION analysis, DRUGSTORES
Abstract

Aims: The Care Home Independent Pharmacist Prescriber Study (CHIPPS) process evaluation hypothesized that contextual factors influenced the likelihood of deprescribing by pharmacist-independent prescribers. The aim of this paper is to test this hypothesis. Methods: From CHIPPS study data, medications deprescribed totalled 284 for 370 residents in UK care homes. Regression analysis was used to describe the relationship between the number of medicines stopped and contextual factors (number of residents cared for, pharmacist employment within associated medical practice, previous care home experience, hours active within trial, years’ experience as a pharmacist and as a prescriber). Results: Number of residents and pharmacist-independent prescriber employment within a medical practice were positive predictors of deprescribing. Conclusion: Previous experiences were not related to deprescribing likelihood. Increasing the number of residents increases the opportunity for deprescribing and therefore this relationship is intuitive. The location within a medical practice is an interesting finding that requires further exploration to understand its exact nature. [ABSTRACT FROM AUTHOR]

Published
2023
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10. Using routine healthcare data to evaluate the impact of the Medicines at Transitions Intervention (MaTI) on clinical outcomes of patients hospitalised with heart failure: protocol for the Improving the Safety and Continuity Of Medicines management at Transitions of care (ISCOMAT) cluster randomised controlled trial with embedded process evaluation, health economics evaluation and internal pilot

Author

Moreau, Lauren A, primary, Holloway, Ivana, additional, Fylan, Beth, additional, Hartley, Suzanne, additional, Cundill, Bonnie, additional, Fergusson, Alison, additional, Alderson, Sarah, additional, Alldred, David Phillip, additional, Bojke, Chris, additional, Breen, Liz, additional, Ismail, Hanif, additional, Gardner, Peter, additional, Mason, Ellen, additional, Powell, Catherine, additional, Silcock, Jonathan, additional, Taylor, Andrew, additional, Farrin, Amanda, additional, and Gale, Chris, additional

Published
2022
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25. The barriers and facilitators to stopping inappropriate medicines ('deprescribing') for older people living in care homes

Author

Bolton, Emma Victoria, Alldred, David Phillip, Easthall, Claire, and Spilsbury, Karen

Subjects
362.61
Abstract

Background: UK care home residents are prescribed an average of 8-10 medicines daily with evidence that inappropriate prescribing is prevalent leading to problematic polypharmacy. This increases the risk of adverse drug events that negatively affect resident outcomes, quality-of-life and have financial costs to the NHS. Deprescribing (the cessation of inappropriate medicines) can reduce inappropriate prescribing, however, there are significant barriers to its implementation in this setting. Identifying and understanding barriers and facilitators of stopping inappropriate medicines is necessary to improve the implementation of deprescribing in care homes. Methods: A literature review was conducted to synthesise existing evidence. Semi-structured interviews were conducted with residents, relatives, care home staff, GPs and pharmacists. Themes and explanations were developed using Framework Analysis. Theoretical models of behaviour change were applied to identify candidate components for a novel intervention for deprescribing in care homes. Findings: The literature review highlighted a lack of evidence regarding residents’ and relatives’ attitudes to deprescribing, and a lack of depth regarding barriers and facilitators to deprescribing. Three themes were identified from the empirical data: 1) individuals involved in the deprescribing process; 2) social barriers; 3) logistical barriers. Theme 1 highlighted the complexity of the deprescribing process and themes 2&3 identified and explained systematic barriers and facilitators to deprescribing. Social barriers included a reluctance to discuss life expectancy and healthcare professionals’ perceptions of residents and relatives. Logistical barriers included the unavailability of key stakeholders and navigating health and social care systems. Potential intervention components included; demonstrating the behaviour of deprescribing, providing feedback on its outcomes plus provision of prompts. Conclusions: This thesis has provided novel, in-depth explanation and insight of the barriers and facilitators to deprescribing from the perspective of key stakeholders. This was utilised to identify potential components of a deprescribing behaviour change intervention for implementation and evaluation in care homes.

Published
2020

27. The influence of formulation and medicine delivery system on medication administration errors in care homes for older people.

Author

Alldred DP, Standage C, Fletcher O, Savage I, Carpenter J, Barber N, and Raynor DK

Subjects
Aged, Aged, 80 and over, Capsules adverse effects, Humans, Tablets adverse effects, United Kingdom, Dosage Forms, Drug Delivery Systems, Homes for the Aged statistics & numerical data, Medication Errors statistics & numerical data, Nursing Homes statistics & numerical data
Abstract

Introduction: Older people in care homes are at increased risk of medication errors and adverse drug events. The effect of formulation on administration errors is not known, that is whether the medicine is a tablet or capsule, liquid or device such as an inhaler. Also, the impact on administration errors of monitored dosage systems (MDS), commonly used in UK care homes to dispense tablets and capsules, is not known. This study investigated the influence of formulation and MDS on administration errors., Methods: Administration errors were identified by pharmacists (using validated definitions) observing two drug rounds of residents randomly selected from a purposive sample of UK nursing and residential homes. Errors were classified and analysed by formulation and medicine delivery system., Results: The odds of administration errors by formulation, when compared with tablets and capsules in MDS, were: liquids 4.31 (95% CI 2.02 to 9.21; p = 0.0002); topicals/transdermals/injections 19.61 (95% CI 6.90 to 55.73; p < 0.0001); inhalers 33.58 (95% CI 12.51 to 90.19; p < 0.0001). The odds of administration errors for tablets and capsules not in MDS were double those that were dispensed in MDS (adjusted OR 2.14, 95% CI 1.02 to 4.51; p = 0.04)., Conclusions: Inhalers and liquid medicines were associated with significantly increased odds of administration errors. Training of staff in safe administration of these formulations needs implementing. Although there was some evidence that MDS reduced the odds of an administration error, the use of MDS impacts on other aspects of medicines management. Because of this, and as the primary topic of our study was not MDS, a prospective trial specifically designed to evaluate the overall impact of MDS on medicine management in care homes is needed.

Published
2011
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