Background and Importance Suboptimal medicines use is a challenge for health systems globally, contributing to suboptimal outcomes, inefficiencies and sustainability issues, including waste.

Aim and Objectives The aim was to utilise the Clinical Pharmacy Team to drive medicines optimisation and sustainability in a Health and Social Care Trust through the safe, effective and economic use of medicines.

Material and Methods In 2001, a person-centred, whole systems approach to medicines optimisation was implemented in a Health and Social Care Trust. Central to the model was a ward-based Clinical Pharmacy team delivering a comprehensive clinical pharmacy service including medicines reconciliation, medicine review, patient education, interface communication and extended roles for the Clinical Pharmacy team. Evaluation included length of stay, readmission, medicines appropriateness using the Medicines Appropriateness Index and clinical significance of pharmacist interventions using the Eadon grading tool. The model was further developed and evaluated over two decades to include pharmacist prescribing, post-discharge telephone follow-up and person-centred structured medicine review and was extended to include nursing and intermediate care settings.

Results Initial evaluation demonstrated significantly improved medicines appropriateness, reduced length of stay (2 days) and readmission (number needed to treat =12). Further benefits were achieved through post-discharge telephone follow-up (10% reduction in readmission) and structured medicine reviews (94.7% interventions deemed clinically significant and 92% of medicines stopped remained stopped 1year post-review).

Conclusion and Relevance This work has demonstrated improved medicines optimisation and sustainability and has been scaled and spread to other European countries including Austria and Poland. It has been identified as an example of best practice to inform Clinical Pharmacy Services in Central and Eastern Europe¹ and work is ongoing to innovate and further develop the model.

References and/or Acknowledgements 1. Urbańczyk K, Guntschnig S, Antoniadis V, et al. Recommendations for wider adoption of clinical pharmacy in Central and Eastern Europe in order to optimise pharmacotherapy and improve patient outcomes. Front. Pharmacol. 2023;14:1244151. doi: 10.3389/fphar. Aug 2023.1244151

Conflict of Interest No conflict of interest.