Designed for Independence – a new model of (self)-care in medicines management among older people

The UK (and global) issue of medication non-adherence -- people not taking their prescribed medicines -- poses a major challenge to health and social care, leading to poor health outcomes, medicines wastage, and a strain on already burdened health and social care systems. 50% of medicines prescribed for long-term health conditions are not taken as intended (NHS, 2018).An acknowledged approach to combatting non-adherence is Medicines Optimisation (MO) -- where individualised data on the impact of medication is known, so people receive the right medicines, at the right time. This includes empowering and enabling people to self-care -- more easily report side-effects and move to medicines that _work_ _for them_. Currently, there is no workable MO focused service model in social care. This project aims to address this.

Our 16-month project is business-led by technology specialists Connected Health Systems Ltd (CHS) and demand-led by Oxfordshire County Council (OCC) to meet the under-provision of an MO service within health and social care.

CHS will use their proven technology -- an assistive technology used at home which identifies _if, when and what_ quantity of medicines have been taken. This information goes into an intelligent platform, LOOP, which provides data on adherence to the service user's carer. This system has been designed to be accessible by vulnerable populations in urban and rural areas.

This project combines this technology with OCC's Reablement Service to create a new model of self-care. Reablement supports service users to live independently. However, to ensure adherence they currently conduct daily face-to-face medication visits to older people's homes, limiting a service user's ability to self-care. The proposed project will reduce these through remote monitoring of medicines adherence, enabling targeted face-to-face, rather than routine, visits from Reablement.

To get this right, person-centred design is key. 40-50 service users will be actively part of iterating (adapting) the design of this new model by using versions of the service and feeding back to our Oxford AHSN evaluation partners on how effectively it allows them to self-manage their medicines and communicate back to Reablement about e.g., medicine side effects or other reasons that might impact on taking their medicines.

All this new knowledge will be fed into the new service model design, leading to the development of a new service model of care, co-designed and delivered in Oxfordshire with the aim of scaling-up and rolling out across the UK.