• To review NHS Drug Wastage analyses and gain a better perspective of the scale of the problem.
• To consider initiatives which have been implemented in the past and review successful and unsuccessful strategies to reduce NHS Drug Wastage.
• To gain a fuller understanding of the issues surrounding non-adherence to medicines including:
  • Swallowing Difficulties
  • Dysphagia
  • Apathy
  • Amotivation
• To review the factors that make medicines acceptable/non-acceptable/difficult to swallow, including an analysis of the strengths and weaknesses of the following formulation factors:
  • Tablets
  • Capsules
  • Coatings
  • Dissolvable items
  • Oral Liquids

• To review data generated to date regarding the Medicines Acceptability Questionnaire and its appropriateness – is it indeed ‘fit for purpose’.

18.00 NHS Drug Wastage – the Size of the Problem, and Responsibilities for Prescribers.

Speaker: Dr Haydn Holmes – York Health Economic Consortium

In 2010 the report titled: “Evaluation of the Scale, Causes and Costs of Waste Medicines” was published by the York Health Economics Consortium. This report assessed and reviewed the scale of the problem of drug waste within the NHS. Some of the conclusions were subsequently contested resulting in the report being republished in 2015 in another form. Understanding the size of the problem and the initiatives that can be introduced to reduce pharmaceutical waste is not an easy task. This talk will review how the current prescription service generates over prescriptions and will detail how services seek to reduce this waste. There are differing views over the size of the problem. These will be assessed and discussed including a secondary assessment of interventions that have been made to seek to reduce this waste. Recommendations towards best practice will be discussed and reviewed.

18.30 Swallowing Disorders and the Problems that these bring for Patients trying to take Oral Solid Medication

Speaker: Dr David Smithard – Chair of the UK Swallowing Disorders Research Group

Studies have suggested that approximately 37% of adults struggle to swallow tablets. It is unknown to what extend this impact on patient adherence to medication. This talk will provide a comprehensive review of Dysphagia and its severity, complications and sequelae – such as pneumonia – and its relationship to Parkinson’s as well as the best treatments and practice when dealing with Dysphagia

19.00 Apathy/Amotivation – Definitions, the scale of the Problem and Options or Intervention to Improve Adherence

Speaker: Dr Jill Rasmussen – Fellow of the Royal College of General Practitioners

Apathy and amotivation are becoming better recognised as major causes of morbidity especially in the older population. Initiatives are being taken to better understand these problems and to help patient overcome these issues. Dr Rasmussen will provide a summary of the current state of play specifically addressing interventions made in her local area.

19.30 Review of data on Tablet size/shape/dynamics and how easy these are to Swallow including a Review of Literature on Alternative Formulations

Speaker: Dr Fang Liu – an Associate Professor at the University of Hertfordshire and Founder of Fluid Pharma Ltd

Dr Liu will outline factors in pharmaceutical formulation design that could affect medicine acceptability in older patients and considers new and conventional formulations for use in older adults. Various new methods will be outlined, with their pros and cons assessed in regard to how they could create safer methods of prescribing.

20.00 An introduction to the Medicines Acceptability Questionnaire and recent study work with an oral liquid version of a once weekly biphosphate

Speaker: Dr Debi Bhattacharya – Dr Debi Bhattacharya Senior Lecturer in Pharmacy Practice at UEA

Questionnaires that assess the acceptability of different formulations are few and far between. The University of East Anglia has recent development the Medicines Acceptability Questionnaire and tested its validity through trial activity. Dr Bhattacharya will review development process and discuss the study dynamics through to the creation of a finalised questionnaire.