§ Sandra GidleyTo ask the Secretary of State for Health (1) what representations he has received on poor concordance with medication for older people living in sheltered housing; [161937]
(2) what monitoring is undertaken by his Department of the medication of older people with particular reference to (a) concordance and (b) over-medication; and if he will make a statement; [161938]
(3) what guidance he has provided to staff at extra care sheltered housing schemes with regard to management and administration of the medicines of frail elderly people. [161940]
§ Dr. LadymanI am not aware of any representations suggesting there is a particular problem with the use of medications in sheltered housing.
The National Minimum Standards for Care Homes for Older People set out the requirements care homes are expected to meet and include a standard on medication.
The regulatory body, the National Care Standards Commission (NCSC), takes the standard into account when carrying out inspections of care homes.
National Minimum Standards for Domiciliary Care Agencies set out the requirements that agency staff are expected to meet and these also include a standard on medication. The standards apply to agencies providing personal care to people in their own homes, including extra care housing and sheltered housing schemes. The NCSC takes the standard into account when they register and inspect domiciliary care agencies.
601WThe NCSC and, from 1 April 2004, the Commission for Social Care Inspection, has the powers to take whatever enforcement action it considers necessary in the event of poor management or administration of medicines including overmedication.
§ Sandra GidleyTo ask the Secretary of State for Health how many adverse drug reactions and adverse incidents relating to the medication of older people living in sheltered housing thert were in the last 12 months for which figures are available; and if he will make a statement. [161939]
§ Dr. LadymanReports of suspected adverse drug reactions (ADRs) to medicines are collated by the Medicines and Healthcare products Regulatory Agency (MHRA) and the Committee on Safety of Medicines (CSM) through the spontaneous reporting scheme, the Yellow Card scheme. The table shows details of the number of reports of suspected adverse drug reactions received through the Yellow Card scheme in 2003 for individuals aged 60 years and above. The figures provided relate to the number of reports received. Some reports may contain more than one reaction.
Reports received between 1 January 2003 and 31 December 2003 Age range (years) Number of reports received 60–69 2,389 70–79 2,231 80–89 1,234 90+ 196 We cannot specify whether any of these reports relate to individuals in sheltered housing, as residential details of patients are not collected by this scheme.
It is important to note that data from the Yellow Card scheme, as for all spontaneous reporting schemes, is limited by under-reporting. This does not impair its usefulness for detection of signals of emerging drug safety issues but means that numbers of reports are not complete. A report of an adverse reaction does not necessarily mean that it was caused by the medicine. Additionally, a range of factors may affect how an individual responds to a medicine, for example, their medical history and underlying disease conditions and other concomitant medication.
Use of medicines in the elderly is higher than in other age groups and elderly patients are. more likely to be using combinations of medicines.