MDT case study

Multi-disciplinary Team Meeting (MDT) Case Study June 2015

Penwith

This case study clearly demonstrates the value of structured multi-disciplinary meetings in GP practice involving a range of practitioners.

Situation

During a Penwith GP practice MDT meeting the dementia support worker raised that her patients daughter in law had recently questioned a change in medication. She had tried contacting the GP on a Friday afternoon and ended up leaving a message with the receptionist. The GP was aware of this and apologised for not getting back to her but was on duty that day and had to prioritize.

Background

The medication being questioned is Donepezil which is used to treat dementia. It’s brand name is Aricept and it was the first drug to come off patent and be available generically. The price difference is significant, e.g 5mg tablets Aricept £59.85 generic £1.20 for 28 respectively. The pharmacy optimisation team advised the move to generic Donepezil as the products are bioequivalent and no issues in switching have been raised elsewhere.

It transpired that the GP practice had switched and prescribed generically without explaining to the patient. It appeared at the same time as the switch the patient had started to deteriorate ringing the family a bit confused on a couple of occasions.

Assessment

It was fascinating observing this situation as part of the MDT, what happened next was that the pharmacist said ‘I could have helped you with this’. Both the GP and the dementia support worker said ‘we didn’t know that you could do that?’ The pharmacist explained her role and offered to contact the family direct. As a result of this the pharmacist has spoken to the daughter in law who reasonably agreed that it could be coincidental. The pharmacist was able to spend time discussing the evidence behind the decision which was very reassuring.

Recommendation

This case study highlights the importance of having a diverse expertise around the table at the MDT. The value of knowing your team, their roles and responsibilities are essential in reducing duplication and releasing time to care for practitioners. This team will now refer direct to the pharmacist for any medication enquiries and there has also been the offer of pharmacy domiciliary visits and GP data analysis from eclipse live.

Furthermore the delay in getting this information to the family caused uncertainty and anxiety. The MDT process has improved their communication between practitioners in this locality to prevent delays in care.