Reducing Harm, Restoring Confidence: A Collaborative Digital Approach to Safer Medication Practices

Cwm Taf Morgannwg University Health Board

Introduction:

Older adults living with frailty or complex medication regimens face a high risk of avoidable harm due to poor adherence and service pressures. Locally, domiciliary visits often centred around medication, creating dependency and delaying care escalation. In response, a cross-sector team introduced digital medicines dispensers to improve patient safety, independence, and reduce preventable harm.

Methods:

Using the Model for Improvement, Pharmacy Technicians led the rollout of devices offering audio-visual prompts and real-time adherence monitoring. Stakeholders - including patients, families, GPs, social care, pharmacies, and industry - co-designed training, escalation protocols, and education materials. Iterative PDSA cycles tested and refined device selection, pharmacy filling models, and service integration, including for patients with existing care packages.

Outcomes:

The project improved safety and adherence across all cohorts (≥86%), triggered 155 timely interventions via alerts, and led to a 46% drop in admissions, 36% fewer ED visits, and 55% reduction in bed days over six months. Seven individuals reduced care packages, saving over £36,000 annually. PROMs showed improved anxiety, self-care, and pain. 87% of patients reported greater independence, and community pharmacy teams enhanced their digital confidence and collaboration.

Learnings:

Digital tools must be simple, reliable, and combined with timely human oversight. Patient selection and education are critical. Shared learning, structured evaluation, and interprofessional collaboration strengthened safety and engagement. Network limitations in rural areas and early identification of suitable patients emerged as key challenges.

What next?

A business case has been submitted for scale-up. Plans include embedding devices in Discharge-to-Assess and Mental Health pathways, expanding community pharmacy participation, and contributing to regional digital toolkits. Cost-effectiveness and policy alignment will be explored to support broader adoption. This person-centred model offers a replicable, safety-focused solution aligned with national quality and value goals.