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Pharmacists call for more medicines reviews

The regular reviews will cut problematic polypharmacy and save money

Mark Gould

Monday, 04 February 2019

The Royal Pharmaceutical Society (RPS) has published new guidance on polypharmacy for patients and clinicians which it hopes will improve patient care, cut waste, and save the NHS money.

The guidance encourages GPs and pharmacists to undertake regular reviews of patients, especially those who are taking 10 or more different medications, to prevent unpleasant or potentially harmful interactions.

The benefits of such reviews include:

  • A reduction in problematic polypharmacy
  • Improved health
  • Patients more likely to take their medicines
  • Fewer wasted medicines

RPS president Professor Ash Soni, who is a community pharmacist, said: “As people live longer lives with complex and multiple conditions, they are prescribed an increasing number of medicines. Patients with a high pill burden, those taking high-risk medicines or who have complicated medicine regimes can find it difficult to cope.

“Their prescription often gets added to again when they need extra medical care and medicines often remain on the prescription that are no longer needed. This increases the risk of side effects and interactions between medicines and leads to poor health, a lower quality of life and costly unnecessary admissions to hospital.

“The role of pharmacists in reviewing people’s medicines and ensuring they are on the right medicines for their conditions is becoming increasingly important. The greater integration of pharmacists across primary care is an ambition of the NHS Long-Term Plan and the five-year funding announcement around the GP contract. Closer working across the health professions is the way to drive patient-centred care and help ensure patients only take the medicines they need and get the most benefit from them.”

Professor Soni, said: "What we have today is patients who are taking lots and lots of different medicines and the consequence of that, the way they mix, is you get different interactions, different side-effects, different adverse reactions, different things that may make you feel unwell.

"They may not be working ideally together, they may be working against each other slightly.

"So, it's about seeing how we make sure the medicines you're taking all work together for you," he said.

The RPS wants to see regular medicine reviews, perhaps every six months, for patients who are prescribed 10 or more drugs.

And Professor Soni says regular medicine reviews offer an added benefit to the wider NHS, which spends around £20bn each year on medication.

"We know that 8% of hospital admissions are medicine-related, 30% to 50% of medicines are not taken in the way they were intended.

"So, these things are all designed to help you as the patient get the best from your medicine."

To save money and prevent drugs being wasted some parts of the UK including Harrogate, in North Yorkshire, have launched "medicines amnesties", where out-of-date, unused or unwanted drugs are handed back to the GP surgery or pharmacy. In Harrogate, the local Clinical Commissioning Group spends around £25m on medication each year. A saving of just 1% would mean an extra £250,000 that could be spent on local health services.

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