Medication review and polypharmacy

Medication reviews and polypharmacy

Medication Review

Definition

The definition of a medication review is a “structured, critical examination of a patient’s medicines with the objective of reaching an agreement with the patient about treatment, optimizing the impact of medicines, minimizing the number or medication related problems and reducing waste”. (Room for Review, 2002)

Why is it important?

Prescribing accounts for the second highest area of expenditure across all sectors of the NHS

In primary care, wasted medicines are estimated to be at least £300 million per year, of which half is avoidable

Polypharmacy

Definition

There is no single definition of polypharmacy, although it is often defined as the use of five or more medicines on a daily basis[1]. This may be any combination of prescription drugs, OTC medicines and dietary or herbal supplements. Others use the term to refer to the experience of adverse effects from taking multiple medicines simultaneously, regardless of the number

The most commonly reported definition of polypharmacy was the numerical definition of five or more medications daily, with definitions ranging from two or more to 11 or more medicines.

Why is it important?

Polypharmacy is much more complex than just being on a large number of repeat medications

Polypharmacy itself can be perceived as a “condition” possibly threatening healthy old age.

The burden of medicines > burden of disease

Case Scenario

Please use the “The 7-steps Medication Review” framework to identify key issues you would discuss with the patient and possible changes you would make.

WEBINAR RECORDING DISCUSSING CASE WITH CLINICAL PHARMACIST (PLEASE WATCH AFTER WORKING ON THE CASE)

https://qmplus.qmul.ac.uk/course/view.php?id=3432

You may find the following links useful:

https://www.diabetes.org.uk/

https://www.cdep.org.uk/

https://www.sign.ac.uk (SIGN 154 & 116 combined quick reference guide) p10