Medication Review


What is a medication review?

A medication review is defined as “a structured, critical examination of a patient’s medicines with the objective of reaching an agreement with the patient about treatment, optimising the impact of medicines, minimising the number of medication related problems and reducing waste”.

(Room for Review, 2002)

Why are medication reviews important?

  • ADRs responsible for 5-17% admissions (80% of which are avoidable)
  • Risk of interactions 50% if on 5 medications, approaches 100% if on 8+

Levels of medication review


A technical review of the list of a patient’s medicine


A review of medicines with the patient’s full notes


A face to face review of medicines and condition


Lewis T (2004) Using the NO TEARS tool for medication review. BMJ ; 329 : 434.

Room for review.  A guide to medication review: the agenda for patients, practitioners and managers. 1st Edn (2002).   London, Medicines Partnership

NICE NG 5 (2015) Medicines optimisation : the safe and effective use of medicines to enable the best possible outcomes.

NICE NG56 (2016) Multimorbidity : clinical assessment and management

A Guide to to Medication Review (2016) Sandwell and West Birmingham CCG

Checklist Basic

Check / record / update mobile number

Check / record / update SMS preference

Check / record / update ETP nomination

Check / download / arrange monitoring bloods

Check / arrange monitoring biometrics

Check / update number of issues

Check compliance / concordance

Check / record / update any hospital-issued medications

Ensure quantities align

Switch to 2 monthly  where possible

Switch to ETP-compliant preparations where possible

Removal of repeat medications not issued > 3 months

Check / record / update recall date

Record completion of medication review

Checklist Advanced

Check / action outstanding QIF/QOF alerts

Check / action outstanding tasks

Check / action outstanding workflow

Medication optimised based on review

Check / update script notes as indicated

Opportunistic identification of potentially inappropriate medicines (PIMs) and/or potential prescribing omissions (PPOs)


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