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
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
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)