Medicines optimisation: key therapeutic topics summarise the evidence-base on topics identified to support medicines optimisation, but are not formal NICE guidance.

These topics are selected and prioritised therapeutic areas where there are potential opportunities for maintaining or improving quality and improving value from our use of medicines. Releasing resources from one area of health care while maintaining or improving quality of care means those resources are available for use elsewhere, for example - the prescribing of innovative medicines.

The selection of metrics to support these topics is overseen by the NHS England Medicines Optimisation Intelligence Group, and work is ongoing in this area.

2019 update of medicines optimisation: key therapeutic topics published

View all therapeutic topics

This update has retained 12 topics from 2018:

  • asthma: medicines safety priorities
  • hypnotics
  • antipsychotics in people living with dementia
  • antimicrobial stewardship: prescribing antibiotics
  • type 2 diabetes mellitus: medicines optimisation priorities
  • wound care products
  • acute kidney injury (AKI): use of medicines in people with or at increased risk of AKI
  • multimorbidity and polypharmacy
  • psychotropic medicines in people with learning disabilities whose behaviour challenges
  • safer insulin prescribing
  • medicines optimisation in chronic pain
  • chemotherapy dose standardisation.

Three topics have been retired:

  • biosimilar medicines
  • anticoagulants, including non-vitamin K antagonist oral anticoagulants (NOACs)
  • non-steroidal anti-inflammatory drugs.

Two topics have been added:

  • shared decision making
  • suicide prevention: optimising medicines and reducing access to medicines as a means of suicide.

The evidence context for all the current topics has been updated in the light of new guidance and important new evidence. Historical content for retired topics is available for reference but has not been updated.

Dr Bruce Warner, Deputy Chief Pharmaceutical Officer NHS England, said:

"I am delighted to welcome the latest update of medicines optimisation: key therapeutic topics, which continue to be developed in collaboration with the Medicines Value Programme and inform the medicines optimisation dashboard. This year’s update includes 2 new topics on shared decision making and suicide prevention: optimising medicines and reducing access to medicines as a means of suicide. These topics are high priority areas nationally and raising their awareness will assist implementation.

The appropriate use of medicines has never been so high profile, as highlighted in the NHS Long Term Plan. With the annual medicines bill now standing at over £16 billion and rising, it is vitally important that we maintain momentum to ensure medicines optimisation becomes embedded further into the NHS.

This work is being led by the four Regional Medicines Optimisation Committees, working across all parts of the NHS to ensure we improve value and outcomes from medicines for patients and taxpayers."


More information

Our integrated process statement sets out how we select topics and prepare the documents.

Past consultations