Options for local implementation

Options for local implementation

  • Multimorbidity is associated with reduced quality of life, higher mortality, polypharmacy and high treatment burden, higher rates of adverse drug events, and much greater health services use (including unplanned or emergency care).

  • Polypharmacy in people with multimorbidity is often driven by the introduction of multiple medicines intended to prevent future morbidity and mortality in individual health conditions. However, the absolute benefit gained from each additional medicine is likely to reduce when people are taking multiple preventative medicines but the risk of harms increases. Resources and screening tools are available to help guide decision‑making about the appropriateness of prescribing and stopping medicines (deprescribing).

  • Develop and agree an action plan for multimorbidity and polypharmacy to inform local medicines optimisation strategic and operational plans. Shared learning case studies are available showing how NICE guidance and standards have been put into practice by a range of NHS organisations.

  • Develop an individualised, person-centred approach to reviewing people with multimorbidity and polypharmacy, in line with the NICE guideline on multimorbidity. This may be included in local education and support initiatives to assist shared decision making in individualising care.

  • When discussing the risks and benefits of treatment, the law now requires healthcare professionals to take reasonable care to ensure that the patient is aware of any material risks involved in any recommended treatment, and of any reasonable alternative or variant treatments. NICE has produced several patient decision aids to help healthcare professionals explain the risks and benefits of treatments (see the shared decision-making page on the NICE website).