Quality statement 6: Structured medication review

Quality statement

Local healthcare providers identify people taking medicines who would benefit from a structured medication review.

Rationale

A structured medication review, with the clear purpose of optimising the use of medicines for some people (such as those who have long‑term conditions or who take multiple medicines), can identify medicines that could be stopped or need a dosage change, or new medicines that are needed. Structured medication review can lead to a reduction in adverse events. To offer a structured medication review to people who would benefit, local healthcare providers must first have systems in place to identify those people.

Quality measures

Structure

a) Evidence that local healthcare providers have arrangements to identify people taking medicines who would benefit from a structured medication review.

Data source: Local data collection.

b) Evidence that local healthcare providers have arrangements to offer structured medication reviews to people who are likely to benefit.

Data source: Local data collection.

Process

a) Proportion of people taking medicines for long‑term conditions who are identified as potentially benefiting from a structured medication review.

Numerator – the number in the denominator who are identified as potentially benefiting from a structured medication review.

Denominator – the number of people taking medicines for long-term conditions.

b) Proportion of people taking multiple medicines who are identified as potentially benefiting from a structured medication review.

Numerator – the number in the denominator who are identified as potentially benefiting from a structured medication review.

Denominator – the number of people taking multiple medicines.

Data source: Local data collection.

c) The proportion of people identified as potentially benefiting from a structured medication review who have a structured medication review.

Numerator – the number in the denominator who have a structured medication review.

Denominator – the number of people identified as potentially benefiting from a structured medication review.

Data source: Local data collection.

Outcome

a) People with long‑term conditions gain optimum outcomes from use of medicines.

Data source: Local data collection.

b) People using multiple medicines gain optimum outcomes from use of medicines.

Data source: Local data collection.

c) Patient satisfaction with outcomes from the use of medicines.

Data source: Local data collection.

What the quality statement means for service providers, healthcare professionals and commissioners

Service providers (such as GP practices, acute and mental health services) ensure that systems are in place to identify people taking medicines who would benefit from a structured medication review. Such patients may include people taking medicines for long‑term conditions and people taking multiple medicines.

Healthcare professionals (such as GPs and pharmacists) ensure that they identify people taking medicines who would benefit from a structured medication review. Such patients may include people taking medicines for long‑term conditions and people taking multiple medicines. Healthcare professionals should carry out the review with patients who agree to attend when the need and purpose of the structured medication review is clear. The healthcare professional should take into account the person's views, whether the person has had or has any risk factors for developing adverse drug reactions and any monitoring that is needed.

Commissioners (such as clinical commissioning groups and NHS England) ensure that they commission services that identify people taking medicines who would benefit from a structured medication review. Where the need and purpose is clear, structured medication reviews should be carried out with patients who agree to attend.

What the quality statement means for patients, service users and carers

People who may benefit from a structured medication review of their medicines are invited to talk about this with their healthcare professional. They might be asked because they are taking several medicines or are taking medicines for long‑term conditions. The review can help to identify any medicines that are no longer needed or any that need the dosage changed. The healthcare professional should listen to the person's views and take these into account. They should also think about whether the person has had or has any risk factors for developing adverse drug reactions and whether any monitoring is needed.

Source guidance

Definitions of terms used in this quality statement

Structured medication review

A structured medication review is a critical examination of a person's medicines with the objective of reaching an agreement with the person about treatment, optimising the impact of medicines, minimising the number of medication‑related problems and reducing waste.

[Medicines optimisation: the safe and effective use of medicines to enable the best possible outcomes (2015) NICE guideline NG5]

Equality and diversity considerations

Healthcare professionals should recognise that people's ability to understand the importance of medication reviews may differ, and ensure that people are supported to understand the purpose and benefits of a structured medication review. Healthcare professionals should take into account that people may need additional support to understand the issue, for example, if English is not their first language or if they have communication or sensory difficulties.