Four Guiding Principles for Medicines 0ptimisation

Medicines optimisation is about evaluating and measuring the effectiveness of medicines prescribed to an individual. It helps to prevent over-prescribing, engage patients in their own healthcare planning and monitor patient progress.

In order to empower patients and the public in making the most of their medication, it’s essential that healthcare professionals understand the concept behind medicines optimisation. The four guiding principles we look at in this article describe medicines optimisation in practice, and how they impact outcomes. The principles meet current national guidance and good practice guidance regarding medicines optimisation.

 Principle 1

Understand the patient’s experience

An open dialogue between yourself and the patient or their carer must exist to obtain the best possible outcomes from the medicines they take. It must be emphasised that the patient indeed has a choice about their medication, playing an active role in the management of their own condition. Clinicians must also recognise that a patient’s experience may well change over time, even if the medication itself does not. 

 What are the intended outcomes of this principle?

• Patients can make more informed choices about their lifestyle, healthy living and the medication they take
• Improved engagement with patients
• To better understand a patients’ beliefs and preferences so they can make informed decisions about their medicines and treatment plans
• Patients are able to take/use their medicines as agreed.
• Patients feel empowered to discuss their views on their medication, how it impacts their daily life and what it means to them.

 Principle 2

Evidence based choice of medicines

This is about ensuring that the most appropriate choice of clinically and cost-effective medicines (informed by the best available evidence base) are made that best meets the patient’s needs.

 What are the intended outcomes of this principle?

• Using the best evidence available to bring about optimal patient outcomes. This could for example mean following NICE guidance, local formularies etc. Outcomes must also be measured
• Any medicines no longer needed are stopped, as are treatments where the value to the patient is limited
• Decisions about access to medicines are transparent and in accordance with the NHS Constitution.

 Principle 3

Making sure medicines are as safe as possible

It’s the responsibility of all clinicians and healthcare professionals to make sure their patients are using their medication as safely as possible. This includes avoiding or limiting side effects and interactions. There must also be safe processes and systems in place, along with effective communication between professionals. 

 What are the intended outcomes of this principle?

• Patients are more confident in taking their medicines
• There’s less chance of avoidable harm occurring
• Patients remain well and there is a reduction in admissions and readmissions to hospitals related to medicines usage
• Patients feel more confident in asking for help with their medicines if required
• Patients discuss potential side-effects and there is an increase in reporting to the Medicines and Healthcare products Regulatory Agency (MHRA)
• Patients take medicines they no longer need to community pharmacies so they can be safely disposed of
  
   

Principle 4

Making medicines optimisation part of routine practice

This is about strongly encouraging healthcare practitioners to routinely discuss their patients’ treatments and outcomes with each other and with the patients/carers themselves. Again, the concern is in achieving best patient outcomes.

 What are the intended outcomes of this principle?

• Patients can freely and easily discuss and review their medicines with those involved in their care
• Patients receive consistent messages about their medicines due to effective team liaison
• It becomes routine practice to signpost patients to further help with their medicines and to local patient support groups
• Less medication is wasted
• Communication between healthcare professionals and agencies regarding patient medication is improved
• The NHS benefits from better value for money invested in medicines
• The impact of medicines optimisation is routinely measured

Do you feel confident in understanding NHS guidance around medication reviews?

Every time a patient’s medicines are changed, stopped, or increased, their medications should be reviewed. This however presents challenges for clinicians. In our in-house Medication reviews, structured medicines reviews (SMRs), medicines optimisation and deprescribing course, we look to help practitioners tackle these challenges.

The course offers guidance on identifying patients who are taking too many medications and explores the when, how and why to stopping treatment. It’s particularly aimed at clinicians who conduct SMRs or any form of medication review.

Currently being delivered in-house online, the course is worth 4 hours of valuable CPD over half a day (9am - 1pm). 

Interested in enhancing your skills as a pharmacist? The “Introduction to Telephone Consultation and Communication Skills for Medicines Review and Chronic Illness Management in General Practice” course is a one-day training events that offers practical skills in telephone consultations, medicines reviews, and chronic illness management. Don’t miss out on this opportunity to improve patient care! .  This scheduled course is worth 8 hours CPD and runs from 9:30am- 5:00pm.