Medication review provides an important opportunity to discuss medicine taking and to work towards concordance.  There is considerable activity around the county on medication review as the NHS strives to meet the standard set out in the NSF on Older People. The quality of this activity is variable and patient involvement is often limited.

 

Standards for medication review All people over 75 years should normally have their medicines reviewed at least annually and those taking four or more medicines should have a review 6 monthly.   These standards should be achieved by April 2002

 

A wide variety of approaches to medication review is being employed, as there is no single agreed definition of what a review should consist of, nor who should carry it out.  Significantly and disappointingly, from the concordance perspective, not all medication review currently as carried out involves patients. It may simply consist of a pharmacist reviewing the patient record and making recommendations to the prescriber, if appropriate.  This is clearly a great deal better than nothing at all.  However, such an approach relies on information about what the patient theoretically ought to be taking as per the formal record, and takes no account of the patient’s own experience of their medication, their attitudes and preferences, and, crucially, what medicines and doses they are actually taking.

 

Medicines Partnership and the national Medicines Management Collaborative Programme carried out a joint project to publish a succinct, practical guide to medication review.  The aim of the project is to assist local organisations to improve the quality and patient-focus of their medication review, recognising that they are starting from very different points.

 

Project outputs include

 

These are now available on-line, visit the Medication Review pages.