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Developing Local Guidance

Once a high level strategy has been defined, further work will be needed to develop detailed local guidance on review procedures.
 
This needs to cover:
  • How patients will be identified for review
  • The procedure for the review (there may be more than one type of review to meet the needs of different patients at different times, such as an annual clinical medication review with a prescription review every six months)
  • How patients will be informed and involved in treatment decisions
  • Who will carry out the reviews
  • How recommendations will be communicated to the prescriber and actioned, if the review is not by the prescriber
  • How reviews will be recorded and the outcome of reviews shared between professionals and with the patient. (Not all primary care and community staff have access to clinical records. Using patient-held shared health and social care records may be one potential approach)
  • How changes will be monitored.
 
There may be a need to develop tools to support the new process such as standard forms and letters and a patient satisfaction survey. This website contains a set of proforma tools which have been used in practice and collated for this project by the Pharmacy Practice Group at the University of Leeds. They can be downloaded and tailored for local use. It also includes a library of tools developed and used by a range of organisations in their own medication review processes.
 
TOOLS AVAILABLE TO DOWNLOAD
 
  • List of questions/areas to be covered in a medication review and information sources
  • Medicine monitoring guide for the reviewer, to highlight risks/issues with particular medicines
  • Compliance assessment tool
  • Leaflet/information sheet for patients
  • What a medication review is
  • Questions to ask in the review
  • Patient-held medication reminder chart
  • Patient experience questionnaire.
 
Visit the Tools Directory
 
Depending on the types of review that are used (section 3), thought may also need to be given to how the reviewer will access patient information without compromising confidentiality, how recommendations will be communicated to prescriber and patient, and how any resulting changes will be monitored. Particular thought needs to be given to how patients are to be involved in reviews and how their views are to be given precedence in treatment decisions. This is always a challenge, and may be particularly difficult where reviews are carried out without the patient being present.

 
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