Medicines review

This is the first part of two on medicines review. The first part concentrates own the early review and the second on the later annual review.

In reading these you may feel that this supports the employment of pharmacists within general practice. It does. Medicines optimisation should be embedded into general practice. If we achieve medicines optimisation then we improve outcomes for patients. As a side effect of this we will also reduce referrals, reduce admissions, reduce waste and reduce the social burden of ill health.

The patient medication experience, presented in a previous blog suggests that the second stage of experience occurs when the patient experiences the effects of the medicine in their body. This is the time that contact should be made with the patient. It will vary with the medicine in question, but one to two weeks might be a good option for most medicines.

The opening question is again very important and links to the answer that you are after. A question like ‘how are you getting on with the medicine’ generates the answer ‘fine’ and closes down the conversation. Relate the question to the goal of the treatment. And ask about a feeling or experience that needs an explanatory response. We need an ‘open’ response that leads us seamlessly into a fuller discussion.

It may also be at this time that the patient is thinking about the duration of treatment and the control that they might take. They may want to stop it, alter it or take as prescribed. Your discussion may help them to make a decision that suites them better.

There are advantages of a pharmacist doing this early review. They have interpersonal skills and knowledge of medicines, but more importantly they are not the doctor and a patient may talk more freely and seek more information.

Embedding medicines optimisation is an important issue for the NHS.


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