Medicines Optimisation – the meaning of guidelines

The Royal Pharmaceutical Society published their guidelines with the support of a range of professional bodies and organisations. But what does it all mean and how will the changes play out.

It’s all  a bit vague for me. Nice ideas, but what are the instructions for healthcare professionals? What do I have to do differently? So here is a quick overview of instructions:

Prescribers – need must better engagement with patients. It is their disease – so the problem and the solution is in their hands. Medicines are not always the best solution and usually they represent only a part of the care package required. So prescribers must understand what the patient goals actually are. I have blogged on this looking at goals for diabetes – have a quick look. This is absolutely fundamental – if we start wrong then it’s catch up all the way.

Pharmacists – we also need to understand patient goals and dig deeper into data. If we understand what is really important to patients then we can match treatments to this. We need to present medicines in terms of patient goals and not service goals. This will help prescribers help patients to choose medicines that are most likely to achieve their goals.

All Healthcare Professionals must recognise the patient medication experience. I have blogged about this before also, but we have a number of important points in the experience. How medicines are presented to patients, when they feel the effects, when they reflect on the long term use and when they decide what to do. At every point patients may need to access a healthcare professional or other patients to discuss things.

Pharmacists and prescribers must put in place systems that ensure the safe use of medicines. We have talked for ages about medication review and reconciliation and critical incident reporting, but to be honest, where these have been driven in secondary care, they lag behind in primary care. Lots to do.

Patients – well you have a part to play as well. It’s not your fault, but you do have to speak up and remind us all that you are the patient, you are usually the primary carer, the condition is yours, the goals are yours and no solution works without you.

Community pharmacy. Many patients who actually want to take their medicines have difficulty – you are there to sort their problems. You are also a constant ear. Ask patients how they are getting on with their treatment, learn about treatments and use your skills to advise. Be there when the patient wants to stop smoking, lose weight, eat better or needs support to self care.

So there is a lot to do and we all have a role to play


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