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Polypharmacy

Keith Ridge to lead government review of 'problematic polypharmacy' in the NHS

A review into overprecribing in the NHS will look at ways to reduce the problem, including making handover notes more efficient, increasing the role of digital technology and improving management of repeat prescriptions.

Keith Ridge, NHS England’s chief pharmaceutical officer

Source: Jeff Gilbert

Keith Ridge, NHS England’s chief pharmaceutical officer, will lead a review into over-prescribing in the NHS

The government has ordered a review of overprescribing in the NHS to improve the safety of patient care.

The review, which will be led by Keith Ridge, chief pharmaceutical officer of NHS England, will also look into improving the efficiency of patient handover notes between primary and secondary care and will investigate the role of digital technology in reducing overprescribing.

In a statement, the Department of Health and Social Care (DHSC) said the review “will look at addressing ‘problematic polypharmacy’ — where a patient is taking multiple medicines unnecessarily”.

It added that the review will also seek to improve the “management of non-reviewed repeat prescriptions — including encouraging patients to ask questions about their treatment to ensure they don’t remain stuck on repeat prescriptions which are no longer needed”.

According to the 2016 Health Survey for England, nearly half of patients aged over 75 years were taking five medicines or more.

Sandra Gidley, chair of the English Pharmacy Board at the Royal Pharmaceutical Society (RPS), said: “We know that taking lots of different medicines can sometimes cause problems for people, particularly for those living with many long-term conditions.

“As people are living longer, often with complex and multiple conditions, the role of pharmacists in reviewing people’s medicines and ensuring they are on the most appropriate medicines for their conditions will become increasingly important.”

She added: “By working closely with other health professionals this initiative will help make sure that patients are taking the right medicines at the right time and not taking medicines that they do not need.”

The DHSC has said the review will focus particularly on situations where prescriptions for different medications potentially overlap, treating the same condition, as well as considering circumstances where conditions could be better managed by other forms of care, such as social prescribing.

Ridge said: “NHS England’s recent successes in reducing unnecessary antibiotics and medicines [in] care homes and GP practices, on polypharmacy, and on beginning to end overmedication for people with learning disabilities, all show what can be — and indeed now is being — done on this important topic.”

The review will sit alongside other government initiatives aimed at improving prescribing practices, such as the medicines safety programme, which is working on reducing medication errors, and NHS England’s medicines value programme, which is looking at cutting variation in prescribing.

Matt Hancock, health and social care secretary, said that polypharmacy “can lead to serious issues for patients such as increased admissions to hospital or antibiotic resistance”.

He added: “As we invest an extra £20.5bn a year into our NHS we want to empower doctors and pharmacists to use the data available to ensure patients get the medicines they need and stop taking those that no longer benefit them.”

NHS spending on medicines in England has grown from £13bn in 2010/2011 to £18.2bn in 2017/2018, according to DHSC estimates, with more than 1 billion prescription items dispensed in primary care by both GPs and pharmacists.

Citation: The Pharmaceutical Journal DOI: 10.1211/PJ.2018.20205875

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