Our surgery Pharmacist, Mrs Wendy Humphris, has been with the practice for a few years now and has met many of you for medication review appointments. We thought it would be helpful to everyone to explain how we run the system of medication reviews.

Why do we do Medication reviews?

Medicines are the most common medical intervention and cost £10 billion a year, which is about 18% of NHS expenditure. Four out of five people over the age of 75 years take at least one medicine, 36% are taking four or more.

However research suggests that up to 50% of drugs are not taken as prescribed and side effects from drugs are a factor in lots of admissions to hospitals.

It is important to review what drugs you are on regularly to ensure that they remain safe, effective, cost efficient and are the right ones for you. As well as this, our dispensing contract and general medical contract require us to review patient medication regularly. For most of these reviews we must conduct face-to-face reviews with the patient.

So, medication reviews have always happened, but we have re-organised the system over the last couple of years.

When do the reviews take place?

Wendy has 15 minute appointments all day on Wednesdays and on Thursday mornings. She can do some reviews by telephone but the majority will need to be done in person.

What’s in it for you?

A medication review is an opportunity to address any problems with your medication and ask questions.

Questions you may wish to raise:

• What does the medicine do?
• Why is it important that I take this medicine, are there any other options?
• When and how should I take it?
• How long should I take it for?
• Is there anything about the medicines that I should know?
• How do I store the medicine?
• How will I know if it is helping?
• Where can I get more information?

Hopefully a medication review will help you to get the most benefit from your medicines and reduce the possibility of adverse effects.

How do we organise the reviews?

Each prescription that is on repeat has a review date on your computer record. This date appears on the portion of your prescription that is returned to you, with your medicines.

The dispensary uses this as their authorisation to issue the repeat prescription when you put in a request for more medication.

We are only able to add a date for the whole prescription and not for individual drugs on the prescription. If the date expires, then the dispensary will ask you to make a review appointment with myself, or the doctor, as appropriate. They may put a letter in your prescription bag with your drugs, to ask you to make an appointment or ask you when you telephone through a repeat request.

Sometimes when you see the doctor or speak to them on the telephone they may update the prescription if that is appropriate.

What happens at a medication review?

She will usually confirm which medicines you are taking on a regular or ‘as needed’ basis and make sure you know why that medicine is prescribed and are happy to take it.

She also usually asks about any herbal remedies or supplements you may be taking.

She will ask how well you feel the medicine works and whether you have any side effects or problem with the drugs, such as difficulty in using an inhaler or eye drops or even getting the tablets out of the foil packaging.

Practical aspects of ordering and obtaining supplies can also be discussed.

She can also get more information about the treatment or condition if you have specific questions relating to the drugs or some information you have read elsewhere or in a news item.

She is able to remove items from the screen to leave those that are currently being used, however she can not prescribe new medicines, although she will always discuss your case with the GP should queries arise during the appointment. Follow up later by letter or telephone is her usual course of action if required.

The review date on the prescription will be extended as appropriate, usually for 12 months but circumstances vary.

She will offer medication support where necessary such as reminder charts or dossett boxes or other appliances. She can also provide written information or point you to other internet based information.

She will ensure that you have had the right monitoring tests, which might be a blood pressure check, diabetic or asthma review or sometimes a blood test and will ask you to make appointments for these where necessary.

She can take blood pressures and do inhaler checks within these appointments.

It has not been possible to always match up the medication reviews with the annual reviews for certain conditions so the two things may happen separately.

She makes a record of the review in your notes so it is available to other practice staff as appropriate to ensure smooth management of your care.

You can ask for a medication review before the expiry date on your prescription if there is anything in particular you wish to discuss.

We hope this has helped to explain our system of calling people for medication reviews. It is important that you take your medication regularly and request further supplies before you run out, allowing 2 working days from request to receipt of medicines. If you have a review appointment already booked, please tell the dispensary staff when you request your prescription, especially if your review date has already expired.