Polypharmacy Community of Practice: Preparing patients for a Structured Medication Review

Health Innovation KSS, supported by colleagues from Medway Valley Primary Care Network (PCN) in Kent and Medway and Southview Practice in Surrey Heartlands, recently facilitated a Community of Practice shared learning event to help clinicians to prepare patients for a Structured Medication Review (SMR).

An SMR is defined by NICE as a critical examination of a patient’s medicines with the objective of reaching an agreement with the patient (or their carer) as part of a shared decision-making process about treatment, optimising the impact of medicines, minimising the number of medication-related problems and reducing waste.

The Community of Practice provided an opportunity to share patient information materials developed by the Health Innovation Network through the national polypharmacy programme and showcase examples of where they have been used in practice.

Developing materials to support SMRs

The materials have been designed to help patients to understand the processes, empower them to get the most out of their SMR and support them with any changes to their medicines. Work to date has shown that the use of these materials is helping to remove barriers to engagement with patients in communities that traditionally may not have taken up the invitation to review their medicines. Further information about the patient information materials and how they can be accessed can be found here.

Supporting SMRs in seldom heard community groups

In Kent, Surrey and Sussex two sites were funded to utilise the materials with a seldom heard community group and record any changes to the uptake of SMRs along with clinician and patient feedback.

Medway Valley PCN in Kent and Medway focused on patients from ethnic minority groups and Southview Practice in Surrey Heartlands focused on patients with Learning Disabilities. Both sites shared a case study which will form part of a national evaluation.

Highlights of the Southview Practice case study include:

• A 30% increase in attendance at SMR appointments in the cohort of patients with Learning Disability
• Clinicians reported that, as a result of the intervention, they were able to stop or reduce a number of medicines during the project period.
• One carer said the resources helped them to raise concerns about some of the medicines the patient they cared for was prescribed.

Highlights of the Medway Valley PCN case study include:

• the intervention led to 17 medicines being changed, reduced or stopped.
• The impacts included reducing the anticholinergic burden score, changes to opioids and antidepressants, changes to improve kidney safety and stopping statins.

Both sites intend to continue using the resources for all patients invited for an SMR in future.

You can access the full case studies to find out more:

Southview case study

Medway Valley study

Community of Practice

46 clinicians including GPs, clinical pharmacists, Advanced Clinical Practitioners (ACPs) and pharmacy technicians joined the online Community of Practice. During the session Health Innovation KSS emphasised the importance of SMRs and shared the Health Innovation Network resources available to support clinicians and patients navigating the process.  Delegates were able to hear the examples where they have been used in practice with seldom heard communities and given the opportunity to ask questions to support adoption of the materials within their own practice.

If you’d like to find out more about our Polypharmacy or Medicines Optimisation work, please get in touch.