Structured Medication Review resources boost patient engagement and improve the quality of consultations

It’s one year since the Health Innovation Network launched its NHS-branded patient information materials to support people invited for Structured Medication Reviews (SMRs) with healthcare professionals. The Network is now funding 25 Primary Care Networks (PCNs) in high-deprivation areas to promote SMRs, supporting NHS efforts to reduce healthcare inequalities.

New findings from two pilots with CORE20 PCNs in Greater Manchester and Nottingham indicate that the resources improved the quality of consultations and increased interventions to address problematic polypharmacy (1). The materials were tested with 269 patients (1). The participating practices included some of the most deprived 20% of the national population in England, with high levels of polypharmacy and language being a significant engagement barrier.

Patients in the pilots reported that the materials helped them to think about their medicines before their appointment, saying that they helped them feel more secure talking about their medicines issues and that they appreciated receiving the documents in their first language. In the case of Nottingham PCN, attendance rates for Structured Medication Reviews increased by 88% (1).

Created with the University of Leeds and patients, these free resources help improve medicine consultations and shared decision-making. The materials, now available in 12 languages with easy-read versions and animations, are particularly aimed at helping patients taking multiple medicines who may face challenges with polypharmacy.

Speaking of the impact of the patient information materials, Sarah Hafeez, Advanced Medicines Optimisation Pharmacist for NHS Greater Manchester Integrated Care Board, said: “The introduction of the patient information materials has helped to break down language and communication barriers with the aim of enabling our clinicians to have better conversations with patients about their medicines and improving the process of shared decision-making. Patients are coming more prepared, resulting in more meaningful conversations about their medicines. I am looking forward to seeing the benefits that their continued use will bring.”

 

Amy Semple, Health Innovation Network National Programme Manager for Polypharmacy, added: “We are delighted to find that the patient information materials are making such a positive difference – helping to breakdown communication barriers, address health inequalities and improve the outcomes of Structured Medication Reviews. We are excited to now also be funding 25 PCNs in areas of deprivation to encourage the targeted uptake of Structured Medication Reviews with more marginalised communities, through the use of the patient information materials.”

Healthcare professionals can access these materials, including invitation letters, leaflets, and animations on the Health Innovation Network website.

What are SMRs? 

Structured Medication Reviews are the best tested intervention for reducing problematic polypharmacy (2). However, studies (3) also show that most patients do not understand what a Structured Medication Review is and receive limited, if any, information to help them understand or prepare for their appointment.

People who may benefit from a Structured Medication Review are those who are taking multiple medicines (usually for a number of long-term conditions) and may be experiencing the problems that can be associated with polypharmacy. A Structured Medication Review has been shown to help to identify medicines that are no longer appropriate for such patients or that may need a change in dose.

Research has shown an increased risk of problematic polypharmacy for older patients and those from poorer backgrounds (2). A higher proportion than average of Black, Asian and Minority Ethnic populations are taking eight or more medicines (2).

Patient materials 

These innovative patient information materials help patients to understand the process, empower them to get the most out of their Structured Medication Review 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.

The resources include a Patient Structured Medication Review Invitation Letter; Stopping Medicines Safely Leaflet; Me and My Medicines and Are Your Medicines Working patient information leaflets; a patient-facing animation and an animation for GP waiting rooms. The resources are available in 12 community languages, including easy read and audio versions. Further information about the patient information materials and how they can be accessed can be found here.

References

(1) Lad, B. A campaign to help patients discuss their medicines nearly doubled our medication reviews. The Pharmaceutical Journal, PJ, May 2024, Vol 312, No7985;312(7985) https://doi.org/10.1211/PJ.2024.1.314200

(2) Department of Health & Social Care: Good for you, Good for us, Good for everybody. 2021.

(3) Okeowo, D et al. Barriers and facilitators of implementing proactive deprescribing within primary care: a systematic review, International Journal of Pharmacy Practice, Volume 31, Issue 2, April 2023, Pages 126–152, https://doi.org/10.1093/ijpp/riad001