Medicines Optimisation

Medicines optimisation is a patient-focused approach to getting the best from investment in and use of medicines.  It requires a holistic approach, an enhanced level of patient centred professionalism, and partnership between clinical professionals and a patient.

Shared decision-making (SDM) is an essential part of evidence-based medicine, seeking to use the best available evidence to guide decisions about the care of the individual patient, taking into account their needs, preferences and values.  SDM supports person centred, alongside care planning and self-management. For further information and resources to support person centred care see link

Medicines optimisation approach requires multidisciplinary team working. Healthcare professionals will need to work together to individualise care, monitor outcomes, review medicines appropriately and support patients when needed.

Below is a selection of resources that can support medicines optimisation.

General principles 

NICE NG5- Medicines Optimisation Guidance

NICE Multimorbidity guidance - September 2016

NPC - Medication Review Guidance - A guide to medication review - March 2008 This document from 2008 continues to provide a framework for medication review in a variety of settings, including primary care. It details the involvement of patients/carers in the medication review to enable partnership in decision making about medicines.

Clinical decision support tools

PrescQIPP IMPACT (Improving Medicines and Polypharmacy Appropriateness Clinical Tool) tool - March 2016

STOPP/Start version 2

STOPPFrail (Screening Tool of Older Persons Prescriptions in Frail adults with limited life expectancy): consensus validation (see table 1 under results for agreed STOPPFrail criteria)

Royal College of General Practitioners - Prescribing Safety Indicators - 2014

PrescQIPP - Medication and falls - December 2014

NHS Scotland - Anticholinergic Burden Scale (There is no single standard anticholinergic burden scale, this is an example that may aid medication reviews)

Resources to support patient decision making

NICE - Shared decision making

NICE - patient decision aids

Patient Info - Decision aids

Also see Me and My Medicines.  The Me and My Medicines campaign encourages patients, families and carers to ask questions about their medicines so that they can be helped to get the most benefit and make informed shared decisions.  This leaflet  can be used in consultations to support conversations.

Patient information leaflet to support: 

Polypharmacy and deprescribing resources

General resources

Multimorbidity and frailty and moving towards end of life

Tools to help with review

Medicines adherence

Last updated on 20/09/2021 by KerryWade