When speaking to patients about their medicines, health care professionals should review whether therapy is appropriate and still being adhered to. Pharmacy based services such as medicines use reviews are adherence-centred reviews with patients on multiple medicines, particularly those receiving medicines for long term conditions. Clinical medication reviews are a critical examination of a patient’s medicines with the objective of reaching an agreement with the pa-tient about treatment, optimising the impact of medicines, minimising the number of medication-related problems and reducing waste.
Medicines optimisation may include stopping a treatment. Medicines should be stopped on an individual basis if:
- there is no valid or relevant indication for prescribing as assessed by changes in symptoms, signs, laboratory and diagnostic test results.
- the known possible adverse drug reactions outweigh the possible benefits.
- there is a risk of cumulative toxicity if particular medicines are taken together.
- the patient is choosing to not take/use the medication as prescribed or intended.
- unlicensed medicines (‘specials’) are being prescribed when an alternative medicine or formulation will provide the same therapeutic benefit.
- non-drug measures can provide benefit, without adverse effects.