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  Don Lavoie is alcohol programme manager at Public Health England and Gul Root is lead...
Don Lavoie is alcohol programme manager at Public Health England and Gul Root is lead pharmacist, Health and Wellbeing Directorate, Public Health England
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medicines-shelvesMarch 11 2015

NICE has issued new guidelines on medicines optimisation. The online document, NG5, “offers best practice advice on the care of all people who are using medicines and also those who are receiving suboptimal benefit from medicines,” says NICE.

NG5 updates and replaces recommendation 1.4.2 in the NICE guideline on medicines adherence and it replaces PSG001 ‘Technical patient safety solutions for medicines reconciliation on admission of adults to hospital’, issued in 2007.

The guidance sets out a list of key priorities for implementation as well as recommendations for practice and research. One of the key priorities is the need for medicines-related communication systems for when patients move from one care setting to another.

“Health and social care practitioners should share relevant information about the person and their medicines when a person transfers from one care setting to another,” it says. This should include, but is not limited to, all of the following:

•    contact details of the patient and their GP
•    details of other relevant contacts identified by the person, such as other family members of their nominated community pharmacy
•    information about known drug allergies and reactions to medicines/excipients
•    details of all current medication (prescribed, OTC, and complementary/alternative) - “name, strength, form, dose, timing, frequency and duration, how the medicines are taken and what they are being taken for”
•    any changes to medicines and the reasons
•    date and time of the last dose, such as for weekly or monthly medicines, including injections
•    what information has been given to the patient and/or their carers
•    other information such as “when the medicines should be reviewed, ongoing monitoring needs and any support the person needs to carry on taking the medicines.”

NICE also recommends: “Consider sending a person's medicines discharge information to their nominated community pharmacy, when possible and in agreement with the person.”

Other priorities are to make sure that organisations consider using multiple methods to identify medicines-related patient safety incidents. Organisations should also make sure medicines reconciliation is carried out “by a trained and competent health professional – ideally a pharmacist, pharmacy technician, nurse or doctor.”

As well as knowing about what the medicines therapeutic uses are and how the medicines need to be managed, these people should also have effective communication skills, it says.

Included in the recommendations is further guidance on medicines-related communication systems, medicines reconciliation, medication review, self-management plans, patient decision aids, clinical decision support and medicines-related models of organisational and cross-sector working.

The Royal Pharmaceutical Society issued its own guidance on medicines optimisation in 2013. Liz Butterfield, RPS England Pharmacy Board lead for Medicines Optimisation, said: “We welcome this guideline that asks pharmacists, doctors and nurses to discuss and pay attention to people’s wishes about treatment.

“The Royal Pharmaceutical Society’s principles of medicines optimisation are reflected in this guideline and emphasise that decisions about treatment must be shared between patients and healthcare professionals.”

Links:

NICE Guidance NG5    

RPSGB comment    

RPSGB ‘Medicines Optimisation: Helping patients to make the most of medicines’ 2013    

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