NICE publishes its first medicines optimisation guidance

Draft guidelines encourage patient-centred care and improved NHS communications

The National Institute for Health and Care Excellence (NICE) has published new guidance on how NHS patients in England and Wales can achieve the full benefits of their medicines.NICE, which provides healthcare guidance for the NHS, said the draft guidelines on medicines optimisation are intended to make sure patients “get the most appropriate medicines when they are needed” in a safe manner.

The guidance encourages shared decision-making between patients and professionals in health and social care. It is a response to the UK’s ageing population and growing number of people with long-term conditions who take medicines on a regular basis, according to NICE.

Around 15 million people in England now have a long-term condition, such as heart failure and diabetes, yet 30% to 50% of medicines prescribed for long-term conditions are thought not to be taken as intended.

This lack of optimisation includes taking an incorrect dosage of medicine or taking medicines at inconsistent times, and can be down to a variety of reasons, including problems in paying for medicines, problems in acquiring medicines in rural areas and a poor understanding of treatment.

Safety concerns are particular relevant for the growing number of patients with more than one long-term condition who take a variety of medications. According to the BMJ, around 5% to 8% of all hospital admissions are due to preventable problems with medicines such as adverse effects or their interaction with other medicines or conditions.

A key part of the NICE guidance is to improve communications across care settings. According to the Royal Pharmaceutical Society, between 30% and 70% of patients have an error or unintentional change to their medicines when moving from one care setting to another.

To combat this NICE has published a list of the key information that should be known about a patient moving from one setting to another. This includes known allergies and reactions to medicines or their ingredients, and the type of reaction experienced; what medicines the person is currently taking and why; and changes to medicines, including medicines started or stopped, or dosage changes, and reasons for the change.

The draft guidance also makes recommendations about what systems HCPs can use to identify, report and learn from medicines-related patient safety incidents that are both effective and cost-effective.

The guidance adds to existing efforts to improve medicines optimisation within England’s NHS, including the launch of a dashboard to bring together health data in a one place.

Health minister Lord Howe last month made a call for community pharmacists to drive optimisation by improving their relationship with patients, while Pfizer – working with several pharmacy associations – has produced a medicines optimisation scratch card that allows patients to guide discussions with pharmacists based on their priorities.

Source PMLive http://www.pmlive.com/pharma_news/nice_guidance_to_improve_use_of_medicines_605915

NICE publishes its first medicines optimisation guidance