Medication review

If you are currently, or have been, enrolled on the NHS England funded Clinical Pharmacists in General Practice, Medicines Optimisation in Care Homes or Primary Care Pharmacy Education Pathways you should not enrol on this SMR e-course. The reason for this is that the learning on these pathways will already have given you the skills and knowledge you need to provide SMRs under the specification of the Network DES.

Please note, to provide Structured Medication Reviews under the terms of the Network Contract Directed Enhanced Service (DES) "pharmacists must have completed – or at least be enrolled on – the Primary Care Pharmacy Educational Pathway (PCPEP) or a similar training programme that includes independent prescribing" and so participating in this e-course alone will not enable you to comply with this requirement.

The aim of this course is to equip you with the knowledge, skills and behaviours that you need to begin undertaking person-centred structured medication reviews.

This e-course will begin on the following dates:

• 16th January 2023

This Structured medication review e-course is no longer associated with an e-assessment. The original e-assessment has been withdrawn and we are currently undertaking a review process in order to determine the most suitable approach to support you to evaluate your learning as a result of undertaking the e-course. Please refer back to this page for updates.

Learning Outcomes:

• describe the importance of shared decision making and recognise its value in the structured medication review process
• identify gaps in the information needed to undertake structured medication review
• use evidence-based reference sources appropriately to support clinical decision making
• demonstrate clinical knowledge of the most commonly used medicines in the treatment of long-term conditions
• develop an appropriate level of clinical judgement and skills to provide prioritised recommendations to a prescriber resulting from a structured medication review.

This programme aims to help you to develop your knowledge and skills to improve your confidence and competence in working with patients and other health and social care professionals to enable patients to get the best possible outcomes when they are taking multiple medicines.

Learning Outcomes:

• explain the terminology associated with polypharmacy and what it means for patients and the health and social care team
• list the causes and consequences of polypharmacy in relation to the patient, their carer and the wider NHS
• identify medicines that cause problems for patients with polypharmacy and triggers that may indicate that polypharmacy is problematic
• explain the main considerations when stopping a patient's medicines, what barriers might exist and how to overcome these
• describe how you could use decision-making tools and strategies to support your practice when consulting with patients on multiple medicines
• explain how you could undertake patient-centred discussions about polypharmacy with patients during a medication review or medicines use review
• work in partnership with the patient to prioritise interventions and agree referral strategies
• identify and apply suitable resources and tools to support you in identifying polypharmacy issues and solutions as part of your clinical judgement and experience
• describe the process of shared decision-making and recognise its value in supporting adherence in patients taking multiple medicines
• identify a change you could make to your practice to improve your approach to managing polypharmacy.

This is a downloadable programme that enables you to describe the key communication and consultation skills and techniques required for person-centred care. You will learn how to explore a person’s beliefs, ideas, concerns and expectations and tailor the consultation to help them get the best from their medicines and to make informed health and lifestyle choices. The programme also develops your skills in engaging the person in shared decision making and enabling them to be a true partner in the consultation.

Learning Outcomes:

• explain the concept of patient-centred care
• describe the key communication and consultation skills and techniques required to conduct patient-centred care
• apply methods to assess your own practice and identify areas of improvement
• support patients, by using a patient-centred approach, to help them get the best from their medicines and/or in making healthy lifestyle choices
• further develop your practice by exploring tools and techniques, such as health coaching.

This guideline covers safe and effective use of medicines in health and social care for people taking 1 or more medicines.

This guideline covers optimising care for adults with multimorbidity (multiple long-term conditions) by reducing treatment burden (polypharmacy and multiple appointments) and unplanned care.

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The Consultation skills for pharmacy practice (CSfPP) website has been developed in association with Health Education England to support pharmacy professionals in developing patient-centred consultation practice; it presents a six-step learning and development pathway with useful tools and resources to support personal reflection, learning and assessment.

You can access this website here: Consultation skills for pharmacy practice

Learning Outcomes:

• explain why consultation skills are important for all pharmacy professionals
• recognise your professional responsibility to reflect on and develop your consultation skills, by working towards the new practice standards
• establish how productive your consultation skills are currently and identify key areas on which to build your expertise
• describe and apply the key skills, models and techniques that support a patient-centred approach to your consultation practice
• engage in the CSfPP assessment process to review your learning and development effectively
• explore how you can continue to develop your skills and behaviours in practice.

In this programme you will consider what is different about consulting with people with mental health problems. You will also recognise the impact of stigma and discrimination experienced by those with mental health problems and how to adapt your consultation style to address their needs and concerns.

Learning Outcomes:

• describe the mental health treatment gap and the importance of parity of esteem (valuing mental health equally with physical health)
• recognise the impact of stigma and discrimination experienced by those with mental health problems
• select the key national practice standards most applicable to pharmacy consultations with people with mental health problems
• reflect on your consultations with people experiencing mental health problems
• maximise the effectiveness of your consultations in this field by applying person-centred skills and behaviours
• identify possible risks in your consultations with people with mental health problems.

This report proposes a pragmatic approach, offering the terms ‘appropriate’ and ‘problematic’ polypharmacy to help define when polypharmacy can be beneficial.