Optimising the structured medication review
Research type
Research Study
Full title
Medicines optimisation in general practice: an interpretive policy analysis and video-reflexive ethnographic approach to improve delivery of structured medication reviews.
IRAS ID
318490
Contact name
Nina Fudge
Contact email
Sponsor organisation
Queen Mary University of London
Duration of Study in the UK
1 years, 1 months, 27 days
Research summary
The number of medicines prescribed in the NHS is increasing. Over a third of people in England aged 80 – 89 are prescribed at least 8 medicines. Taking multiple prescription medicines (known as polypharmacy) can be problematic. The risks of taking multiple prescription medicines increase with age and with the number of medicines prescribed. Risks to patients include falls, hospitalisation, and adverse drug reactions. Problematic polypharmacy creates a burden of work for patients and clinicians: requesting and processing prescriptions, assembling and organising medicines, managing medicines supplies. Some prescribed medicines may not be needed or taken, resulting in financial waste and environmental harm.
Medicines optimisation in general practice can reduce the harms and risks of polypharmacy. In 2021, NHS England introduced a programme to reduce the harms of polypharmacy and unnecessary medicines. This includes inviting patients prescribed 10 or more medicines for a Structured Medication Review (SMR).
The evidence that SMRs can reduce polypharmacy and harmful prescribing is limited. We don't know much about what happens in a medication review, which professionals in primary care deliver them, or what patients think of them.
The aim of this study is to explore the policy of medicines optimisation in primary care and how SMRs contribute to reducing problematic polypharmacy. I will investigate who delivers SMRs in practice, and how patients and professionals make sense of the policy and act on it. I will observe and video-record professionals and patients doing SMRs in three general practices. I will then organise interviews for patients and workshops for professionals to review the short video clips, inviting them to reflect on the SMR process and what improvements could be made. This process will inform the development of guidance for practitioners to deliver SMRs to improve medicines safety.The research is funded by THIS (The Healthcare Improvement Studies) Institute.
REC name
Wales REC 4
REC reference
25/WA/0129
Date of REC Opinion
27 Aug 2025
REC opinion
Further Information Favourable Opinion