💊

NICE Guidance on Medicines Optimisation

Mar 17, 2025

NICE Guidance on Medicines Optimisation

Key Principles

  • Patient Involvement: Individuals have the right to participate in discussions and make informed decisions about their healthcare.
  • Use of NICE Guidelines: Provides clarity on prescribing practices, including off-label use, and emphasizes informed decision-making.
  • Evidence-Based Guidance: Recommendations are informed by the best available evidence.

1.3 Medicines Reconciliation

  • Definition: Process of ensuring an accurate list of a person’s medications, including over-the-counter and complementary medicines, is maintained and communicated.
  • Acute Setting (1.3.1): Conduct reconciliation within 24 hours when transitioning between care settings.
  • Multiple Reconciliations (1.3.2): Required during hospital stays at admission, ward transfers, or discharge.
  • Primary Care (1.3.3): Reconciliation post-hospital discharge should occur within one week.
  • Organizational Responsibility (1.3.4): A designated health professional should oversee reconciliation processes.
  • Competency (1.3.5): Professionals conducting reconciliation should be trained and competent.
  • Patient Involvement (1.3.6): Involve patients and carers in the reconciliation process.
  • Documentation (1.3.7): Record information electronically or on paper.

1.4 Medication Review

  • Purpose: Structured, critical evaluation to optimize medication use and reduce waste.
  • Target Groups (1.4.1): Includes those with polypharmacy, chronic conditions, or older individuals.
  • Health Professional Role (1.4.2): Led by a qualified individual with technical, therapeutic, and communication skills.
  • Considerations During Review (1.4.3): Include patient views, concerns, all medications, and safety assessments.

1.5 Self-Management Plans

  • Definition: Plans supporting individuals in managing their conditions using medicines.
  • Discussion Points (1.5.1): Include knowledge, benefits, risks, preferences, plan usage, and support needs.
  • Plan Content (1.5.2): Should detail start/review dates, medicines, allergies, and when to seek professional advice.
  • Review (1.5.3): Ensure no issues with plan usage.

1.6 Patient Decision Aids

  • Role: Facilitates shared decision-making, enhancing patient involvement in their healthcare.
  • Patient Involvement (1.6.1): Offer opportunities for decision-making participation.
  • Values and Preferences (1.6.2): Understand and respect individual values/preferences.
  • Use in Consultations (1.6.3 - 1.6.5): Apply evidence-based medicine principles and use decision aids appropriately.
  • Training (1.6.10): Healthcare professionals should be trained to use decision aids effectively.

1.7 Clinical Decision Support

  • Definition: Integrated IT systems to support decision-making and prescribing.
  • Considerations (1.7.1 - 1.7.4): Systems should support but not replace clinical judgement, include safety alerts, and be up-to-date.

Terms Used in Guidance

  • Adverse Drug Reaction: Unintended response to a medicinal product.
  • Complementary Medicine: Non-mainstream treatments.
  • Over-the-Counter Medicines: Can be bought without a prescription.
  • Polypharmacy: Use of multiple medications.
  • Preference-Sensitive Decision: Based on patient preferences and values.