Department of Health Skip to content

Please note that this website has a UK government access keys system.

You are here:

9. Medication Review

No image map

9.1 Medication review has been defined as: 'A structured, critical examination of a patient's medicines with the objective of reaching an agreement with the patient about treatment, optimising the impact of medicines, minimising the number of medication-related problems and reducing waste' (8).

9.2 The report of the national clinical audit of Sudden Unexpected Death in Epilepsy (SuDEp) found inadequate medicines management in 47% of deaths in children (9). Aspects identified include prescribing of inappropriate drugs and doses, and lack of regular medication reviews. The audit also found that children and parents received insufficient information, especially about the side effects of medicines and the possibility of sudden death from epilepsy.

9.3 There is good evidence to show that medication reviews can improve safety, enhance appropriateness of prescribing and reduce unnecessary use of medicines resulting in improved health outcomes. Medication reviews can identify inappropriate doses being prescribed (too high or too low), side effects that a patient may be experiencing, the information needs of patients, and when to change or stop treatment.

9.4 A concordant discussion during a medication review can provide an opportunity to discuss reasons for non-compliance with prescribed medicines. Medication reviews also provide an opportunity to carry out a wider review of the patient's clinical condition, which may involve different health professionals. The Medicines Partnership has developed a medication review guide for both professionals Room for Review 8 and patients/parents Focus on your Medicines - a patient guide to medication review (10).

9.5 Reviewing and improving repeat prescribing systems, which identify when a medication review needs to be carried out, can be beneficial for patients. The National Prescribing Centre published Saving time, helping patients: A good practice guide to quality repeat prescribing (11) in January 2004, a resource to help general practices to review their repeat prescribing processes and to develop services that are efficient, effective, safe and convenient for patients, carers, and healthcare staff. This guide has been commended by the Royal College of General Practitioners and the General Practice Committee Prescribing sub-committee of the British Medical Association.

9.6 It is important that medication histories take account of the use of complementary therapies. Parents may feel discouraged from discussing complementary therapies in consultations with health professionals, resulting in incomplete medication histories.

Primary Care Trusts and NHS Trusts ensure that:

  • All children with epilepsy have regular medication reviews (in line with the SuDEp recommendation);
  • Mechanisms are in place for regular review of medicines used to treat children and young people with complex, long term conditions;
  • There is equitable access to medication reviews, where appropriate, for children in all settings including children's homes and young offenders institutions, and
  • Professionals taking medication histories ensure that the use of complementary therapies is taken into account.

Access keys