• Guidance for medics on multi-pill prescriptions

    NHS Highland has produced new guidance to help GPs and hospital doctors review patients who take a large number of different prescribed drugs at the same time.
    NHS Highland Consultant Physician in Medicine for the Elderly, Dr Martin Wilson, said: “Some patients can be on a long list of drugs, so it’s important we check and review what they are taking and make sure patients are on the best and safest combination. For example, a drug that was right when it was first prescribed many years ago may no longer be helping.”
    Dr Wilson added: “ Some patients may be putting up with side effects quite unaware they are linked to a drug or combination of drugs they are taking. In other cases, the drug they are on may no longer be needed. The patients who benefit most from these reviews are those taking 10 or more drugs and those whose health is most vulnerable, including care home residents.”
    Thomas Ross, who is Lead Pharmacist for South East Highland Community Health Partnership (CHP), explained that prescribing drugs is the most common intervention in the NHS. Eight out of 10 people over the age of 75 take at least one prescribed medicine and one in three take four or more.
    Mr Ross said: “Adverse reactions to drugs can account for up to 17% of hospital admissions. Evidence has also shown that around half of all people aged 75 or over many not be taking their medicines as intended.
    “The review has to be conducted with the patient or their carer and there has to be agreement as to what is continued, what is changed and what is stopped. The review gives patients a chance to ask any questions about their medicines.
    “We need to ensure that, if a patient is taking a medicine, they are taking it for a valid reason. If not, it should be stopped. We also need to ensure that medicines are not causing patients any harm from side effects. And patients should always tell their doctor or pharmacist if they are not taking a medicine.”

    GPs have already done more than 4,000 reviews with the target of making drug prescribing as safe and effective as possible. In many of these reviews, patients have had one or more drugs stopped or changed.
    The guidance is being implemented through GP practices and by hospital doctors.