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Repeat prescribing and medication reviews blamed for overprescribing

Report highlights role of systemic and cultural factors

September 24th 2021

Tagged: Clinical guidance news Dispensary guidance news England

By Ailsa Colquhoun

Lack of a standard approach to repeat prescriptions and ineffective review are among the reasons for overprescribing, a report  by England’s chief pharmaceutical officer has found.

Good for you, good for us, good for everybody:  A plan to reduce overprescribing to make patient care better and safer, support the NHS, and reduce carbon emissions finds that  repeat prescriptions can be issued for months, even years, without effective review. The report estimates that at least 10 per cent of the current volume of medicines may be overprescribed. Currently, around 15 per cent of people in England take five or more medicines a day, with 7 per cent on eight or more.

The review also notes that overprescribing is a serious problem in health systems internationally that has grown dramatically over the last 25 years. The main causes of overprescribing fall into two categories:

  • systemic: key factors are single-condition clinical guidelines, a lack of alternatives to prescribing a medicine, a need for on-going review and deprescribing to be built into the process of prescribing, inability to access comprehensive patient records, lack of digital interoperability, and pressure of time
  • cultural: a healthcare culture that favours medicines over alternatives and in which some patients struggle to be heard

To reduce overprescribing, the report recommends greater shared decision-making with patients, better guidance and support for clinicians ,more alternatives to medicines, such as physical and social activities and talking therapies, and more Structured Medication Reviews (SMR) for those with long-term health conditions.

Chief Pharmaceutical Officer for England Dr Keith Ridge said: “Medicines do people a lot of good and this report is absolutely not about taking treatment
or services away from people where they are effective. But medicines can also cause harm and can be wasted. Building on important initiatives now underway, including the rapid expansion of clinical pharmacists alongside GPs, and the scaling up of social prescribing, this report shows how the NHS can make the most of a once in a generation opportunity to reset prescribing in a new, patient-centred way.”