Introduction
This study looks at the problems doctors and other healthcare professionals face when reviewing patients' medications. Structured medication reviews (which are shortened to SMRs in this piece), were first introduced in the UK in 2020. SMRs aim to allow healthcare professionals and patients to work together to decide on the best medicines for the patient. They also aim to reduce harm from medicines in people who take multiple medications to help manage complex health issues.
SMRs have potential to improve people’s lives, but there is limited research on how SMRs are carried out in practice. In addition, there is little research on the challenges health providers face in leading this type of review.
This study is part of the larger DynAIRx project. DynAIRx is working to create Artificial Intelligence (AI) tools that use health records, clinical guidelines, and risk models to help make SMRs quicker and easier.
Methods
Between 2022-2023, researchers spoke to healthcare professionals and patients. They held:
- 6 focus groups with doctors, pharmacists and other professionals,
- 3 focus groups with patients,
- 5 one-on-one interviews with healthcare workers.
We asked participants about their experiences of leading SMRs or receiving SMRs and what challenges they faced.
The focus groups and interviews were recorded and the researchers looked for patterns in the responses to identify common themes.
Findings
Researchers identified two key themes that make SMRs less effective:
- Problems with how SMRs are done,
- Medication-related challenges.
Specific issues included:
- Not enough staff to carry out SMRs,
- Preparation takes too long and sometimes patients need several appointments,
- Poor communication between GPs and hospitals,
- Trouble managing mental health and specific groups of medications that can cause falls,
- Patients not showing up for their appointments,
- Difficulties in talking to patients and understanding their needs.
Implications
This study highlighted the difficulties healthcare practitioners and patients face during SMRs. SMRs are complicated and may take a long time and several appointments. There is a clear need for a system that will better facilitate this type of review. The introduction of a digital tool to improve how an SMR is carried out could save preparation time and be an interactive way to engage patients’ feedback. This study also shows there is a need to prioritise the people who would most benefit from this kind of appointment.
The DynAIRx project will use this study’s findings to create digital tools to help healthcare providers summarise a patient's journey. DynAIRx also aims to build digital tools that can identify patients who would benefit from SMRs and recommend the best care for those with multiple long term health conditions and medications.
Takeaways
- Structured Medication Reviews (SMR) aim to help healthcare professionals and patients to make decisions about the medications together.
- People who have multiple long-term conditions would typically attend an SMR.
- Researchers conducted interviews and focus groups with GPs, pharmacists, psychiatrists and people living with multiple long-term conditions.
- The paper’s findings have the potential to help patients across the UK by addressing issues healthcare providers and patients currently face whilst attending a SMR.
- This study highlights how the introduction of digital tools can help people living with multiple health conditions by improving how their medicines are prescribed and reviewed.
We thank Farheen Yameen for her valuable insights and contributions in shaping this summary to ensure it is accessible and clear to a wide audience.
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