Medicines to consider deprescribing
This is a quick reference guide that can be used to support decisions around de-prescribing medicines when conducting SMRs. The document contains links to local and national guidance, as well as de-prescribing tools such as STOPP/START and the 7 Steps to appropriate polypharmacy guidance.
Health Innovation East Midlands – Polypharmacy Programme
Training Opportunities
As part of their polypharmacy programme, the Health Innovation East Midlands are running local polypharmacy Action Learning Sets (ALSs) to upskill the primary care workforce to be more confident about stopping unnecessary medicines. For more information, please follow the link.
Patient information materials
As part of their public behaviour change, the Health Innovation East Midlands have developed a range of patient information materials in different community languages to support and prepare people who have been invited for a medication review with their GP, pharmacist or other healthcare professional. These are available to download from the HIEM website: Patient-Information.
Useful Resources to support deprescribing and medication reviews
PrescQIPP
Medication and falls
Guidance is provided on deprescribing Fall-Risk-Increasing Drugs (FRIDs) and when deciding whether to initiate medicines in older people at risk of falls
Good prescribing – ensuring appropriate polypharmacy
In conjunction with the ‘ensuring appropriate polypharmacy’ flowchart, this bulletin aims to support decision making at different stages of prescribing and medication review.
IMPACT - Improving Medicines and Polypharmacy Appropriateness Clinical Tool
This bulletin provides suggestions for consideration for clinicians to optimise medicines use, and provide practical advice (where it is available) about how to safely stop/discontinue/withdraw a medicine and issues to consider.
Health Innovations Network
The mechanics of tackling overprescribing and problematic polypharmacy
Developed by clinical leaders with a passion for improving the quality of structured medication reviews, especially for older people taking multiple medicines. It is intended to help Primary Care Networks (PCNs) and GP practices think about how to organise teams to tackle overprescribing and problematic polypharmacy.
NHS Scotland
7 Steps to appropriate polypharmacy
This is intended as a guide to structure the review process. There are also tables by therapeutic area, and information and the rationale behaind targeting drugs / drug groups along with practiceal advice.
Specialist Pharmacy Service (SPS)
Understanding polypharmacy, overprescribing and deprescribing
The SPS website hosts information, resources and tools, including an article on a person-centered approarch to poloypharmacy and medication review that can be used as a framework when undertaking structured medication reviews and deprescribing.
Useful tools
The ACB Calculator
For calculating the anticholinergic burden score fr specific drugs.
The Gold Standards Framework (GSF) Pronostic Indicator Guidance
The preferred frailty assessment tool in Lincolnshire ICS is the Rockwood Clinical Frailty Scale. Where clinically indicated for complex patients, this can be followed up by Edmonton. (Please note: Rockwood CFS is not validated for under 65s or for people with a learning disability. Please use Edmonton for people aged under 65 and for people with a learning disability).
There is a useful Clinical Frailty Score (CFS) App available for both Apple and Android, which can be used to calculate the CFS score.