• PHARMACOTHERAPY
• CLINICAL PHARMACY
• MEDICAL EDUCATION & TRAINING
• SIDE EFFECTS OF DRUGS
• THERAPEUTICS
• Polypharmacy

In 2014–2015 the NHS in England invested £15.5 billion a year in medicines, an increase of 7.8% from £14.4 billion in 2013–2014 and an increase of 19.4% from £13.0 billion in 2010–2011.1 Medicines are the biggest intervention made when treating patients in the NHS. When used optimally, medicines are a cost-effective solution for improving health outcomes for patients and their quality of life. They are one of the most successful interventions made in the health system and have helped to produce significant falls in mortality—14% for cancer and 41% for circulatory disease—over the past decade.2

And yet we know that 30%–50% of patients do not take their medicines as they have been prescribed so their full value may not be realised. We also know that medicines can cause harm; adverse drug reactions cause approximately 6.5% of hospital admissions, over 70% of which are avoidable.3 Wastage of medicines is an important cost pressure, but these are dwarfed by the cost of failing to achieve best outcomes from the medicines prescribed to patients. Between 2003 and 2013, the average number of prescription items per year for every person in England increased from 13 to 19.4 So why is this?

The use of multiple …