Updated polypharmacy guidance launched to support safer, person centred care

The refreshed guidance continues to put people at the heart of decision‑making.

Scotland’s updated polypharmacy guidance has been published, strengthening national efforts to ensure people with multiple long‑term conditions receive safe, effective and person‑centred care. As populations age and multimorbidity becomes more common, many individuals are prescribed increasingly complex combinations of medicines. This can lead to poorer health outcomes, rising costs, and avoidable environmental impact; challenges that fall most heavily on those already facing disadvantage.

The refreshed guidance continues to put people at the heart of decision‑making. It places greater emphasis on shared conversations between people and clinicians, supported by the evidence‑based 7‑Steps model for medicines reviews.

What is new in the guidance?

The revised guidance offers expanded, practical support for multidisciplinary teams carrying out polypharmacy reviews. Key updates include:

• Updated Cumulative Toxicity and Anticholinergic Burden tools to help clinicians identify and reduce medicines‑related harm.
• Revised Drug Efficacy (Numbers Needed to Treat) tables to support meaningful discussions about the potential benefits of common treatments.
• Enhanced clinical “hot topics” with tailored considerations for groups such as people living with frailty, mental health conditions or multiple comorbidities, issues often more prevalent in areas of deprivation.
• New case studies designed for learning across GP practices, secondary care, community settings and palliative care.
• Updated National Polypharmacy Indicators, including a dedicated suite for care homes, to help track progress and understand prevalence and outcomes.
• Revised case‑finding indicators to support identification of individuals who may benefit from a review, including those at risk of medicines‑related harm.
• Updated Medication Sick Day Guidance, reflecting new medicines such as those used in diabetes management.

A new Polypharmacy Dashboard now provides additional context to the National Therapeutic Indicators, including demographic and prevalence data. Alongside this, a complementary set of Scottish Therapeutics Utility (STU) searches is available to primary care teams, helping practices identify patients who may benefit from review.

To further support implementation, an implementation toolkit has been developed, allowing clinicians and teams to select the steps most relevant to their local context. A free, accredited training package on delivering comprehensive 7‑Steps polypharmacy reviews is also available on Turas for multidisciplinary professionals.

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