Ensuring the best medication outcomes for patients through iSIMPATHY

iSIMPATHY, a collaborative project developing medicines reviews, has improved care for patients prescribed multiple medicines.

Medicines are the most common healthcare intervention used within the health system, and the use of the right medicine for the right patient at the right time is central to this. For many people, taking multiple medicines – known as polypharmacy – can be appropriate for their needs. In some cases, however, it may be problematic, such as when the increased risk of harm from interactions between drugs or between drugs and diseases outweigh the intended benefits.

A ground-breaking new project called iSIMPATHY (Implementing Stimulating Innovation in the Management of Polypharmacy and Adherence Through the Years) sought to address this, and where possible reduce the harm that taking multiple medicines can have. The project did this by training healthcare professionals to deliver ‘medicine reviews’, which support patients and clinicians to define and achieve realistic goals of drug treatment, and helping enable patients to lead healthy and active lives.

Medicine reviews achieve the best outcomes for patients’ health and wellbeing, but they are also cost effective. They provide immediate effects by ensuring optimal use of medicine (which may result in deprescribing) but also because of the downstream effect reviews can have, such as reduced hospital admissions, time in hospital and other primary care and social care settings. These reviews use the ‘7 steps approach’, which asks patients:

• What Matters To You?
• Is this the right medicine for you?
• Are you taking unnecessary medicine?
• Is your medicine effective?
• Is your medicine harmful?
• Is your medicine cost effective?
• Agree and Share Medicine Plan

After three years of delivering over 6,000 medicines reviews, and training over 160 additional GPs, hospital doctors and pharmacists to undertake these comprehensive medicines reviews, the iSIMPATHY project came to an end on Friday 31 March 2023.

On 7 March, I had the pleasure of Chairing the iSIMPATHY Closure Celebration Event, where we hosted a variety of speakers to mark the end of the project. This was a fantastic opportunity to showcase the successful output of the project, share findings from the evaluation report, and consider future opportunities for partnership and further embedding medicines reviews and their positive impact. It has been a privilege to serve on the Project Board and support the delivery of medicine reviews to over 6,000 patients, and training to 160 GPs, hospital doctors and pharmacists. My thanks to my ALLIANCE colleague Tommy Whitelaw for joining me and providing a presentation on the importance of kindness and keeping the patient at the centre in this work.

Preliminary results show that the interventions used over the three-year project have potentially prevented major organ failure and adverse drug reactions. A final evaluation report and summary is currently underway, to be published in June, and I know that from this learning we will be able to expand and improve this incredible and innovative work to reach more people – potentially saving lives and money.

It is clear that the project can not only reduce harm for patients, but also reduce medicines waste which accounts for 25% of the NHS carbon footprint, both of which are key to delivering Realistic Medicine and a more sustainable health system for Scotland.

The iSIMPATHY project has been supported by around €3.5m since 2019, mainly through European Union funding as well as input from the three countries’ project partners (Scottish Government and NHS Scotland, the Republic of Ireland’s Health Service Executive and the Northern Irish Health and Social Care Trust and Medicines Optimisation Centre). Visit the project website for more information and resources on polypharmacy and medicines reviews.

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