Structured Medication Review (SMR)

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A clinical service that provides comprehensive reviews of patients' medications to optimise usage, reduce risks, and improve health outcomes.

What does Structured Medication Review (SMR) mean?

What is ?

A Structured Medication Review (SMR) is a comprehensive clinical assessment conducted by a pharmacist or other qualified healthcare professional within primary care networks in the UK. It aims to optimise medication usage, improve therapeutic outcomes, reduce medication-related risks, and ensure medicines are providing clinical benefit while being cost-effective. SMRs prioritise patients with complex medication needs, multiple long-term conditions, or those taking high-risk medications, helping to reduce polypharmacy issues and improve patients' understanding of their treatment plans.

Structured Medication Review (SMR) Best Practices

What is ?

  • Prioritise patients who would benefit most, including those on multiple medications, care home residents, and those with complex needs
  • Ensure shared decision-making with patients throughout the review process
  • Document all decisions and follow-up actions in patient records
  • Establish clear referral pathways for patients requiring specialist intervention
  • Regularly audit SMR outcomes to demonstrate service value and identify areas for improvement

Use Structured Medication Review (SMR) in a Sentence

What is ?

  1. The clinical pharmacist conducted a Structured Medication Review (SMR) to identify potential interactions between the patient's numerous prescriptions.
  2. Following his hospital discharge, the Primary Care Network arranged a Structured Medication Review (SMR) to reconcile his medication changes.
  3. The NHS contract requires Primary Care Networks to deliver Structured Medication Reviews (SMRs) to care home residents at least annually.
Frequently Asked Questions about
Structured Medication Review (SMR)

What does Structured Medication Review (SMR) mean?

A Structured Medication Review (SMR) is a comprehensive, clinical review of a patient's medicines and detailed aspects of their health. It's conducted by a qualified healthcare professional, typically a clinical pharmacist, within UK primary care. The purpose is to optimise medication use, improve patient outcomes, reduce medicine-related harm, and ensure medications are both clinically and cost-effective.

Who is eligible for a Structured Medication Review in the NHS?

Patients prioritised for SMRs typically include those taking multiple medicines (polypharmacy), with complex medication regimens, care home residents, those with severe frailty, with recent hospital admissions, at high risk of medication-related harm, taking high-risk medications (such as anticoagulants or opioids), or experiencing problematic side effects. The NHS specifies these priority groups as part of the Primary Care Network Directed Enhanced Service (DES) contract.

What happens during a Structured Medication Review?

During an SMR, a qualified healthcare professional will review all medications (prescription, over-the-counter, and supplements), discuss how the patient is managing their medicines, assess effectiveness, identify any side effects or concerns, check for interactions, and ensure the treatment plan aligns with the patient's needs and preferences. The review typically takes 20-30 minutes and may result in continuing, adjusting, adding, or stopping medications, with all decisions made collaboratively with the patient.

How do Structured Medication Reviews differ from Medication Reviews?

SMRs represent a more comprehensive approach compared to traditional medication reviews. They are conducted by specifically trained professionals (usually clinical pharmacists), follow a structured format with defined outcomes, involve shared decision-making, focus on optimisation rather than just compliance, and are targeted at specific patient groups based on need rather than being universally applied. They also form part of the NHS contract requirements for Primary Care Networks.

What are the benefits of Structured Medication Reviews for patients?

SMRs offer numerous benefits including reduced risk of medication-related harm, improved medication effectiveness, decreased inappropriate polypharmacy, better management of side effects, increased patient understanding and adherence, prevention of hospital admissions due to medication issues, and potentially improved quality of life. They also ensure patients' treatment aligns with their personal health goals and preferences through shared decision-making.

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