The SIMPATHY project, which has been running for several years and involves a number of different countries, aims to reduce inappropriate polypharmacy. The project evaluated all the available EU guidance documents relating to the management of polypharmacy and found that only the guidance documents from Scotland, the Netherlands and Germany scored the maximum quality rating. The third edition of Scotland’s Polypharmacy Guidance, Realistic Prescribing, published in 2018, aims to provide guidance on preventing inappropriate polypharmacy at every stage of the patient journey. It contains a clear structure for both the initiation of new treatments and the review of existing treatments. 

The 2018 version was updated to place a greater emphasis on what matters to the patient. A ‘7-Steps’ approach to medication review was developed with patient groups, and doctors and pharmacists in primary and secondary care, which can be seen below.