Structured Medication Review (SMR)

Structured Medication Review (SMR)

💊 Structured Medication Review (SMR)

💷 How much is this worth to me?

This template supports delivery of:

  • PCN DES requirements for Structured Medication Reviews

  • Best practice in deprescribing, optimisation, and personalised care

Accurate use improves safety, identifies medicines-related harm, and supports contractual delivery across frailty, care homes, and long-term condition groups.

📊 High-level overview of the specification requirements

An SMR must be:

  • Patient-centred

  • Conducted by a trained pharmacist or pharmacy technician

  • Appropriately coded and documented

Reviews are prioritised for patients:

  • In care homes

  • With frailty/polypharmacy

  • Taking high-risk medications

  • Recently discharged or with poor adherence

📌 What do you need to know?

This template guides a thorough review across several domains:

🩺 Consultation Details

  • Record:

    • Type of consultation (face-to-face, phone)

    • Type of activity (e.g. SMR, audit, optimisation)

  • Tick who performed the review (e.g. pharmacist, technician)

👵 Frailty and Falls

  • Frailty score and severity

  • Falls risk assessed by:

    • GP

    • MDT

    • Falls service

    • Morse score or equivalent

⚕️ Technical Review

  • Tick if:

    • Directions are adequate

    • Patient understands purpose

  • Record:

    • Over-the-counter medication

    • Use of compliance aids

    • Confirmation that all quantities were checked

🧠 Self-Management and Proactive Care

  • Is the patient managing their medicines safely?

  • Has proactive care been continued or ended?

💬 Lifestyle

  • Record:

    • Smoking status

    • Alcohol intake

  • These are often revisited during reviews for cardiovascular risk

💡 Therapeutic Review

  • Record:

    • Indication checked for each drug

    • Side effects discussed

    • Evidence of shared decision-making

    • Medication discontinued where appropriate

💡 Hints and Tips

  • Always tick that the review was done by a trained pharmacist or technician — this validates the SMR for PCN DES

  • If the patient has frailty, ensure this is coded and linked to falls or polypharmacy discussions

  • Record both what was reviewed and any action taken, even if no change was made

  • Use free text for nuance — this supports clinical audit and revalidation

  • If the SMR is declined or missed, use a failed encounter code to protect reporting