The review discussion may include:

• Asking the patient how compliant they are with prescriber’s instructions
• How and when they take medication labeled with “as directed” or “as required”
• Assessing the patients knowledge of each medicine to see if they know what it is for, when and how to take it
• Assessing perceived side effects and advice on tolerability
• Dealing with practical issues that prevent the patient obtaining, taking, ordering and using their medicines
• Identification of overstocking or unwanted medicines and removal if safety is an issue
• Assessment of potential change of dosage form to facilitate effective use with due regard to formularies and cost implications (on approval of GP)
• Suggestions on optimisation in dose and strength, but not to impact on clinical management

The review is recorded (either paper based or electronically). Results are accessible by the patient, the accredited pharmacist and the patients GP. A Report Form is given to both the patient and GP with points of action for all parties concerned, as appropriate, but will most commonly be patient orientated.