Project period: September 2018 – January 2019 

GW4 community leads 

University of Bath: Margaret Watson (initial PI, now at Strathclyde) 
University of Bristol: Rupert Payne (PI) 
University of Exeter: Nicky Britten 
Cardiff University: Molly Courtenay 

Project overview 

Medicines Optimisation is the name of a relatively recent policy to ensure the safe and effective use of medicines and thus to enable the best possible outcomes. The project aimed to bring together expertise in this area across GW4, to identify the most salient research issues to take forward as a community. 


Medicines are the most commonly used therapeutic intervention in the NHS, accounting for £16.8 billion annually in England. Over 1 billion prescription items are dispensed annually in the community. Up to 50% of medicines for chronic (long-term) conditions are not used as intended. As a result, patients’ health outcomes are not optimised. Over and under-use of medicines leads to diminished benefits, greater costs and increased harms. This is recognised as a global Patient Safety problem in the World Health Organisation’s Global Challenge “Medication without harm”, which aims to halve severe, avoidable harm globally by 2021. 

Medicines Optimisation is “the safe and effective use of medicines to enable the best possible outcomes”. The stakeholders of medicines optimisation are patients, public and clinicians (e.g. general practitioners, pharmacists, nurses), commissioners, policy makers and guideline developers. 

Project summary 

The community successfully brought together stakeholders from the GW4 institutions, who provided a broad range of methodological and specific skills necessary to meet immediate project outcomes, and to develop research priorities arising from the project. A workshop allowed the community to reach consensus about medicines optimisation research priorities and led to a manuscript and development of funding proposals that the community are continuing to progress. 

Community site (GW4 Portal)