In an era of complex medication regimens and specialized care, the humble community pharmacy is emerging as an unexpected hero in healthcare safety.
Imagine you have five different prescriptions from three different doctors, plus a few over-the-counter supplements. You take some in the morning, some at night, and one with food—except when you forget. You've noticed new symptoms but aren't sure if they're side effects or something else.
This scenario affects millions worldwide, but a powerful solution is hiding in plain sight: the medication review. More than just counting pills, this service represents a transformative approach to medication safety that turns community pharmacies into crucial hubs of patient-centered care.
A medication review is defined as "a structured, critical examination of a person's medicines with the objective of reaching an agreement with the person about treatment, optimising the impact of medicines, minimising the number of medicine-related problems and reducing waste" 7 .
Think of it as a comprehensive "medication check-up" that goes far beyond simply filling prescriptions. During these reviews, pharmacists assess whether each medication is appropriate, effective, and safe, checking for potential interactions, unnecessary treatments, and opportunities to simplify complex regimens 4 .
The service has evolved significantly from basic prescription verification to sophisticated clinical evaluations. In many healthcare systems, medication reviews are now formally recognized and reimbursed, especially for vulnerable populations like older adults managing multiple chronic conditions 3 7 .
The modern medication landscape makes these reviews increasingly critical:
of elderly community-dwelling Europeans take five or more medications daily 3
unplanned hospital admissions annually in Europe due to adverse drug events 3
more frequent visits to pharmacies than to primary care physicians 2
Medication reviews have demonstrated significant benefits across multiple dimensions. Studies have shown they can reduce drug-related problems, improve medication adherence, and decrease hospital readmissions 1 2 4 .
Recent research from Southwest Ethiopia provides compelling insights into both the potential and challenges of implementing medication review services in diverse healthcare settings 1 .
In this cross-sectional study conducted between March and April 2025, researchers surveyed 105 community pharmacy professionals across three towns to evaluate their knowledge, attitudes, and practices regarding Medication Therapy Management (MTM), a comprehensive form of medication review 1 .
Statistical analysis categorized scores as "high" or "low" based on median splits, allowing researchers to identify associations between demographic factors and medication review capabilities 1 .
The results revealed a complex picture of medication review implementation in community settings:
The most commonly provided service was verbal education and training (62.9%), while more comprehensive elements like formulating medication treatment plans (32.4%) or performing comprehensive medication reviews to identify problems (34.3%) were significantly less common 1 .
Demographic factors played a significant role in implementation quality. Age was significantly associated with knowledge (p = 0.027), while gender (p = 0.004) and qualification (p = 0.035) correlated with attitudes, and experience (p = 0.006) with practice 1 .
| Barrier Category | Percentage |
|---|---|
| Lack of MTM training | 40% |
| Lack of time | 36.2% |
| Limited staff | 35.2% |
| Lack of interprofessional collaboration | 33.3% |
The benefits of well-implemented medication review services extend far beyond the pharmacy counter.
Medication reviews directly address medication-related problems, which include unnecessary drug therapy, ineffective medications, incorrect dosing, adverse drug reactions, and adherence issues 4 .
reduction in medication errors and readmissions 2
Effective medication reviews transform patients from passive recipients to active participants in their healthcare. As one study noted, these services "empower patients to actively participate in management of their medications" 1 .
While the primary focus of medication reviews is clinical improvement, the economic impact is substantial. One study noted that "patients with 5 or more chronic conditions comprise 12% of the population but contribute to 41% of the total health care spending" 8 .
Successful medication review services depend on both methodological approaches and supporting infrastructure.
| Component | Function | Examples |
|---|---|---|
| Structured Framework | Provides systematic approach | Bristol Medication Review Model 4 |
| Technology Support | Enables efficient implementation | Fit-for-purpose software 3 |
| Process Guidance | Supports consistent delivery | Detailed process support materials 3 |
| Expert Consultation | Provides troubleshooting | Expert support lines 3 |
| Documentation Tools | Facilitates communication | Standardized forms for recording interventions |
The Bristol Medication Review Model, developed through systematic review and stakeholder consensus, exemplifies an evidence-based framework that can be adapted across healthcare settings 4 . Its structure is "underpinned by patient values and preferences, with parallel information gathering and evaluation stages, feeding into the final decision-making and implementation" 4 .
As healthcare systems worldwide grapple with aging populations and increasing chronic disease burden, medication reviews are poised to play an even more crucial role.
Shifting from simply preventing errors ("what went wrong") to understanding and enhancing adaptive capacity ("what went right") 8
Implementing systems like MedSafeMap to guide pharmacists in safely providing complex chronic care management 8
Recognizing pharmacist prescribing as a strategy to improve access to care and medicines 5
Initial focus on ensuring accurate dispensing of medications with limited clinical assessment.
Expansion to comprehensive assessment of medication appropriateness, effectiveness, and safety.
Medication reviews become part of collaborative healthcare teams with shared patient records.
AI-powered tools and digital platforms support more efficient and comprehensive medication management.
The COVID-19 pandemic accelerated the expansion of pharmacist responsibilities, demonstrating their critical role in healthcare delivery when traditional channels were disrupted 2 8 . This experience has created momentum for more permanently integrating comprehensive medication management into routine pharmacy practice.
Medication reviews represent a fundamental shift in the role of community pharmacies—from transactional dispensaries to transformative healthcare destinations. While implementation challenges remain, the evidence consistently demonstrates that when pharmacists have the tools, time, and training to conduct thorough medication reviews, patient outcomes improve, healthcare systems become more efficient, and medication safety is significantly enhanced.
The next time you visit your community pharmacy, remember that the expertise available extends far beyond filling prescriptions. Through medication reviews, pharmacists are equipped to partner with you in optimizing your medication regimen, ensuring that each pill you take moves you closer to your health goals—safely and effectively.
Start a conversation with your community pharmacist today—it might be the most important health discussion you have this year.