Polypharmacy prescribing guidance - draft: consultation

We are consulting on this draft updated polypharmacy prescribing guidance. 'Appropriate Prescribing - Making medicines safe, effective and sustainable 2025-2028' aims to further improve the care of individuals taking multiple medicines through the use of 7-Steps medicine reviews and promotes a holistic approach to person-centred care.

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28. Appendix P: Data tables for National Therapeutic Indicator charts

Table 45: People prescribed high dose opioids (morphine daily equivalent 90mg or more) in the previous six months as a percentage of all people prescribed strong opioids (Chart 2)

NHS Board

January 2022 to June 2022

January 2023 to June 2023

January 2024 to June 2024

Scotland

1.98%

1.89%

1.74%

Dumfries & Galloway

3.55%

3.43%

3.16%

Borders

2.86%

2.87%

2.57%

Shetland

2.66%

2.44%

2.26%

Highland

2.57%

2.35%

2.22%

Grampian

2.46%

2.47%

2.17%

Western Isles

2.78%

2.69%

2.12%

Lothian

2.15%

2.04%

1.89%

Fife

2.00%

1.90%

1.80%

Forth Valley

1.73%

1.74%

1.67%

Tayside

1.85%

1.68%

1.59%

Lanarkshire

1.76%

1.69%

1.57%

Greater Glasgow & Clyde

1.61%

1.57%

1.45%

Orkney

1.70%

1.72%

1.31%

Ayrshire & Arran

1.66%

1.51%

1.27%

Table 46: People with T2DM prescribed a SGLT-2i/GLP-1RA and existing therapy suggestive of atherosclerotic cardiovascular disease (ASCVD), as a percentage of all people prescribed anything from BNF Chapter 060102 in the same quarter as a nitrate and/or nicorandil, aspirin or clopidogrel (Chart 3)

NHS Board

April 2022 to June 2022

April 2023 to June 2023

April 2024 to June 2024

Scotland

30.15%

39.12%

46.42%

Shetland

10.98%

24.02%

29.61%

Grampian

19.98%

27.97%

36.55%

Forth Valley

21.29%

29.28%

36.65%

Dumfries & Galloway

26.04%

33.88%

40.93%

Fife

27.06%

35.48%

42.78%

Lanarkshire

29.35%

37.00%

43.86%

Borders

16.15%

30.39%

44.44%

Ayrshire & Arran

28.25%

37.66%

45.23%

Tayside

29.74%

37.77%

46.84%

Western Isles

29.17%

42.32%

51.25%

Highland

31.77%

43.79%

51.32%

Greater Glasgow & Clyde

37.27%

45.29%

51.71%

Lothian

34.55%

46.27%

52.06%

Orkney

28.75%

42.31%

52.94%

Table 47: Adults prescribed antidepressant medications long-term (>= 2 years) as a proportion of adults in receipt of antidepressant medications (Chart 4)

NHS Board

April 2022 to June 2022

April 2023 to June 2023

April 2024 to June 2024

Scotland

57.16%

57.88%

58.35%

Dumfries & Galloway

60.66%

62.11%

62.75%

Western Isles

61.97%

61.23%

62.11%

Lanarkshire

60.10%

60.62%

61.45%

Shetland

61.52%

59.98%

61.21%

Ayrshire & Arran

58.94%

60.32%

61.14%

Borders

59.70%

60.00%

60.95%

Tayside

57.69%

58.55%

59.19%

Greater Glasgow & Clyde

58.50%

58.85%

58.94%

Highland

56.62%

57.63%

58.02%

Grampian

55.73%

56.91%

57.46%

Fife

55.16%

56.12%

56.85%

Forth Valley

57.59%

57.37%

56.66%

Orkney

55.29%

55.54%

55.25%

Lothian

51.65%

52.63%

53.37%

Table 48: People prescribed benzodiazepine or z-drug (for more than eight weeks) with an antidepressant as a proportion of all people prescribed an antidepressant (Chart 5)

NHS Board

April 2022 to June 2022

April 2023 to June 2023

April 2024 to June 2024

Scotland

8.26%

8.08%

7.73%

Lanarkshire

10.91%

10.59%

10.01%

Western Isles

9.62%

9.20%

9.49%

Greater Glasgow & Clyde

9.72%

9.68%

9.34%

Dumfries & Galloway

8.90%

8.74%

8.16%

Ayrshire & Arran

7.75%

7.62%

7.33%

Borders

7.11%

7.13%

7.32%

Fife

7.66%

7.52%

7.32%

Grampian

7.70%

7.63%

7.13%

Tayside

7.37%

6.86%

6.55%

Highland

6.69%

6.51%

6.40%

Lothian

6.71%

6.54%

6.13%

Shetland

5.75%

5.31%

5.33%

Forth Valley

5.46%

5.17%

4.99%

Orkney

4.49%

4.97%

4.51%

Table 49: Number of people aged 75 years and over prescribed an antipsychotic as a percentage of all people aged 75 years and over (Chart 6)

NHS Board

April 2022 to June 2022

April 2023 to June 2023

April 2024 to June 2024

Scotland

2.85%

2.85%

2.85%

Grampian

3.24%

3.26%

3.27%

Western Isles

2.99%

2.99%

3.16%

Forth Valley

3.10%

3.05%

3.08%

Greater Glasgow & Clyde

3.07%

3.08%

3.06%

Tayside

3.08%

3.04%

3.01%

Lanarkshire

2.92%

2.91%

2.98%

Lothian

2.90%

2.90%

2.78%

Shetland

2.49%

3.08%

2.78%

Highland

2.81%

2.78%

2.73%

Ayrshire & Arran

2.39%

2.53%

2.60%

Fife

2.38%

2.43%

2.51%

Dumfries & Galloway

2.41%

2.26%

2.28%

Orkney

1.74%

1.83%

1.82%

Borders

1.69%

1.55%

1.70%

Table 50: Percentage of people prescribed an SSRI in combination with antiplatelet, NSAID, DOAC or warfarin without gastro-protection as a proportion of all people prescribed an SSRI (Chart 7)

NHS Board

April 2022 to June 2022

April 2023 to June 2023

April 2024 to June 2024

Scotland

7.32%

7.13%

7.19%

Dumfries & Galloway

8.99%

8.75%

8.36%

Grampian

7.45%

7.26%

7.55%

Ayrshire & Arran

7.74%

7.63%

7.51%

Highland

7.56%

7.55%

7.44%

Borders

7.50%

7.71%

7.36%

Lanarkshire

7.53%

7.38%

7.33%

Greater Glasgow & Clyde

7.53%

7.29%

7.32%

Lothian

7.13%

7.00%

7.32%

Forth Valley

6.64%

6.46%

6.68%

Fife

6.77%

6.50%

6.59%

Western Isles

7.78%

7.05%

6.15%

Tayside

6.34%

6.01%

6.02%

Shetland

5.21%

4.70%

5.77%

Orkney

5.91%

5.83%

5.76%

Table 51: Number of people aged 65 years and over co-prescribed an NSAID and ACE inhibitor/angiotensin receptor blocker and diuretic, as a percentage of all people aged 65 years and over prescribed an ACE inhibitor/angiotensin receptor blocker and diuretic (Chart 8)

NHS Board

April 2022 to June 2022

April 2023 to June 2023

April 2024 to June 2024

Scotland

0.40%

0.40%

0.39%

Orkney

0.44%

0.60%

0.65%

Western Isles

0.37%

0.51%

0.49%

Greater Glasgow & Clyde

0.51%

0.49%

0.47%

Dumfries & Galloway

0.52%

0.49%

0.46%

Highland

0.50%

0.50%

0.46%

Ayrshire & Arran

0.46%

0.46%

0.44%

Grampian

0.41%

0.45%

0.42%

Lanarkshire

0.39%

0.38%

0.39%

Fife

0.38%

0.37%

0.35%

Shetland

0.38%

0.42%

0.32%

Forth Valley

0.33%

0.30%

0.31%

Tayside

0.29%

0.28%

0.29%

Lothian

0.29%

0.30%

0.28%

Borders

0.29%

0.27%

0.25%

Table 52: People receiving three or more of benzodiazepine/z-drug, opioid (including tramadol), gabapentinoid, antidepressant or antipsychotic (excluding depots), per 1,000 list size per day (Chart 9)

NHS Board

April 2022 to June 2022

April 2023 to June 2023

April 2024 to June 2024

Scotland

12.03

12.08

12.03

Lanarkshire

16.56

16.64

16.63

Fife

14.13

15.09

15.1

Dumfries & Galloway

15.66

14.92

15.05

Ayrshire & Arran

14.2

14.29

14.05

Tayside

13.87

13.41

13.34

Greater Glasgow & Clyde

12.63

12.67

12.8

Western Isles

12.69

13.11

12.76

Borders

11.01

11.23

11.72

Forth Valley

10.33

10.16

10.17

Highland

9.66

9.63

9.36

Grampian

9

9.13

9.09

Shetland

9.74

9.5

8.9

Lothian

8.53

8.6

8.34

Orkney

8.15

8.76

8.02

Table 53: Number of people prescribed a long-term oral steroid without co-prescription of a bone protecting agent as a percentage of all people prescribed a long-term oral steroid (Chart 10)

NHS Board

July 2021 to June 2022

July 2022 to June 2023

July 2023 to June 2024

Scotland

49.31%

48.81%

47.31%

Lanarkshire

54.72%

54.68%

52.68%

Forth Valley

51.37%

50.68%

50.77%

Greater Glasgow & Clyde

52.85%

52.24%

50.75%

Ayrshire & Arran

51.65%

50.98%

50.44%

Grampian

50.45%

50.21%

47.91%

Lothian

47.82%

48.09%

47.88%

Orkney

50.92%

53.95%

46.34%

Highland

45.02%

45.85%

44.87%

Fife

42.89%

43.23%

41.09%

Tayside

47.06%

43.41%

40.93%

Borders

43.08%

42.60%

38.85%

Shetland

33.16%

39.32%

37.68%

Dumfries & Galloway

40.87%

37.97%

36.76%

Western Isles

44.14%

41.63%

34.87%

Table 54: Number of people aged 75 years and over dispensed more than 10 items of strong or very strong anticholinergics (mARS 2&3) per annum as a percentage of all people aged 75 years and over (Chart 20)

NHS Board

July 2021 to June 2022

July 2022 to June 2023

July 2023 to June 2024

Scotland

7.24%

7.31%

7.59%

Dumfries & Galloway

10.15%

9.63%

9.75%

Greater Glasgow & Clyde

9.50%

9.38%

9.63%

Shetland

10.84%

10.38%

9.55%

Western Isles

9.38%

9.59%

9.45%

Lanarkshire

8.78%

8.98%

9.31%

Ayrshire & Arran

7.74%

7.98%

8.30%

Forth Valley

7.31%

7.43%

8.08%

Highland

7.19%

7.06%

7.38%

Borders

6.87%

6.46%

6.78%

Fife

5.83%

6.27%

6.58%

Tayside

6.15%

6.13%

6.40%

Grampian

5.58%

5.84%

6.15%

Lothian

4.67%

4.94%

5.10%

Orkney

4.46%

4.43%

3.75%

Contact

Email: EPandT@gov.scot

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