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Publication - Advice and guidance

Polypharmacy Guidance: appropriate prescribing, making medicines safe, effective and sustainable 2026 - 2029

Published
2 March 2026
Directorate
Chief Medical Officer Directorate
Topic
Health and social care
ISBN
9781806437757

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 c

View supporting documents Supporting documents

25. Appendix M: Data tables for National Therapeutic Indicator charts

Table 47: 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 2023 to June 2023 January 2024 to June 2024 January 2025 to June 2025
Scotland 4.07% 3.85% 3.62%
Dumfries & Galloway 6.65% 6.22% 5.86%
Borders 5.47% 5.42% 5.25%
Shetland 5.74% 5.60% 5.06%
Western Isles 5.39% 4.79% 4.72%
Grampian 4.89% 4.57% 4.42%
Highland 4.68% 4.54% 4.32%
Fife 4.38% 4.25% 4.06%
Lothian 4.44% 4.16% 3.97%
NHS Forth Valley 3.83% 3.79% 3.75%
Tayside 3.68% 3.45% 3.21%
Orkney 4.27% 3.34% 3.18%
Lanarkshire 3.68% 3.44% 3.15%
Greater Glasgow & Clyde 3.49% 3.38% 3.08%
Ayrshire & Arran 3.36% 2.94% 2.76%
Table 48: 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 2023 to June 2023 April 2024 to June 2024 April 2025 to June 2025
Scotland 39.12% 46.36% 53.01%
Grampian 27.97% 36.12% 43.42%
Forth Valley 29.28% 36.65% 45.68%
Shetland 24.02% 29.61% 48.53%
Fife 35.48% 42.78% 49.77%
Dumfries & Galloway 33.88% 40.93% 50.00%
Lanarkshire 37.00% 43.87% 50.13%
Ayrshire & Arran 37.66% 45.14% 52.84%
Borders 30.39% 44.44% 53.56%
Orkney 42.31% 52.94% 54.74%
Tayside 37.77% 46.84% 56.31%
Highland 43.79% 51.32% 56.37%
Greater Glasgow & Clyde 45.29% 51.74% 56.46%
Western Isles 42.32% 51.25% 57.89%
Lothian 46.26% 52.07% 58.50%
Table 49: Adults prescribed antidepressant medications long-term (>= 2 years) as a proportion of adults in receipt of antidepressant medications (Chart 4)
NHS Board April 2023 to June 2023 April 2024 to June 2024 April 2025 to June 2025
Scotland 57.92% 58.38% 59.41%
Dumfries & Galloway 62.12% 62.78% 64.17%
Western Isles 61.22% 62.16% 62.52%
Shetland 60.04% 61.22% 64.00%
Lanarkshire 60.67% 61.46% 62.33%
Ayrshire & Arran 60.36% 61.17% 62.48%
Borders 60.02% 60.87% 61.17%
Tayside 58.61% 59.20% 60.57%
Greater Glasgow & Clyde 58.89% 58.94% 59.95%
Highland 57.70% 58.03% 58.66%
Grampian 56.95% 57.71% 58.96%
Forth Valley 57.41% 56.65% 58.14%
Fife 56.16% 56.86% 58.21%
Orkney 55.54% 55.25% 56.86%
Lothian 52.70% 53.35% 54.02%
Table 50: 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 2023 to June 2023 April 2024 to June 2024 April 2025 to June 2025
Scotland 8.09% 7.75% 7.44%
Lanarkshire 10.61% 10.03% 9.52%
Greater Glasgow & Clyde 9.69% 9.39% 9.10%
Western Isles 9.22% 9.52% 8.99%
Dumfries & Galloway 8.74% 8.17% 7.48%
Grampian 7.64% 7.28% 7.25%
Ayrshire & Arran 7.63% 7.33% 7.11%
Borders 7.52% 7.33% 6.89%
Fife 7.14% 7.33% 7.03%
Highland 6.87% 6.57% 6.16%
Tayside 6.53% 6.41% 6.20%
Lothian 6.51% 6.08% 5.83%
Shetland 5.35% 5.34% 5.66%
Forth Valley 5.18% 5.00% 4.75%
Orkney 4.97% 4.51% 4.20%
Table 51: 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 2023 to June 2023 April 2024 to June 2024 April 2025 to June 2025
Scotland 2.30% 2.30% 2.37%
Western Isles 2.84% 2.95% 3.40%
Grampian 2.73% 2.76% 2.78%
Forth Valley 2.59% 2.54% 2.73%
Greater Glasgow & Clyde 2.43% 2.44% 2.51%
Lanarkshire 2.34% 2.41% 2.51%
Tayside 2.42% 2.40% 2.46%
Lothian 2.24% 2.21% 2.34%
Shetland 2.31% 2.36% 2.19%
Highland 2.15% 2.10% 2.06%
Ayrshire & Arran 2.01% 2.02% 2.06%
Dumfries & Galloway 2.09% 2.02% 2.02%
Fife 1.94% 1.93% 1.95%
Orkney 1.76% 1.56% 1.92%
Borders 1.55% 1.61% 1.83%
Table 52: 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 2023 to June 2023 April 2024 to June 2024 April 2025 to June 2025
Scotland 7.13% 7.20% 6.87%
Dumfries & Galloway 8.75% 8.36% 7.89%
Highland 7.55% 7.44% 7.35%
Ayrshire & Arran 7.63% 7.50% 7.19%
Grampian 7.26% 7.59% 7.15%
Lanarkshire 7.37% 7.33% 7.10%
Borders 7.71% 7.36% 7.02%
Lothian 7.00% 7.32% 7.01%
Greater Glasgow & Clyde 7.29% 7.33% 6.88%
Fife 6.50% 6.59% 6.39%
Western Isles 7.05% 6.15% 6.32%
Forth Valley 6.45% 6.68% 6.32%
Tayside 6.01% 6.02% 5.77%
Orkney 5.83% 5.76% 5.64%
Shetland 4.70% 5.77% 5.61%
Table 53: Number of people co-prescribed an NSAID and ACE inhibitor/angiotensin receptor blocker and diuretic, as a percentage of all people prescribed an ACE inhibitor/angiotensin receptor blocker and diuretic (Chart 8)
NHS Board April 2023 to June 2023 April 2024 to June 2024 April 2025 to June 2025
Scotland 5.06% 4.99% 4.92%
Orkney 6.73% 7.05% 6.83%
Highland 6.08% 5.98% 6.14%
Dumfries & Galloway 5.68% 5.50% 5.77%
Greater Glasgow & Clyde 5.99% 5.84% 5.68%
Grampian 5.76% 5.55% 5.40%
Lanarkshire 5.11% 5.15% 4.91%
Ayrshire & Arran 5.11% 4.86% 4.79%
Fife 4.81% 4.81% 4.77%
Western Isles 4.99% 4.63% 4.53%
Shetland 4.68% 4.46% 4.52%
Forth Valley 3.95% 4.12% 4.15%
Lothian 3.94% 3.91% 3.84%
Tayside 3.58% 3.60% 3.77%
Borders 4.03% 4.03% 3.68%
Table 54: 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 2023 to June 2023 April 2024 to June 2024 April 2025 to June 2025
Scotland 12.[13] 12.[02] 11.[95]
Lanarkshire 16.[84] 16.[60] 16.[39]
Fife 15.[09] 15.[09] 14.[95]
Ayrshire & Arran 14.[28] 14.[01] 13.[97]
Dumfries & Galloway 15.[33] 15.[03] 13.[96]
Tayside 13.[45] 13.[33] 13.[22]
Greater Glasgow & Clyde 12.[65] 12.[79] 12.[77]
Western Isles 13.[07] 12.[76] 12.[25]
Borders 11.[69] 11.[70] 11.[80]
Shetland 9.[50] 8.[90] 10.[73]
Forth Valley 10.[15] 10.[16] 10.[01]
Grampian 9.[26] 9.[28] 9.[53]
Highland 9.[61] 9.[35] 9.[48]
Orkney 8.[76] 8.[02] 8.[40]
Lothian 8.[55] 8.[25] 8.[10]
Table 55: 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 2022 to June 2023 July 2023 to June 2024 July 2024 to June 2025
Scotland 48.80% 47.21% 46.42%
Lanarkshire 54.68% 52.55% 50.70%
Forth Valley 50.68% 50.80% 50.66%
Greater Glasgow & Clyde 52.23% 50.54% 50.12%
Ayrshire & Arran 50.98% 50.13% 48.16%
Orkney 53.95% 46.34% 47.06%
Highland 45.85% 44.84% 46.52%
Lothian 48.08% 47.88% 46.45%
Grampian 50.21% 48.00% 46.09%
Western Isles 41.63% 34.72% 43.40%
Fife 43.23% 40.94% 41.04%
Tayside 43.41% 40.69% 39.17%
Borders 42.60% 38.85% 37.83%
Shetland 39.32% 37.68% 37.31%
Dumfries & Galloway 37.97% 36.66% 36.84%
Table 56: Number of people aged 75 years or over prescribed sulfonylureas as a percentage of all people aged 75 years prescribed an antidiabetic drug (Chart 19)
NHS Board April 2023 to June 2023 April 2024 to June 2024 April 2025 to June 2025
Scotland 39.12% 46.36% 53.01%
Grampian 27.97% 36.12% 43.42%
Forth Valley 29.28% 36.65% 45.68%
Shetland 24.02% 29.61% 48.53%
Fife 35.48% 42.78% 49.77%
Dumfries & Galloway 33.88% 40.93% 50.00%
Lanarkshire 37.00% 43.87% 50.13%
Ayrshire & Arran 37.66% 45.14% 52.84%
Borders 30.39% 44.44% 53.56%
Orkney 42.31% 52.94% 54.74%
Tayside 37.77% 46.84% 56.31%
Highland 43.79% 51.32% 56.37%
Greater Glasgow & Clyde 45.29% 51.74% 56.46%
Western Isles 42.32% 51.25% 57.89%
Lothian 46.26% 52.07% 58.50%
Table 57: 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 2022 to June 2023 July 2023 to June 2024 July 2024 to June 2025
Scotland 10.12% 10.58% 10.91%
Dumfries & Galloway 13.35% 13.40% 13.83%
Lanarkshire 12.87% 13.31% 13.81%
Greater Glasgow & Clyde 12.24% 12.80% 13.03%
Ayrshire & Arran 11.20% 11.83% 12.20%
Western Isles 12.34% 12.55% 11.51%
Forth Valley 9.76% 10.75% 11.21%
Shetland 13.55% 12.92% 11.02%
Borders 9.73% 10.13% 10.12%
Highland 9.29% 9.72% 9.88%
Fife 8.85% 9.35% 9.76%
Tayside 9.03% 9.43% 9.71%
Grampian 8.50% 9.03% 9.47%
Lothian 6.93% 7.27% 7.64%
Orkney 6.49% 5.72% 6.25%

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