Background: This review scopes the evidence on the effectiveness and cost-effectiveness of interventions to improve suboptimal use of medicines in order to determine the evidence gaps and help inform research priorities.
Sources of data: Systematic searches of the National Health Service (NHS) Economic Evaluation Database, the Cochrane Database of Systematic Reviews and the Database of Abstracts of Reviews of Effects.
Areas of agreement: The majority of the studies evaluated interventions to improve adherence, inappropriate prescribing and prescribing errors.
Areas of controversy: Interventions tend to be specific to a particular stage of the pathway and/or to a particular disease and have mostly been evaluated for their effect on intermediate or process outcomes.
Growing points: Medicines optimization offers an opportunity to improve health outcomes and efficiency of healthcare.
Areas timely for developing research: The available evidence is insufficient to assess the effectiveness and cost-effectiveness of interventions to address suboptimal medicine use in the UK NHS. Decision modelling, evidence synthesis and elicitation have the potential to address the evidence gaps and help prioritize research.
Keywords: cost-effectiveness; economics; medicines management; medicines optimization; review.
© The Author 2014. Published by Oxford University Press.