Medication Optimisation

Medication optimisation is a structured review of your current pain medications to ensure they are safe, effective and appropriate for your condition.
The aim is to maximise benefit while minimising side effects, drug interactions and unnecessary long-term medication use, particularly where strong pain medicines or multiple medications are involved.

This service may be suitable for patients who:

Are taking multiple pain medications with limited benefit.
Are taking a combination of opioids and gabapentinoids (gabapentin or pregabalin).
Are taking opioid doses above 50 mg oral morphine equivalent (OME) per day, where a medication review is recommended.
Have experienced side effects or diminishing benefit from their current pain medications.
Would like support in reducing reliance on medication while exploring evidence-based non-drug approaches to pain management.
Are unsure whether their current medications are providing meaningful benefit or causing unwanted side effects.
Would like an independent specialist review of their current pain medication regimen.

A detailed review of your current and previous pain medications
Discussion of your pain experience, functional goals, and concerns
Personalised recommendations, which may include:
• Gradual dose reduction or tapering
• Switching to safer or more effective alternatives
• Planning for non-drug-based treatments such as injections, nerve blocks, or physiotherapy
A collaborative approach, with advice shared with your GP or referring clinician

Our clinic provides evidence-based medication advice to your GP in line with HSC Northern Ireland prescribing guidance.
Medication trials, prescribing, and ongoing monitoring are undertaken by your GP or the clinician responsible for your long-term care.
We are not permitted to prescribe controlled (scheduled) pain medications within our private practice.
Where appropriate, we will provide clear recommendations to your GP as part of a broader medication optimisation plan. The responsibility for prescribing, monitoring effectiveness, managing side effects, and making dose adjustments remains with your primary care provider.

This approach ensures that your medications are managed safely, consistently, and in accordance with HSC Northern Ireland prescribing policies.

Determining whether your current medications are providing meaningful benefit.
Reducing side effects, medication-related harm, and unnecessary drug use.
Reducing the risks associated with long-term use of opioids and other pain medications.
Identifying medications that are no longer effective or are no longer needed.
Optimising the balance between pain relief, function, and quality of life.
Developing a safer, evidence-based long-term medication strategy.
Increasing confidence in managing your pain through the right combination of medication, rehabilitation, self-management, and ongoing support.