The Medicines Optimisation Innovation Centre (MOIC) in Northern Ireland has become a pivotal force in advancing healthcare, particularly in the essential field of medicines optimisation. In this case study, marking a decade since its inception, Katherine Redpath examines MOIC’s achievements, ongoing projects and future aspirations.
The suboptimal use of medicines presents a significant global challenge1, resulting in adverse health outcomes, inefficiencies and considerable waste.
Concurrently, the growing ageing population in the UK and the rising prevalence of individuals with multiple long-term conditions have significantly increased the demand for medicines.
Despite its smaller geographical area and population, Northern Ireland consumes more medicines than other regions of the UK in terms of prescription items per person.2
In early 2016, the Department of Health, Social Services and Public Safety published the Northern Ireland Medicines Optimisation Quality Framework3 to enhance health outcomes by ensuring that medicines deliver the best possible results whenever they are prescribed, dispensed or administered.
The framework focuses on consistently delivering best practice while also facilitating the development and implementation of new, evidence-based practices. This was achieved through an innovation and change programme that involved collaboration among multidisciplinary professionals and patients.
Background and strategic aims of MOIC
The Medicines Optimisation Innovation Centre (MOIC) was established in 2015 to address these issues within Northern Ireland and support the implementation of the Framework.
Funded primarily by the devolved Department of Health and supported through grant acquisition and commercial income, MOIC aims to inform policy and assist commissioners in enhancing population health and wellbeing.
Its four strategic themes are:
- A focus on the needs of patients and the Northern Ireland population
- To accelerate the adoption of innovation into practice to improve clinical outcomes and efficiency
- To build a culture of partnership and collaboration
- To make a meaningful contribution to the Northern Ireland economy.
Key MOIC stakeholders
Headed by director Professor Michael Scott and deputy director Dr Glenda Fleming, the MOIC team provides clinical pharmacy expertise supported by a diverse, multidisciplinary array of clinical knowledge from the Health and Social Care (HSC) sector, alongside insights from patient representatives.
MOIC has established a network of partnerships with stakeholders across academia; industry, including small- and medium-sized enterprises and multinationals in collaboration with Invest NI; and healthcare. This collaboration provides multidisciplinary and multi-sector clinical expertise and engages policy influencers, extending beyond Northern Ireland to reach Europe and internationally.
These collaborations are crucial for securing funding for large-scale European projects and facilitating knowledge exchange.
A legacy of achievement, a decade of medicines optimisation progress
MOIC has demonstrated considerable success, sustainability and impact since 2015 and has been recognised as an example of best practice internationally, with a number of EU-funded projects underpinning this.
SHAPES
Smart and Healthy Ageing through People Engaging in Supportive Systems (SHAPES) focused on healthy ageing.
Running from 1 November 2019 to 31 December 2023, the project tested the abilities of digital tools, including robotics and smart devices, to support older citizens living in their own homes to maintain a high-quality standard of living.
With a focus on medicines optimisation, this pilot project included an app to optimise medication use and improve adherence, which enabled remote monitoring by pharmacists and other healthcare professionals.
SIMPATHY
The Stimulating Innovation Management of Polypharmacy and Adherence in THe ElderlY (SIMPATHY) project ran from 1 June 2015 to 31 May 2017. It centred on medicines optimisation via appropriate use of polypharmacy and increasing adherence in older adults.
It comprised of a person-centred approach to managing polypharmacy and associated multimorbidities using a 7-Steps tool to undertake a comprehensive medication review.
iSIMPATHY
Following on from this, the Implementing SIMPATHY (iSIMPATHY) project sought to transform the approach to optimisation of medicines through the delivery of medicine reviews to over 6,000 patients taking multiple medicines, enabling people with multimorbidities to live healthy and active lives.
It involved pharmacist, hospital doctor and GP training on delivering structured medicine reviews and managing inappropriate polypharmacy. The overall aim was to embed a single approach for polypharmacy management and adherence.
Running across Northern Ireland, Scotland and the border areas of the Republic of Ireland from 30 September 2019 to 29 December 2022, it firmly established the value of cross-border working in this field.
The project’s evaluation report highlighted that work was underway to incorporate the person-centred comprehensive medicines review model used in iSIMPATHY into mainstream use and guidance.
ENABLE COST Action
The European Network to Advance Best practices and technoLogy on medication adherencE (ENABLE) project involved multidisciplinary stakeholders, including pharmacists, working together to identify best practices and successful medicines adherence management strategies.
They focused on quality characteristics of a good adherence enhancing technology, showcasing the range of technologies available in an online repository and identified regulatory aspects, policies and guidelines.
The four-year project, which concluded in October 2024, created a multidisciplinary network of relevant stakeholders that worked collaboratively towards economically viable implementation of medication adherence enhancing technologies across different European healthcare systems.
iMPROVE
Launched on 1 March 2025, MOIC’s latest project is Innovation in person-centred Medication Prescribing and Review for Optimal Value and Efficacy (iMPROVE). Running until 28 February 2029, it will leverage pharmacogenomics and diagnostics to personalise medicines and medicines reviews.
It aims to develop, implement and assess a new personalised and person-centric healthcare pathway, optimising prescribing of common medications in Northern Ireland, Ireland and Scotland in primary care.
The integration of pharmacogenomic and medicine review care pathways will foster resilience in the primary care sector, helping to alleviate pressures on secondary care in the project regions by reducing avoidable A&E attendances, admissions, delayed discharges and primary care contact.
Collaboration across sectors
MOIC has led the evaluation of various cross-sector projects. Post-discharge telephone follow-ups by clinical pharmacists are now standard practice in the Northern Health and Social Care Trust – one of five health and social care trusts in Northern Ireland. Consultant pharmacists for older people have also increased their involvement in nursing homes and intermediate care settings throughout the country.
Other initiatives include pharmacist case management based in GP practices, Pharmacy First services in community pharmacies, which use rapid diagnostics to manage sore throats and urinary tract infections, and new prescribing models by non-medical prescribers.
MOIC has also worked to develop a test bed approach within the HSC sector. The Test Bed Programme, launched by NHS England and NHS Improvement, unites NHS organisations with industry partners to trial digital technology combinations alongside pathway redesign in real-world environments. Its aim is to harness digital innovation to transform healthcare delivery for patients and their carers. The facility focuses on late-stage product development and preparing innovations for market, while providing industry partners with access to HSC clinicians and patients.
Strategic partnerships for medicines optimisation
MOIC has established over 25 cross-sector agreements, Memoranda of Understanding and partnerships across Ireland, Europe and internationally. Examples include collaboration with:
- The Polish Society of Clinical Pharmacy to enhance clinical pharmacy
- The Commonwealth Pharmacists’ Association on antimicrobial stewardship and the development of clinical pharmacy
- Cluster Saude de Galicia on pharmacogenomics in Spain
- Health Innovation Hub Ireland on clinical pharmacy and innovative technologies.
Additionally, partnerships focusing on environmental sustainability have been established throughout Europe.
MOIC manages the HSC Industry Partnership on behalf of the government of Northern Ireland, which aims to ensure collaboration between the pharmaceutical industry and the HSC sector to deliver ‘Triple Win’ benefits for patients, the health service and the economy. Additionally, MOIC serves as a knowledge provider for Invest NI and works directly with industry partners of all sizes.
Several projects have been completed in collaboration with industry, including cardiovascular priority pathways, smart procedure packs and testing a novel adherence technology to support individuals with respiratory diseases.
Hope and priorities for medicines optimisation in 2025
As we progress through 2025, MOIC aims to build upon its achievements and enhance its influence. Key priorities include:
- Expanding digital health initiatives through greater integration of digital technologies to enhance medication adherence, remote monitoring and patient engagement
- Strengthening international collaborations by expanding partnerships to tackle global health challenges and share best practices
- Enhancing the economic impact by fostering increased collaboration with the industry to drive innovation and growth in the healthcare sector
- Continuing to focus on sustainability and further developing and implementing projects that address the environmental impact of medicines
- Continuing to influence the HSC sector by further developing and disseminating successful HSC projects throughout all Trusts, while also advancing the HSC test bed
- Influencing policy to provide strong evidence for making decisions about medicines optimisation.
Conclusion
MOIC aims to further strengthen its position as a leading centre for medicines optimisation, driving innovation and enhancing health outcomes for the people of Northern Ireland and beyond.
By continuing to promote collaboration, embrace innovation and prioritise patient needs, MOIC is well-positioned to make a significant and lasting impact on healthcare delivery in the years to come.
These impacts build upon the unique skill sets of pharmacy teams, including those within hospital settings, and embed medicines optimisation at the heart of patient care.
Author
Katherine Redpath MSc
Communications manager, Medicines Optimisation Innovation Centre
References
1 World Health Organization. Global burden of preventable medication-related harm in health care: a systematic review. 7 March 2024 [Accessed April 2025].
2 Business Services Organisation. Northern Ireland Statistics and Research Agency. Family Practitioner Services. General Pharmaceutical Services Annual Statistics 2022/23. June 2023 [Accessed April 2025].
3 Department of Health, Social Services and Public Safety. Northern Ireland Medicines
Optimisation Quality Framework. March 2016 [Accessed April 2025].
