Medicines & Healthcare System - Medicines play a crucial role in people's lives, with prescribing being the most common healthcare intervention [2][3] - The UK spends approximately 25 billion pounds annually on medicines, the largest expense for the National Health Service after staff costs [3] - Over 1 million people in the UK take 10 or more medicines daily, increasing the risk of side effects, drug interactions, and hospitalization [8][9] - Up to 50% of medicines are not taken as intended, leading to 300 million pounds worth of wasted medicines in the UK [10] - Medicines are implicated in 165% of unplanned hospital admissions in the UK as a primary or contributing cause [13] - Deprescribing, stopping or reducing medication dosages, can significantly improve patient outcomes [16][17][18][19] - Shared decision-making, involving patients in treatment choices, is crucial, utilizing the "BRAN" framework (Benefits, Risks, Alternatives, and what if we do Nothing) [20][21] Environmental Impact of Medicines - Medicines cause ecological damage, exemplified by the 95% decline in India's vulture population due to diclofenac [23] - Pharmaceutical pollution is present in rivers worldwide, including English national parks, with active ingredients like antibiotics, antidepressants, and hormones detected [26][27] - Pharmaceutical pollution impacts wildlife, causing mortality, behavioral changes, and reproductive issues, such as feminization of fish from oral contraceptives [28] - The pharmaceutical industry needs to design greener drugs, and the water industry should improve wastewater processes [29][30]