iMPROVE

What is iMPROVE?

iMPROVE is a €10.1M EU funded project running across Northern Ireland (Counties Derry~Londonderry and Tyrone), Republic of Ireland (Counties Donegal and Sligo) and Scotland (Tayside).

iMPROVE will run for four years and is supported by PEACEPLUS, a programme managed by the Special EU Programmes Body (SEUPB). The goal is to help 10,000 people who live with ongoing health conditions by making their medication safer and more effective. The project will use a personalised approach to healthcare that focuses on each person’s unique needs.

People who join the study will take part in a six-month programme. During this time their medicines will be reviewed by clinical members of the iMPROVE project team who are based within general practice (primary care) and they will agree and share a medicine plan. Where deemed clinically appropriate participants will be offered pharmacogenomic (or drug-gene) testing, a type of medical test that looks at your genes to understand how your body responds to different medicines.

A PeacePlus project

The project is supported by PEACEPLUS, a programme managed by the Special EU Programmes Body (SEUPB) through provision of a grant up to €10.1m.

What does iMPROVE aim to achieve?

The iMPROVE project brings together healthcare teams from different regions to work on shared health challenges. Many people today live with multiple long-term health conditions and take several medications, which can sometimes be ineffective or cause side effects. GP practices are under pressure, with long waiting lists and patients needing more support.

iMPROVE will introduce a more personalised way of prescribing medicines—focused on each person’s unique needs. Pharmacogenomic testing will be delivered on a cross-border basis in primary care on the island of Ireland for the first time, helping improve treatment safety and effectiveness. Learning from Scotland’s experience of delivering person-centred medication reviews, and piloting pharmacogenomic testing, will inform the project. Here’s what the project aims to do:

Support 10,000 people over four years with a person-centred approach to prescribing medicines.
Train local healthcare teams to deliver a new care pathway and use new tools and approaches.
Secure appropriate ethical, governance and regulatory approvals to facilitate safe, effective and efficient rollout and assessment.
Measure the benefits of the new care pathway by monitoring participant’s symptoms and quality of life, rate of adverse drug reactions and prescribing choices.
Report on whether the new approach is equitable, accessible, and sustainable.
Help address health inequalities by delivering person-centred care and working to ensure that people get the right medicines for their needs.
Improve wellbeing and promote peace and prosperity in project regions by focussing on mental health and pain, helping people to feel better and miss less work.

iMPROVE plans to continue to embed the Medication review: 7-Steps to appropriate Polypharmacy as introduced by the successful iSIMPATHY project and incorporate scientific innovation into medication review through pharmacogenomic testing.

Why is iMPROVE important?

When medicines are prescribed inappropriately—either the wrong type, wrong dose, or unnecessary ones—it leads to higher healthcare costs and reduces the quality of life. Every year, around 8.6 million people across Europe are admitted to hospital unexpectedly because of problems caused by their medications.¹ These are known as adverse drug events, or ADEs, which happen when a medicine causes harm instead of helping.

In the UK, ADEs are a major issue—especially for older adults. About 16.5% of hospital admissions for people aged 65 and over are due to ADEs, and in emergency medical units, the number can be as high as 20%.² These events don’t just affect people’s health—they also come with a huge financial cost. In the UK alone, ADEs cost the healthcare system about £2.21 billion every year.³

A key cause of ADEs and treatment failure is that people’s bodies respond differently to medicines based on their genes. Some common genetic differences can make medicines less effective or more likely to cause side effects. Studies suggest that 85–90% of people in Ireland and the UK have at least one genetic variation that could affect how they respond to certain medicines.⁴ These are known as drug-gene interactions and understanding them could help prescribers prescribe more safely and effectively.

iSIMPATHY Evaluation Report iSIMPATHY is supported by the European Union’s INTERREG VA Programme and managed by the Special EU Programmes Body (SEUPB) [Internet]. Available from: https://www.isimpathy.eu/uploads/iSIMPATHY_Evaluation_report_ver8_online.pdf

de Lemos J, Loewen P, Nagle C, McKenzie R, You YD, Dabu A, et al. Preventable adverse drug events causing hospitalisation: identifying root causes and developing a surveillance and learning system at an urban community hospital, a cross-sectional observational study. BMJ Open Quality. 2021 Jan;10(1):e001161.

Costs of adverse drug reactions | Centre for Health Economics and Medicines Evaluation | Bangor University [Internet]. cheme.bangor.ac.uk. [cited 2024 Mar 6]. Available from: https://cheme.bangor.ac.uk/news/costs-of-adverse-drug-reactions-17622

Youssef E, Kirkdale CL, Wright DJ, Guchelaar H, Thornley T. Estimating the potential impact of implementing pre‐emptive pharmacogenetic testing in primary care across the UK. British Journal of Clinical Pharmacology. 2021 Jan 19;87(7):2907–25.

What is iSIMPATHY?

Implementing Stimulating Innovation in the Management of Polypharmacy and Adherence Through the Years (iSIMPATHY) was an SEUPB funded project run across primary and secondary care in Northern Ireland, Scotland and the Republic of Ireland. From 2019 to 2023 iSIMPATHY implemented a person-centred 7-Step pharmacist led medication review. iMPROVE will adopt the same 7-Step model and introduce a pharmacogenomic element to optimise prescribing.

iSIMPATHY aimed to ensure the most sustainable use of medicines for patients by training pharmacists and other healthcare professionals to deliver person-centred medicines reviews and embedding a shared decision-making approach to managing polypharmacy (the use of multiple medicines). It found that there are significant healthcare resource utilisation benefits to using the 7-Steps to appropriate Polypharmacy model, as indicated by a positive return on investment of both medication and healthcare costs, together with patient reported improvements. More information on this successful intervention can be found on the project’s website: iSIMPATHY project

What is pharmacogenomic testing?

Pharmacogenomics is the study of how your genes affect the way your body responds to medicines. It’s a combination of two words: pharmacology (the science of drugs) and genomics (the study of genes and how they work).

Just like people have different eye colours or blood types, we also have genetic differences that affect how our bodies process medications. These differences can influence whether a medicine works well for you, causes side effects, or doesn’t work at all.

Project Partners

The project partners bring the necessary expertise to ensure delivery of the project. Led by the Personalised Medicine Centre at Ulster University, partners have been brought together on a cross border and transnational basis to form the largest critical mass of clinical, academic and community expertise in pharmacogenomics and medication review on the island of Ireland and across much of the UK.