Researchers from Queen Mary University of London (QMUL) have launched a new study to look at how older patients manage when they are prescribed multiple medications.
The co-existence of two or more ongoing medical conditions (‘multimorbidity’) is often accompanied by ‘polypharmacy’, where patients are prescribed four or more medications at the same time.
Lead researcher Dr Deborah Swinglehurst from QMUL’s Blizard Institute said: “Polypharmacy is very common and can be incredibly burdensome and potentially harmful for patients, sometimes leading to adverse reactions, falls and hospital admissions.
“It is also expensive for the NHS and environmentally damaging, as up to half of medicines prescribed for long term conditions go unused. However, there has been little research exploring patients’ perspectives and priorities around medicine-taking nor their actual experiences and practices of fitting medicines into their daily lives and their varying capacity to do this.”
Polypharmacy also poses complex challenges for clinicians not least because most clinical guidance considers single diseases one by one, which is problematic when attempting to treat patients who experience multimorbidities.
The project ‘APOLLO-MM: Addressing the Polypharmacy Challenge in Older People with Multimorbidity’ was launched at the Royal College of General Practitioners, 30 Euston Square, and aims to develop a ‘good practice’ approach to polypharmacy and increase professional and patient engagement with the issue.
The study will involve observing up to 30 patients in their homes and health settings. The patients will be aged 65 years or older with multimorbidity who are prescribed at least ten different medications.
The researchers will follow the patients and their carers for 18-24 months to see how they interact with health services, observe their experience of polypharmacy, and note elements of safe, high-quality prescribing and those that might lead to harmful or wasteful polypharmacy.
The team will also study the GP surgeries and community pharmacies which have prescribing and dispensing responsibilities for the study patients. They will do this by observing professional practices relating to polypharmacy, shadowing staff, following organisational routines and video-recording and analysing ‘medication review’ consultations.
Nina Fudge, research associate on the project, said: “This project is unusual in the prominence it gives to understanding what medicines mean to the people who are expected to take them, rather than being preoccupied with questions about how healthcare professionals might get patients to take their medicines.”
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