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Patient-centred management of polypharmacy: a process for practice.

Nina L Barnett1, Lelly Oboh2, Katie Smith3

  • 1Pharmacy Department, Northwick Park Hospital, Harrow, UK.

European Journal of Hospital Pharmacy : Science and Practice
|June 4, 2019
PubMed
Summary

Polypharmacy, the use of multiple medications, poses risks for older adults. A new seven-step approach aids clinicians and patients in collaborative medication review and safe deprescribing.

Keywords:
EDUCATION & TRAINING (see Medical Education & Training)Evidence based medicineGERIATRIC MEDICINEPHARMACOTHERAPYPRIMARY CARE

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Area of Science:

  • Geriatric Medicine
  • Clinical Pharmacology
  • Public Health Policy

Background:

  • Polypharmacy (use of multiple medications) is increasing in older UK adults.
  • Associated risks include adverse drug events, hospitalizations, and increased costs.
  • Current guidelines often address single conditions, not multimorbidity, and lack deprescribing guidance.

Purpose of the Study:

  • To review UK literature on polypharmacy.
  • To describe resources for medication review.
  • To present a patient-centred, collaborative approach to deprescribing.

Main Methods:

  • Literature review of UK polypharmacy research.
  • Analysis of four key international resources.
  • Development of a seven-step diagrammatic approach for collaborative medication review.

Main Results:

  • Identified a need for evidence-based guidance on reducing and stopping medications.
  • Highlighted four clinician-focused resources.
  • Developed a patient-centred, seven-step deprescribing strategy.

Conclusions:

  • Polypharmacy is a growing concern in older populations.
  • A collaborative, patient-centred approach is needed for safe medication optimization.
  • The proposed seven-step strategy facilitates deprescribing and reduces polypharmacy risks.