Establishing a service to tackle problematic polypharmacy

Area of Science:

• Pharmacology
• Geriatric Medicine
• Patient Safety

Background:

• Polypharmacy is a growing concern, increasing the risk of adverse drug reactions (ADRs) and hospital admissions.
• It negatively impacts functional status and quality of life.
• Current interventions primarily focus on primary care, suggesting a need for secondary care involvement.

Purpose of the Study:

• To pilot a secondary care-based polypharmacy clinic.
• To assess the impact of deprescribing on ADRs and patient outcomes.
• To evaluate potential cost savings associated with medication reduction.

Main Methods:

• A pilot clinic was established in secondary care, led by clinical pharmacologists and pharmacists.
• Medicines were deprescribed based on clinical need and suspected ADRs.
• Adverse drug reaction symptom burden was measured before and after the intervention.

Main Results:

• The study reviewed 24 patients, reducing their medication count by a median of 4 drugs.
• Annual savings of £4,957.44 were achieved through deprescribing.
• Median ADR burden decreased from 15 to 7 following the intervention.

Conclusions:

• The pilot polypharmacy clinic demonstrated potential for clinical improvement and cost savings.
• This model of care could be expanded to enhance outcomes for patients with polypharmacy.
• Integration and sustainability of such services are recommended for improved patient care.