Researchers have shown a possibility of reducing medications for older people through a study published in PLOS Medicine.
According to RCSI University of Medicine and Health Sciences, more and more people around the world have to live with multiple medical conditions, known as multimorbidity, and they have to take multiple medicines for their conditions. This leads to multiple issues for the healthcare system at large in terms of costs, as well as for the individual (and their carers) in coping with taking so many medicines, and for the clinicians who decide what should be taken.
Researchers at The SPPiRE (Supporting prescribing in older people with multimorbidity and significant polypharmacy in primary care) are working towards addressing these challenges. In the study involving 51 GP practices and 404 patients throughout the Republic of Ireland, researchers invited older patients with multimorbidity taking at least 15 regular medicines were invited to attend a medication review with their GP.
The review included screening their prescription for potentially inappropriate combinations of medicines, considering opportunities for stopping medicines and assessing the patient’s priorities for treatment. It then assessed whether this once-off GP-delivered medication review reduced the number of medicines and improved the quality of prescribing.
There was a significant reduction in the number of medicines in the intervention group compared to the control group, with over 800 medicines being stopped in 208 intervention patients. Of the 800+ medicines ceased, 15 possible adverse events were reported, almost all of which were mild reactions that stopped once the medicine was re-introduced, indicating that stopping certain medicines in older people is generally safe.
The quality of prescribing was also assessed, using a checklist of potentially inappropriate combinations of medicines. While there were no significant improvements in the quality of prescribing in the intervention group compared to the control group, overall there were improvements in both groups during the study period.