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New research aims to provide clinicians with a more structured way of managing their patients’ medicines

 

An NIHR funded study provides new insight for clinicians such as GPs and pharmacists to help them manage their patients’ medication more effectively.

With the over-70s and people with existing medical conditions being encouraged to ‘shield’ or self-isolate in lockdown as much as possible, there are concerns many could be avoiding seeking help from GPs and pharmacies in managing multiple medications, known as ‘polypharmacy’.  

The new research from Aston University, in collaboration with the universities of Oxford, Sheffield, Bradford and Wollongong and the NHS, has been published in the journal BMC Geriatrics. 

The team behind the MEMORABLE (MEdication Management in Older people: Realist Approaches Based on Literature and Evaluation) study, led by Dr Ian Maidment, reviewed existing academic literature and carried out 50 in-depth interviews with older people, their family carers and health and care practitioners. 

The researchers identified five ‘key burdens’ faced by older people and their family carers. These included ‘ambiguity’, where the purpose of medicines was not explained clearly, through to ‘fragmentation’ from having to deal with lots of different health and care practitioners and ‘exclusion’ when older people and family carers were not involved in care decisions.

In response, the team proposed a five-stage framework for clinicians to help older people and family carers manage medication more effectively. It places greater emphasis on the need for regular reviews of the medications older people are taking involving patients and their carers – something that isn’t always done routinely at present.

Dr Ian Maidment, from Aston University’s School of Life and Health Sciences, said:

“The reality is that many older people are taking what amounts to a ‘shopping list’ of different medicines. They may all be necessary, but older people and their family carers have told us what a huge burden it can be to remember how and when to take them all. And that was in ordinary times without the added pressures of lockdown.

“What we’re hoping to show with this study is that practitioners need to be aware that the burden and risk with medication is often hidden. There needs to be a simpler way of identifying people who are struggling and more emphasis on fitting managing medication into older people’s day-to-day lives. When prescribing new drugs, GPs will often consider things like side effects, but they equally need to think about how someone will actually manage taking them.”

Jo Rycroft-Malone, NIHR Programme Director and Chair of the Health Services and Delivery Research (HS&DR) Programme said: 

"This research provides important, usable insight into the issues facing older people when it comes to managing their medication. The proposed five step approach will be very useful to practitioners when working with patients and their carers particularly at a time when people may be more concerned about asking for help."

This study was funded by the NIHR Health Services & Delivery Research programme. 

More information about the study is available on the NIHR’s Funding & Awards website.