Medication reviews and polypharmacy in primary care

Medication reviews are one of the main tools doctors and pharmacists can use to make sure people are taking the most appropriate medicines. In this project, we ask who has medication reviews and whether they make any difference to the medicines a person is prescribed. We aim to find out:

Who receives a medication review?

Do the numbers of medicines prescribed change after people have a medication review?

Do the specific medicines prescribed change after people have a medication review?

Background

Lots of people are currently taking more than one medicine at once. Often this is completely appropriate, but it can sometimes cause problems. Taking lots of medicines could cause more side effects or make it difficult to remember which medicines to take. People taking lots of medicines should be invited to have a medication review to make sure all the medicines are still needed, still working, and not causing any problems. This research will tell us whether medication reviews lead to differences in the numbers and types of medicines people are taking. It will also help to show whether certain people are more or less likely to have a medication review.

What will we do?

We will study medication reviews in two groups of people who often take several medicines: people prescribed antidepressants, and older adults. We will use existing data from a research database called the Clinical Practice Research Datalink (CPRD). This contains anonymised electronic health records collected in general practices in the UK. We will look at medication reviews, including who did the review, in the year 2019 to provide a snapshot of people’s experience before the coronavirus pandemic.

To find out whether certain people were more or less likely to have a medication review, we will compare characteristics of people who did and did not have a medication review in 2019. Then, for people who did have a medication review, we will compare the number of medicines a person was prescribed before and after the review. Finally, we will compare which medicines were prescribed before and after the medication reviews to see which medicines tend to be started or stopped.

Patient and public involvement (PPI)

The project idea was suggested through discussions with PPI contributors. The team currently includes three PPI contributors who helped develop the protocol. Our PPI contributors will join regular project meetings to discuss the progress of the research and next steps.

Dissemination

We will write up the results for publication in a scientific journal and present the results at a conference. We will share the results with the public and health professionals using social media, patient participation groups and professional networks, following advice from our public contributors.

Amount Awarded: £35,649