Patterns of medication use and polypharmacy at the end of life

Medicines are among the commonest treatments used by doctors. Doctors are looking after an ageing population, who increasingly have several conditions and complicated medical needs. This is leading to the growing issue of “polypharmacy”, a term that describes the use of multiple medicines. As the end of life approaches, the benefits of taking many medicines are unclear; such patients often welcome reducing the number of medications they receive. However, little is known about how many and what types of medicines patients are prescribed towards the end of life, both medicines for long-term conditions and those aimed at symptom control in the final period of life. Understanding these issues is important if we are to develop successful ways of improving the quality of patient care and medicines use in such patients.
This research will use a large UK store of patients’ computerised health records, known as the CPRD, which has information on about 200,000 patients. We will examine how the numbers and types of medicines prescribed by GPs change over the 12-month period prior to death, and examine what factors affect these patterns of medicines use, such as age, sex, social deprivation, different health problems and cause of death.
This work has the potential to benefit a large number of patients. It will help to identify patients who are at risk of experiencing inappropriate medicines towards the end of their life, and those who do / do not receive medication such as morphine for symptom control. It will help us design ways of improving the quality of prescribing and care for patients in the final months of life.