Evaluation of the new ePACT2 national polypharmacy prescribing indicators

Polypharmacy – the use of multiple medicines for a single individual – is a big challenge for the health service. It can be associated with problems such as side effects, and lots of pills can be a burden for patients. There is therefore a lot of interest in trying to improve care for patients who experience polypharmacy. This requires a way of identifying those patients most at risk of experiencing problems from polypharmacy. The NHS has recently developed an improved computerised system called ePACT2 to record prescription information. This means that it is now far easier to measure how many medicines patients are taking, and whether they are taking particular combinations of medicines that might cause problems. We call these new measures the ePACT2 polypharmacy prescribing indicators.

For these ePACT2 indicators to be useful, we need to first have a better understanding of the factors they are associated with, and whether they truly help us to identify those people who might experience health problems.

We will therefore conduct two pieces of work. The first part will look at ePACT2 polypharmacy indicators from each GP surgery from the whole of England. We will see how the ePACT2 indicators are affected by factors such as the quality of care delivered by a surgery, and how the ePACT indicators vary between surgeries. For the second part, we will use routine, electronic health records from a large national database called CPRD. We will then find out whether patients with potentially problematic prescribing measured using the ePACT2 indicators experience additional difficulties (for example, unplanned admissions to hospital).

The results of this study will be very useful for helping the health service decide how best to use the ePACT2 indicators to help guide better care for people experiencing polypharmacy.

Amount awarded: £157,131