Cookie policy: This site uses cookies (small files stored on your computer) to simplify and improve your experience of this website. Cookies are small text files stored on the device you are using to access this website. For more information please take a look at our terms and conditions. Some parts of the site may not work properly if you choose not to accept cookies.

Join

Subscribe or Register

Existing user? Login

Geriatric medicine

Geriatrician assessment could help GPs with older people’s medicines optimisation

A study published in the BMJ Open has shown that a thorough medication review by a secondary care geriatrician can help drastically reduce polypharmacy in older people.

Older person with a range of medicines in blister packs on the table

Source: Shutterstock.com

Polypharmacy in older people can often be reduced by carrying out a thorough medication review

A study has found that involving secondary care geriatricians in general practice could help support GPs in optimising older patients’ medications.

The study, published in the BMJ Open showed that geriatricians were able to recommend medication changes in 91% of patients who were taking at least eight medications.

The trial was carried out at seven GP practices in the Stoke-on-Trent area and involved 186 GP-selected patients who were on at least eight medications per day and aged 65 years and over. Each patient was invited to a comprehensive assessment with a geriatrician, involving full history and clinical examination, as well as assessments of balance, mobility and mental function who then made recommendations for further assessments, investigations or medication changes.

Overall, geriatricians made 687 recommendations regarding medication for 169 patients. The most common recommendation was to stop medications (34%), with 71% of patients were advised to stop at least one medication. Reducing the dosage (24%) was also frequently recommended. Starting a different medication was recommended for 44% of patients (constituting 18% of recommendations) and changing to an alternative medication was recommended for 35% of patients (13% of recommendations).

After six months, adherence to the recommendations was 72%, and 65% at 12 months, which the researchers say indicates good acceptability by GPs and patients.

The team, led by Ruth Chambers of Stoke-on-Trent Clinical Commissioning Group, said the findings indicated the potential of the strategy to tackle inappropriate prescribing and polypharmacy in primary care.

“Given that about 90% of healthcare contacts take place in primary care, there is much to gain through interventions to address potentially harmful polypharmacy in community settings,” they wrote. “To this end, pharmacists can also make a valuable contribution, as it has been shown that they can result in more appropriate prescribing, drug cost reductions and reduced healthcare services usage.”

Citation: The Pharmaceutical Journal DOI: 10.1211/PJ.2018.20204577

Have your say

For commenting, please login or register as a user and agree to our Community Guidelines. You will be re-directed back to this page where you will have the ability to comment.

Recommended from Pharmaceutical Press

  • BNF and BNF for Children

    BNF and BNF for Children

    Now available as a 1 year print subscription to both the BNF and BNFC, ensuring you have the latest medicines information as it publishes and at a greatly reduced price.

    £138.50Buy now
  • BNF and BNF for Children

    BNF and BNF for Children

    Now available as a 2 year print subscription to both the BNF and BNFC, ensuring you have the latest medicines information as it publishes and at a greatly reduced price.

    £262.50Buy now
  • Patient Care in Community Practice

    Patient Care in Community Practice

    Patient Care in Community Practice is a unique, practical guide for healthcare professionals or carers. Covers a range of non-medicinal products suitable for use at home.

    £22.00Buy now
  • Pharmaceutical Toxicology

    Pharmaceutical Toxicology

    Explains the methodology and requirements of pre-clinical safety assessments of new medicines. Includes registration requirements and pharmacovigilance.

    £40.00Buy now
  • Strategic Medicines Management

    Strategic Medicines Management

    A practical guide to influencing the availability of medicines, and policies of their use. Focuses on the strategic elements of medicines management.

    £33.00Buy now
  • Print
  • Share
  • Comment
  • Save
  • Print Friendly Version of this pagePrint Get a PDF version of this webpagePDF

Supplementary images

  • Older person with a range of medicines in blister packs on the table

Newsletter Sign-up

Want to keep up with the latest news, comment and CPD articles in pharmacy and science? Subscribe to our free alerts.