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Characterising problematic polypharmacy in older community dwelling people attending general practice
Welcome
This 5-year Health Research Board (HRB) funded grant has examined contributors to and consequences of problematic polypharmacy in older adults attending general practice, with a particular focus on prescribing cascades.
Who are we?
We are a cross disciplinary group of researchers, patients, clinicians, professional organisations, healthcare policy makers with an interest in optimising medication safety. Prof Emma Wallace is currently Principal Investigator of this project on a HRB Emerging Clinician Scientist Award.
Our Partners
Why is this research important?
- There is an increasing number of people living with multiple long term health conditions. As a result, there is a need for multiple medications (polypharmacy) as part of treatment.
- While the purpose of these medications is to improve symptoms and the underlying condition, sometimes these medications can have side-effects that can lead to medication-related harm.
- Balancing risks and benefits is a complex task for prescribers, especially in older adults on multiple medications with multiple health conditions. It can sometimes be difficult for doctors to recognise medication side-effects as these symptoms can often overlap with symptoms of other illnesses.
- However, if a medication side-effect is not recognised, then this can lead to a patient being prescribed another medication for the symptom (a prescribing cascade).
- It is therefore very important for patients and their doctors to understand, discuss and weigh up the benefits and risks of each medication.
Problematic Polypharmacy: when someone is taking 5+ medications and one or more of these may be considered potentially inappropriate prescribing (when a medication prescribed is not clinically indicated or when it may cause more harm than benefit)
Adverse Drug Reaction: unintended reaction/side-effect to a medicine at the dose it is usually prescribed
Prescribing Cascade: when a new medication is prescribed to treat/prevent an adverse drug reaction caused by another medication
Unintentional Prescribing Cascade: when an adverse drug reaction is misinterpreted as a new problem, which results in prescribing a new (second) medication