Effectiveness Matters: Reducing harm from polypharmacy in older people (August 2017)

Summary

Effectiveness Matters is a summary of reliable research evidence about the effects of important interventions for practitioners and decision makers in the NHS and public health. It is extensively peer reviewed.

This issue focuses on reducing harm from polypharmacy (the use of multiple medicines) in older people.

Content

Key findings:

• Polypharmacy is common among older people; it can increase the risk of adverse drug reactions and interactions as well as reduce compliance and adherence.
• Positive (but inconsistent) effects of deprescribing interventions have been observed.
• Patient and practitioner decisions about stopping medications are influenced by social influences, expected consequences and factors such as consultation length.
• Practitioners said their own knowledge and skills, plus beliefs about the capabilities of patients could influence their decisions.
• Patients said their emotions, treatment goals, and willingness to experiment could also influence their decisions.
• A multifaceted person-centred coordinated care approach, as advocated in NICE clinical guidelines and by the ‘House of Care’ model, should underpin efforts to reduce harm from polypharmacy in older people.