How many medicines make too many medicines?

by Neal Patel MRPharmS, RPS Head of Corporate Communications

Too many patients take too many medicines.  Polypharmacy, defined as the use of many medicines by one person, is increasingly common and here to stay.  Pharmacists see patients everyday who have difficulties with the large number of medicines they’ve been prescribed.  But is polypharmacy just bad practice, or a reflection of the complexity of modern healthcare?

A new report from the King’s Fund, Polypharmacy and Medicines Optimisation, shows how the practice has both negative and positive potential, depending on the quality of care the patient receives.  An important part of this care is how an individual is helped to understand and use their medicines to best effect – in short, medicines optimisation.

I strongly believe it’s time to build a fully functioning multidisciplinary team in primary care to properly address the needs of our ageing population. The clinical skill-mix of this team needs careful consideration, with clearly defined roles for doctors, nurses and pharmacists working together. The needs of older people along with those who take many medicines, often for many different conditions, needs to be at the heart of this thinking.

There are already specialist pharmacists who work with community-based teams including GPs, nurses, community pharmacists and social care professionals to make sure the needs of older, often housebound people are met. Crucially, these roles are focused on keeping older people well, in their own homes or their care homes by optimising the use of their medicines.

I believe a pharmacist must have overall responsibility for medicines use in the care home.

Pharmacists working in this way will help keep people safe from preventable harm from medicines. The expectations from treatment must be set by patients and their carers supported by expertise from pharmacists and other health professionals.
Too often patients receive treatments which, although complying with NICE guidance, do not match their own wishes and health goals. Now is the time to ensure that older people, as well as others taking many medicines, are given access to regular patient-centred medication reviews by pharmacists to improve their health and prevent adverse reactions.

I’d encourage commissioners and health professionals to look at how patient care can be improved, using new models of integrated care including pharmacists, and to get to know our URL www.rpharms.com/futuremodels where we will regularly add new content.