Exploring experiences of polypharmacy with older people in Orkney

Exploring experiences of polypharmacy with older people in Orkney

One of the greatest challenges currently facing international health systems is multimorbidity and its management.

Funding Body
Robert Gordon University Pump Prime
Award Value
Start Date
January 2019
There are increasing numbers of people living with one or more long-term conditions due to better management of acute conditions and an ageing population. The more conditions a person has the more medications they are likely to be prescribed (polypharmacy). People are at increased risk of adverse drug events with the greater number of medications they are prescribed. People are also at risk of being overburdened by their polypharmacy regimens which can result in poor adherence, ineffective treatments and wasted resources.

Research has shown current polypharmacy decision-making is paternalistic. In response to the rise of multimorbidity and polypharmacy, policy and guidance strongly emphasises more patient-centred medicines optimisation. As well as safe and effective prescribing, medicines optimisation guidance focuses on understanding patient experience and involving patients in explicit decisions (by making clear the various trade-offs between benefit, harm, patient acceptability and choice). The ultimate aim is to help patients take informed ownership of their treatment. Yet, there is little practical guidance on how clinicians and patients can work together to achieve this.

Currently, there is little research exploring patient experiences of managing complex polypharmacy regimens, in particular for those from remote and rural communities.  Ten people taking ten or more medications from remote and rural NHS Orkney will be purposively sampled and recruited via general practices. NHS Scotland’s Primary Care Network will identify eligible patients and general practices will review the list and remove those they feel should not participate and write to the remaining individuals and invite them to participate. The letter will ask those interested to contact the research team for more information. Sampling will be purposive to include a range of patient characteristics, such as age and number of medications prescribed.

Eligible patients who have provided informed consent will initially be provided a diary (paper or digitally recorder). They will be asked to complete this over two weeks, detailing their daily medication regimens and the competing demands on maintaining this regimen. Analysis will initially be thematic using the Framework technique.


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