There is potential to reduce the number of medications prescribed to older people, which could cut medical costs and improve the lives of those with multiple prescriptions, according to the findings of a new Irish study.
Researchers at the RCSI University of Medicine and Health Sciences looked at the potential benefits of medication reviews from a GP in reducing the number of medications prescribed to older patients with multiple medical conditions, known as multimorbidity.
The RCSI study noted that there is an increasing number of older people with multimorbidity who are prescribed several medicines, which can cause challenges for patients, carers, the healthcare system and the clinicians who decide on what should be taken.
The research consisted of a medication review between older patients regularly taking at least 15 different medications and their GP. This review including looking through the patient’s prescriptions for potentially inappropriate combinations, considered opportunities for stopping medicines and assessed treatment priorities.
The study involved a randomised controlled trial with 51 GP practices and 404 patients throughout the Republic of Ireland.
The result was a significant reduction in the number of medications being prescribed to those in the study, with few adverse effects. More than 800 different medicines were stopped in 208 intervention patients, with 15 adverse events reported.
“It’s possible that the identification of this at-risk group who are prescribed at least 15 medicines may in itself have led to improvements in prescribing,” co-author of the study Dr Caroline McCarthy noted.
“It can be daunting for GPs with limited time and resources to actively manage these prescriptions and patients can also be wary about change, particularly if they have been on a medicine a long time.”
Almost all the adverse reactions in the study were mild and stopped once the medication was re-introduced, the researchers found.
“The intervention approach to managing this challenging problem is promising and demonstrates that, even in this very complex group, stopping medicines that may no longer be needed or appropriate is both possible and generally safe,” co-author Prof Susan Smith added.
The research was funded by the Health Research Board’s Primary Care Clinical Trials Network.
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