Half of patients over 75 should be on fewer medicines, warn GPs

GPs believe half of their patients over 75 would benefit from taking fewer medicines and many fear that older patients are not taking their medicines as prescribed six months after consultation, a survey shows.

Almost eight in 10 (79%) GPs said they were not confident that their older patients, aged 75 or older, on four or more medicines were still taking their medicines correctly six months after consultation, according to a report by the community pharmacist campaign group Pharmacy Voice.

Around 50% of patients over 75 would benefit from taking fewer medicines than they currently do, GP respondents said.

The Dispensing Health in Later Life report called for GP and pharmacy organisations to work together ‘with some urgency’ to improve collaborative working and help patients manage their medicines.

It also called for pharmacists to be given the power to add information to patients’ summary care records (SCRs), which are based on patients' GP records.

Polypharmacy

The government has committed to providing all community pharmacies read-only access to SCRs by autumn 2017, but Pharmacy Voice said this should be ‘rapidly followed’ with the ability to update them.

Over a third of the 5.1m people aged 75 or older take more than four medicines, and the age group is estimated to account for at least 45% of the annual £8.9bn NHS prescription cost.

GP Dr Michael Dixon, chairman of the NHS Alliance, said: ‘While there are many reasons why older people need to take a number of medicines, we are nowhere near quantifying the effects of taking multiple medicines concurrently, especially in older patients.

‘Many are confused by the sheer numbers of medicines they have been prescribed, and their health and quality of life is adversely affected when these medicines fail to treat the underlying condition because they are not taken correctly.

GPs and community pharmacists

‘Community pharmacy teams are well placed to undertake regular medicines use reviews, but the exact delivery must be worked through carefully with general practice colleagues to make sure our older patients aren’t sent round the houses, and are advised by the right health professional, at the right time, and in the right place.’

Professor Rob Darracott, Pharmacy Voice chief executive, said: ‘Community pharmacy and general practice are increasingly working more closely together, helping relieve some of the extreme pressures on GPs. We would like to develop that collaboration further.

‘Community pharmacy teams can already provide Medicine Use Reviews but awareness is low. In a year’s time, we would like to be in a position where GPs are actively encouraging older people to access their community pharmacy regularly to help with their medicines management and we have reviewed the current cap on medicine use reviews.’

Photo: JH Lancy

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