Addressing the polypharmacy challenge in older adults with multimorbidity

Led by Deborah Swinglehurst


Deborah is a General Practitioner and primary care researcher. Deborah grounds her research in practice. She seeks to develop ‘practice-based’ evidence for clinicians and policymakers.

Older people living with multiple, long-term conditions (such as diabetes, high blood pressure, asthma) are often taking numerous medicines. This is known as polypharmacy. Whilst the benefits of preventing and treating ill health with medicines are hard to question, having to take a lot of medicines can be a burden for patients and their families. In some situations, polypharmacy can be harmful.

A number of converging factors make polypharmacy an urgent health challenge:

  • an ageing population living with multiple, complex, long-term conditions
  • a health system and best practice guidelines organised around a ‘single disease’ model and a focus on reduction of risk, inadvertently driving polypharmacy
  • a concern that prescribing many medicines is costly and wasteful to an already cash strapped NHS

The APOLLO-MM study is an in-depth ethnographic case study of patients’ and professionals’ experiences and practices of polypharmacy. The research is located in general practices, community pharmacies, and patients’ homes. and uses a variety of qualitative methods to investigate polypharmacy. It is funded by an NIHR Clinician Scientist Award.

The project aims to:

  • identify opportunities to avoid unnecessary or unwanted treatments and vulnerabilities to error and waste
  • produce evidence-based e-learning materials for GPs
  • work with patients to co-design patient engagement resources and raise public awareness of polypharmacy issues.
funded by nihr - White
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