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NHS must adapt to polypharmy, report shows

NHS must adapt to polypharmy, report shows
2 December 2013



The number of people taking ten or more medicines has trebled over the past ten years, new estimates suggest. 
A report released by healthcare thinktank The King’s Fund shows that neither policy, medical training, nor clinical practice have been able to adapt to the significant increase in patients on multiple prescription drugs. 
However, an evidence-based approach to polypharmy should improve outcomes for many people, The King’s Fund believes. 

The number of people taking ten or more medicines has trebled over the past ten years, new estimates suggest. 
A report released by healthcare thinktank The King’s Fund shows that neither policy, medical training, nor clinical practice have been able to adapt to the significant increase in patients on multiple prescription drugs. 
However, an evidence-based approach to polypharmy should improve outcomes for many people, The King’s Fund believes. 
The report suggests that for polypharmacy to be used more effectively there needs to be:
 – Better training for doctors in managing complex multi-morbidity and in polypharmacy.
 –  More research set in the context of using treatments where people have several diseases, rather than selecting subjects who have single conditions.
 –  National guidelines for multi-morbidity to match those for single conditions.
 –  Improved systems, particularly for GPs, to flag problematic polypharmacy.
 –  Regular reviews of patients’ medication and a willingness to consider stopping medication, particularly in cases of limited life expectancy.
 –  Changes in systems of medical care to move away from increased specialisation towards a focus on multi-morbidity.
Martin Duerden, the report’s lead author, said: “Currently patients may still be treated in silos where one specialist doctor will look after their care for diabetes, another for their heart condition and a third for their asthma. They will then be prescribed medicines for each condition but these are often not considered in the whole. 
“We need more generalist doctors able to understand a patient’s medicine intake in its entirety and how they are managing, especially if they have to take numerous medicines at different times in the day.” 
Polypharmacy and medicines optimisation: making it safe and sound is available to view on The King’s Fund website. 

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