Polypharmacy And Deprescribing

Question 1

Over prescribing refers to situations where pts are prescribed drugs…..

(5)

Answer 1

• They do not want or need
• Where potential harm outweighs benefit
• When a better alternative is available but not prescribed
• Where the drug is appropriate for the condition but not for the individual
• When the condition changes and the drug is no longer appropriate but still prescribed

Question 2

What are the causes of o er prescribing? (8)

Answer 2

• Patient care records (difficult to establish full clinical picture)
• Hospital discharge letters (poor information)
• Reluctance to change the prescription of another clinician
• Transfer of care (30-70% experience errors - NICE 2015)
• Treatment guidelines- look at big picture
• Imbalance between starting/stopping
• Repeat prescriptions
• single reviews rather than holistic reviews

Question 3

What is polypharmacy?

Answer 3

(No official definition)

• WHO define it as 4 or more drugs
• Academia define it as 5 or more
• NHS define it as 8 or more

Question 4

What are the main recommendations for deprescribing? (3)

Answer 4

• It should be a shared decision in partnership with pt
• Use tools to identify drugs requiring review
• Documentation is important to ensure you are meeting legal requirements- consent is key