Polypharmacy – new guidance from RPS
It’s great to see new polypharmacy guidance from the Royal Pharmaceutical Society about getting medicines right for every patient. Polypharmacy review is sometimes described as ‘deprescribing’ – not a term I like but in some cases it might be – but the more important message is that the medicines a person is prescribed are the right ones for them at a given point in time. Managing long term medicines for care home residents as a pharmacist prescriber, I have seen time and again the benefits and improved quality of life when medicines are reviewed and changed to be appropriate for the person now….not as they were ten or more years previously. And when these reviews are done collaboratively within a multi-disciplinary team and with ongoing review of changes, the benefits to the person can be dramatic.
Collaborative working is recommended in the guidance and its value cannot be understated. When reviewing a complex medication regime, it can sometimes be difficult to know where to start. The GP passes it to the pharmacist to review, the pharmacist feels competent to review only some of the medicines. But working together, they may find potential for more changes and be able to strategise over the best way forward for the patient.
The key to collaborative working though, is to involve the patient. Whatever changes we as healthcare professionals might think are best for the patient, if they do not want to take the medicines or are unable to take the medicines as prescribed, a review of medicines will confer little if any benefit.
In medication review, as with all consultations, the patient must be at the centre of the decision-making and be involved in decisions where they can. Where they cannot, we should involve their welfare representatives so that previous wishes can be taken into account.