Why are we doing this research?

Patients who have several health issues often need to take several medicines. This means that they have a higher chance of reacting badly to their medication. Bad reactions to medicines can be because of side effects, or different medicines not mixing well in the body, or medicines causing other health problems (for example  kidney or liver problems).

How will it help patients?

Our research theme (Safe Use of Medicines) aims to help patients by finding out:

  • How can we identify patients who are, or might be taking, a set of medicines that could cause them harm?
  • How can we safely stop medicines that might be harmful – this is now often called ‘deprescribing’ by healthcare professionals (doctors, nurses and pharmacists)?

What are our research plans?

Different research activities, or ‘workstreams’, will help us to achieve our aims:

In Workstream 1, we have looked at how stopping medicines happens in real life for older (aged over 65) patients who are frail – these are patients who are more likely to become ill if they react badly to their medicines. We wanted to find out:

  • What things make stopping medicines easier and more difficult
  • What words we should use to describe how to stop medicines that are understood by both patients and healthcare professionals
  • How healthcare professionals and patients talk to each other about stopping medicines
  • How healthcare professionals and patients decide which medicines to stop and how to stop them safely
  • What the best way is for healthcare professionals and patients to work together when stopping medicines.

To find out about this, we interviewed healthcare professionals, patients and their supporting peers (the people who provide support with medicines, or might discuss them with patients, for example a family member). This study is the first one carried out with patients who actually had a medicine stopped and, where patients were interviewed both before and after their medicines were stopped. With their agreement we also video-recorded the interviews and are making a short film about how they felt.

We are now looking at the interviews to see what we can learn and what we might need to find more about. What we learn from the interviews will help us to develop ways to support healthcare professionals and patients when stopping or reducing medicines.

In Workstream 2, we are using a database of frail, older people to look at whether different combinations of medicines might worsen health and well-being. We want to find out if certain combinations of medicines lead to falls, problems with thinking and memory, and admissions to hospital. This is the first time a study of this type has been done with older people who are frail. To make sure our research is useful and can be compared with other studies, we are using methods that are ‘tried and tested’. We will use the results to help prescribers working in GP Practices to search their computer medical records to find patients who might benefit from having a medicine stopped.

Overall our findings from these first two workstreams will support the safe use of medicines by helping us to work out ways to help patients and healthcare professionals make sure patients are taking the right medicines.

How can I find out more?

See our web pages to find more about our study and Safe Use of Medicines research theme.

This text was prepared by the following members of the Safe Use of Medicines team:

A Bhagwat, I Marques, J Olaniyan, D Payne, B Fylan, A Blenkinsopp, D P Alldred