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Over 75s not taking medication correctly, say GPs

Regular Medicines Use Reviews (MURs) essential

Jo Carlowe

Monday, 02 November 2015

Eight in 10 GPs fear their elderly patients are not taking their medication correctly. 

The survey, published today in Dispensing Health in Later Life, and commissioned by Pharmacy Voice, found that 79% of GPs were not confident that patients over 75, on more than four medicines, were taking these correctly, six months after consultation. 

Moreover, GPs surveyed said they believed that more than half (50.3%) of their patients, over 75, would benefit from taking fewer medicines. It is estimated that people over 75 account for at least 45% of the annual prescription cost.

Nine in 10 GPs (92%) reported they would like more support from community pharmacy teams to help their patients take their medicines correctly.

On average, 18.7 prescriptions are dispensed per person per year, at a cost of £8.9 billion. Between 35% and 40% of the 5.1 million people aged over 75 take more than four medicines. This number is expected to rise to 6.1 million people by 2020. Regular medicines reviews have the potential to achieve many millions of pounds of savings, and help reduce the medicines wastage cost of £300 million a year, say the authors.

The foreword to Dispensing Health in Later Life, supported by NHS Alliance and Care England, makes three recommendations:

  • People over 75 on more than four medicines should have access to regular Medicines Use Reviews (MURs) undertaken by their community pharmacy teams, ideally every six months, and immediately after hospital discharge. The cap on the number of funded MURs should be reviewed and GPs should do more to make patients aware of MURs from community pharmacy.
  • National representative organisations representing general practice and community pharmacy should work together and with some urgency on how to improve collaboration, making sure people are advised by the right health professional, at the right time, and in the right place.
  • There should be greater commitment to improved information sharing. This should include allowing community pharmacy professionals secure access to both read and add clinical information to people’s summary health care records, with their consent.

Dr Michael Dixon, chair, NHS Alliance and a Devon GP, said: “While there are many reasons why older people need to take a number of medicines, we are nowhere near quantifying the effects of taking multiple medicines concurrently, especially in older patients. Many are confused by the sheer numbers of medicines they have been prescribed, and their health and quality of life is adversely affected when these medicines fail to treat the underlying condition because they are not taken correctly. Community pharmacy teams are well placed to undertake regular medicines use reviews, but the exact delivery must be worked through carefully with general practice colleagues to make sure our older patients aren’t sent round the houses, and are advised by the right health professional, at the right time, and in the right place.”

Commenting, Professor Rob Darracott, chief executive, Pharmacy Voice, said: “Community pharmacy and general practice are increasingly working more closely together, helping relieve some of the extreme pressures on GPs. We would like to develop that collaboration further. More than a third of people over 75 take four or more medicines. Community pharmacy teams are ideally placed to provide regular advice on taking them correctly, help people understand potential side effects, and assess their ongoing efficacy.

“Regular use reviews, for example every six months, could have a significant impact on the quality of people’s lives, reduce hospital admissions and deliver significant savings to the NHS. If regular reviews achieved just one fewer prescription per person per year, this could deliver tens of millions of pounds back to the service, and enrich life for millions of people who could be taking medicines that are no longer needed or not effective.

“Community pharmacy teams can already provide Medicine Use Reviews but awareness is low. In a year’s time, we would like to be in a position where GPs are actively encouraging older people to access their community pharmacy regularly to help with their medicines management and we have reviewed the current cap on medicine use reviews.”

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