Queen's University Belfast

Academic Institute

Department for the Economy (DfE) formally Department for Employment and Learning (DEL)

Yes

191

Older adults, those aged 65 years and over, commonly suffer from long-term health conditions and are exposed to multiple medicines to treat their conditions. The prescribing of multiple medications in an individual is known as polypharmacy. In the past, polypharmacy had been viewed negatively as the use of too many medicines, but there is now an acceptance that the prescribing of many medicines may be entirely appropriate. However, while polypharmacy may be appropriate, it is still associated with many negative outcomes such as adverse drug event (ADEs), medication errors, increased healthcare costs and potentially inappropriate prescribing (PIP). PIP refers to the use of a medicine where the risk of ADEs is greater than the intended benefit of the drug. PIP is also associated with many negative outcomes such as increased morbidity, increased health care costs, reduced quality of life and mortality. In primary care, it is estimated that between 20-50% of older adults are exposed to PIP. Most studies which have investigated the prevalence of polypharmacy and PIP have only explored a limited number of factors of interest, notably age, gender and socio-economic status, in relation to their association with polypharmacy and PIP. We aim to investigate the prevalence of polypharmacy and PIP in adults aged 65 years and over in primary care in Northern Ireland. We also aim to examine the influence of patient characteristics, household characteristics, socio-economic status and indicators of health on PIP and polypharmacy.

Potentially inappropriate prescribing is associated with many negative preventable outcomes, such as hospitalisations and adverse drug events, leading to an increase in healthcare expenditure, an increase in morbidity and a reduced quality of life for patients. Identifying factors which influence potentially inappropriate prescribing can be used to inform public health intervention development which would address or aim to target these factors. This could potentially lead to an increase in the appropriateness of medication which may have positive impact on both patient welfare and economic value. In addition, determining the relationship between polypharmacy, multimorbidity (the co-existence of multiple health conditions) and potentially inappropriate prescribing may allow us to confirm that not all polypharmacy is inappropriate and that polypharmacy, when prescribed appropriately, is beneficial to patients. Lastly, should this project identify novel risk factors or groups of individuals who are greater risk of potentially inappropriate prescribing, it is hoped that the findings will be used in a larger study to develop and optimise potential interventions aimed at reducing potentially inappropriate prescribing.

11/04/2019

TRE