A missed opportunity - hospital doctors must stop 'risky' medicinesOctober 14, 20213 min read
Hospital doctors and pharmacists should stop ‘risky’ medicines before patients leave hospital - according to researchers at the University of East Anglia.
One in two older people are prescribed a medicine which over time has become inappropriate or unnecessary.
In a recent National Overprescribing Review titled ‘Good for you, good for us, good for everybody’, the government called on doctors and pharmacists working in GP surgeries to tackle the problem of overprescribing.
But research from UEA’s School of Pharmacy has found that nine out of 10 older hospital patients and their family believe that inappropriate or unnecessary medicines should also be spotted and stopped whilst they are in hospital.
And the team say that by the time people are back under their GP care, a major opportunity has been missed.
Prof Debi Bhattacharya, from UEA’s School of Pharmacy, said: “We know that half of older people admitted to hospital arrive having been prescribed a medicine that over time has become inappropriate for them. These medicines will have more risks than benefits.
“And their side effects cause problems, like making them feel drowsy, nauseous or have trouble getting to sleep. These problems impact a person’s quality of life to the extent that they can cause re-hospitalisation.
“Our research has shown that very few patients have one of these ‘risky’ medicines stopped whilst in hospital.
“Continuing medicines when they are not needed unnecessarily harms people and wastes NHS money.
“The time is right to undertake research into ways of safely increasing the number of inappropriate and unnecessary medicines that are stopped,” she added.
To tackle the problem, Prof Bhattacharya is leading a £2.4 million trial to stop risky medicines in hospital - in collaboration with researchers at the Universities of York, Newcastle, Leeds and Leicester, the Norfolk and Norwich University Hospital and Addenbrooke’s Hospital in Cambridge.
Patient and Public Engagement lead for CHARMER, Katherine Murphy, said: “We are working with hospitals and GP organisations across England to see whether the new strategy works, helps people, causes no harm, and is good value for the NHS.
“And for this trial to be meaningful to people, we need to make sure that we look at the things that matter to them when testing whether stopping a medicine has had a positive outcome.”
The research team recently surveyed 200 people including patients, informal carers, doctors, nurses, pharmacists, physiotherapists and researchers to find out what they should look at in the trial.
On reviewing the results Katherine Murphy said: “It was good to see that what people really want us to look at is whether patients can do the things that they want to do, not how much patients can do.
“Being able to walk up a flight of stairs, for example, may be important to some patients but not to others. We need to make sure that medicines are prescribed that support people to get the best quality of life. In the trial, we also need to make sure that the way that we stop risky medicines causes no harm and is good value for the NHS.”
For more information about the CHARMER study visit https://www.uea.ac.uk/web/groups-and-centres/charmer/about-the-research
The research has been funded by the National Institute of Health and Social Care research.
Debi Bhattacharya Senior Lecturer in Pharmacy
She is an expert in medication adherence and in deprescribing (providing alternatives to medication).