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Hospitals urged to reduce prescription of “risky” medicines to older patients

By - Integrated Care Journal

New research from the University of East Anglia (UEA) has led to a £2.4 million initiative across 42 hospitals aimed at reducing the prescription of potentially harmful medicines to older patients.

UEA will be leading a new £2.4 million trial, backed by the National Institute for Health Research (NIHR), which aims to increase the rate at which harmful medicines are de-prescribed to older patients while at the hospital.

New research, published 2 September 2020, suggests that half of older people admitted to hospital arrive having been prescribed a medicine that over time has more risks than benefits. Previous research from UEA revealed that less than 1 in 10 of these patients has one of these medicines stopped while in hospital.

Dr Sion Scott, from UEA’s School of Pharmacy and leader of the study, said: “These medicines offer little or no benefit to the patient but 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. ”

Researchers have highlighted several perceived barriers that currently prevent hospital doctors and pharmacists from de-prescribing. Including but not limited to; thinking that patients and carers may be too attached to their medication, a perception that stopping the medication is riskier than continuing it, and de-prescribing being generally a low priority in hospitals.

Throughout the research, the team at UEA worked with senior geriatricians and pharmacists from five hospitals in England to boost confidence and develop a better approach to de-prescribing. This includes sharing best practice and training pharmacists to help change their beliefs about the risks of de-prescribing.

The new approach also promotes more interventions ranging from implementing an organisational action plan to prioritise de-prescribing, to restructuring pharmacists’ working patterns to enable their contribution to de-prescribing decisions. This new approach will now be trialled across 42 hospital sites in England.

Professor Debi Bhattacharya from UEA’s School of Pharmacy, who will be leading the new trial, stated: “Continuing medicines when they are not needed unnecessarily harms patients and wastes NHS money. The Government recognises this as a major problem through its National Overprescribing Review. We are delighted that our approach to addressing this problem has been funded to undertake a national trial to change hospital practices. ” 

The research was funded by Pharmacy Research UK and Norfolk and Norwich University Hospitals NHS Foundation Trust, and supported by the Medicines Optimisation Research Group East Anglia (MOG_EA), which is a part of UEA Health and Social Care Partners (UEAHSCP).

‘A practitioner behaviour change intervention for de-prescribing in the hospital setting’ is published in the journal Age and Ageing on September 2, 2020.


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