Characterising problematic polypharmacy in older community-dwelling people attending general practice

As people grow older they are more likely to live with multiple chronic conditions such as diabetes, heart disease and arthritis. As a result these people are prescribed multiple medications by their doctors. In Ireland, for example, 6 in 10 people aged over 65 years are prescribed five or more medications and 2 in 10 are prescribed 10 or more medications.

While the purpose of these medications is to improve symptoms and the underlying condition, sometimes these medications can have side-effects that can lead to medication-related injury, for example stomach bleeds, problems with the kidneys and falls. Older people are more likely to have problems with their medications because the way our bodies process medications changes as we age. Also the greater the number of medications we take, the more likely it is we are to have side-effects. It can be sometimes be difficult for doctors to recognise medication side-effects as these symptoms can often overlap with symptoms of other illnesses, for example, tiredness, needing to urinate frequently and feeling dizzy. However, if a medication side-effect is not recognised, then this can lead to a patient being prescribed another medication for the symptom. It is therefore very important for patients and their doctors to understand, discuss and weigh up the benefits and risks of each medication.

Our research will help by developing a list of medications causing side-effects that are difficult to recognise. We will do this by reviewing all the research published in this area and by interviewing a number of stakeholders (patients, carers, pharmacists, doctors, policymakers). We will then ask a large group of international experts for their opinion on the medication list we have developed and once finalised will examine it's usefulness in finding problematic medications for patients.

The overall aim of this project is to characterise problematic polypharmacy in older community-dwelling adults attending general practice, with a particular focus on prescribing cascades.

Award Date
14 February 2020
Award Value
Principal Investigator
Dr Emma Wallace
Host Institution
Royal College of Surgeons in Ireland
Emerging Clinician Scientist Awards 2020