University to lead hospital trial to cut potentially harmful repeat prescriptions for older people

An initiative to stop the use of the continued prescribing of potentially harmful medicines to older patients will be trialled across hospitals in England.

Half of older people admitted to hospital arrive having been prescribed a medicine that over time has more risks than benefits, the University of East Anglia (UEA) said.

Previous research from the university has shown that fewer than one in 10 patients had one of these problematic medicines stopped while they were in hospital.

Researchers at UEA will lead a £2.4 million trial across 42 hospitals aimed at solving the problem.

It comes as research reveals a new approach to increasing the likelihood of potentially harmful medicines being de-prescribed while patients are in hospital.

Dr Sion Scott, from UEA’s School of Pharmacy, who led the study, said: “We know that a large number of older people arrive in hospital, having been prescribed a medicine that over time has become inappropriate for them.

“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.”

He said such problems impact on quality of life to the extent that they can cause the patient to be re-admitted to hospital.

Previous research from the university team showed a number of barriers stopping hospital doctors and pharmacists from de-prescribing.

These include thinking that patients and carers may be too attached to their medication, a perception that stopping medication is riskier than continuing to take it, and de-prescribing being a low priority in hospitals.

The research team worked with senior geriatricians and pharmacists from five hospitals in England to develop a better approach to de-prescribing, which includes sharing best practice and training pharmacists to help change their beliefs about the risks.

The new approach also includes interventions ranging from implementing an organisational action plan to prioritise de-prescribing, to restructuring pharmacists’ working patterns to enable their contribution to such decisions.

The trial will be rolled out in collaboration with researchers at the universities of York, Newcastle and Leeds, the Norfolk and Norwich University Hospital and Addenbrooke’s Hospital in Cambridge.

Professor Debi Bhattacharya from UEA’s School of Pharmacy will lead the trial.

She said: “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 over-prescribing review.

“We are delighted that our approach to addressing this problem has been funded to undertake a national trial to change hospital practices.”

In 2018, Health Secretary Matt Hancock announced a review into over-prescribing in the NHS.

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