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Over 75s on many prescriptions at risk of hospitalisation

Taking too many types of medication is likely to lead to hospitalisation in the over-75 population, new research has suggested.

Patients taking of ten or more medications are 300% more likely to be hospitalised, according to the results of a review by Interface Clinical Services displayed in a poster at last week’s RCGP conference.

Pharmacists reviewed the medical care of over 1,800 patients over a year and found that on average each patient had 14 GP consultations and were prescribed over six different medicines.

More than 20% of patients found to be on medication they did not need. As a result of the review, 35% of patients had their medication stopped and 4% had their doses reduced.

The review saved the NHS £192,000 including savings related to preventing hospital admissions, the company said, adding that adverse and side effects from drugs account for 5% and 17% of all hospital admissions.

The findings come as GPs have been advised to to offer tailored care plans to people with two or more long-term conditions and consider stopping all treatments with ‘limited benefit’, by long-awaited new NICE guidelines on multimorbidity published last month.

The poster said that ‘medication reviews are a key strategy to help practices and patients address [the problem of hyperpolypharmacy]’, concluding that considering the cost of the programme and the reduction in admissions ’the clinical programme would pay for itself 1.8 times in a year’.

Readers' comments (4)

  • Researches found if you dropped one brick on your foot it was less painful than if your dropped ten.

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  • Further research shows a strong association between antibiotics prescribing and the presence of chest infections (and general unwellness) . Indeed in one study 83% of acute admissions to one a&e department in the Newcastle area with a diagnosis of pneumonia had recieved a prescription for antibiotics within the preceding 10 days. Researchers calculated that a staggering 6000 admissions a year might be avoided if GPs had been more careful and not prescribed antibiotics in these patients and thus avoided this unfortunate and seemingly unnecessary association. They go to note that patients on a combination of antibiotics, steroids, home oxygen, senna, movicol, lactulose, and sodium docusate were almost guaranteed to be admitted to hospital in any following 6 month period. More research is needed.

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  • Can we have some common sense here? Correlation and causation are not the same. A more logical explanation could be those who have multimorbidity (and thus take more medications) are more likely to be hospitalised. Stopping the medications will not change the level of multi-morbidity so is unlikely to have any effect on hospitalisation.

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  • @Anonymous | Junior doctor 14 Oct 2016 10:02pm
    "Can we have some common sense here? Correlation and causation are not the same"

    Thank Hippocrates of Kos for someone who is prepared to apply some logic to matters.

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