Plain English Summary
The objectives of this research were to understand what we know about “problematic polypharmacy”, find out the gaps in our knowledge and suggest areas to research in the future. “Problematic polypharmacy” refers to when people take too many medicines which means people are at risk of not getting the full benefit from their medicines. The research started by setting out a set of questions about the impacts of problematic polypharmacy and what can be done to address this.
We looked for a type of research called “systematic reviews” which summarise available research papers or reports which had been undertaken in a particular topic. We found nine systematic reviews relating to problematic polypharmacy. All reviews were international, with most including UK studies.
Based on the evidence in these existing systematic reviews, we concluded that:
Researchers disagree on how to define “too many” medicines. Some studies showed that people living in long-term care facilities (e.g. care homes) take too many medicines but these studies may not apply to the UK.
Taking many medicines is related to having a greater risk of death. This might be because people who have poorer health take more medicines and, due to their poorer health, are also at greater risk of death.
Studies showed that there are actions that can be taken to reduce the problem of problematic polypharmacy, such as reviewing the medication list and stopping certain medicines. These actions do not seem to have an impact on the risk of death, people’s health-related quality of life and the risk of going into hospital.
“Medicine reconciliation” involves doctors, nurses or pharmacists checking the medicines list of people when they go into hospital and/or when they leave hospital. Medicine reconciliation lowers the risk of errors in the medicines list.
We used relevant databases to find out if there were new studies which had made their results available since the systematic reviews were undertaken. We found a total of 7,006 records. This means that there may be studies with information about this topic, but which were not included in the systematic reviews.
Given what we know now, we suggest that more research is done on problematic polypharmacy:
On how many people take too many medicines, how to find them using routine health records, and the impact of taking too many medicines on their health and the costs to the NHS.
On what can we do to reduce the problem of taking too many medicines, how well it works and how far it is good value for money for the NHS.