Case Study: virtual Polypharmacy Workshops

Why did you originally join a Polypharmacy action learning set?

Polypharmacy is increasingly common as patients are becoming more complex. It causes concern to both patients and clinicians. Problematic polypharmacy can lead to harm and I wanted to learn more about recognising and managing this.

What are you now doing differently at your place of work as a result of participating in the action learning set?

As a GP I do not carry out SMR’s but I do always check patients medication lists even when I am not prescribing. Now I actively deprescribe medications and am more conscious to offer non-drug alternatives to patients already taking other medications.

I am also specifically focusing on patients taking NSAIDs with other DAMN medicines. When I encounter this with a patient I ensure they understand the potential risks of taking the medicines together and where possible stop the NSAID and offer an alternative. If they still wish to take the NSAID I discuss sick day rules and any monitoring requirements such as checking renal function.

How and why did you decide which area to focus on? How did you do make this change? Who else was involved?

I decided to focus on deprescribing as I believe that many patients would prefer to take fewer medications and it is important that we ensure that when polypharmacy is unavoidable it appropriately balances the risks and harms.

I decided to specifically look at patients taking an NSAID plus other DAMN medicines because NSAIDs are one of the drug groups most responsible for drug-related adverse events and offering alternatives or reducing their use is a safer option.

Describe what else has changed if the data is not yet available

I have reduced a number of patients’ medications by deprescribing and have stopped/reduced the dose/frequency of NSAIDs or offered alternatives when patients are also taking other DAMN medicines.

Have you learned any useful lessons / insights to share with others?

I have gained confidence deprescribing and managing polypharmacy and found the resources particularly helpful.

Next steps?

I intend to collate the resources and my learning points to share with my practice team.