Avoiding harm: Tackling problematic polypharmacy through strengthening expert generalist practice

Reeve, Joanne

Abstract

Problematic polypharmacy is a growing challenge. Medication that is intended to improve patients' health and wellbeing is instead becoming part of the problem. The way we practice medicine has become a driver for the problem. Dealing with the challenge will need us to think differently about how we do clinical care. A 2013 Kings Fund report stated that tackling problematic polypharmacy requires us to actively build a principle of compromise into the way we use medicines. There are implications for how we consult and make decisions with patients, in how we design health practice and systems to support that decision making, and, in our understanding of the process of research, how we generate the knowledge that informs practice. This review considers the current state of play in all 3 areas and identifies some of the work we still need to do in order to generate the practice-based evidence needed to tackle this most challenging problem. Finding a way to redesign practice to address problematic polypharmacy could offer a template for tackling other related complex issues facing medical practice such as multimorbidity, chronic pain and complex mental health.

Citation

Reeve, J. (in press). Avoiding harm: Tackling problematic polypharmacy through strengthening expert generalist practice. British Journal of Clinical Pharmacology, https://doi.org/10.1111/bcp.14531

• Journal Article Type: Review
• Acceptance Date: Aug 17, 2020
• Online Publication Date: Aug 25, 2020
• Deposit Date: Aug 29, 2020
• Publicly Available Date: Aug 26, 2021
• Journal: British Journal of Clinical Pharmacology
• Print ISSN: 0306-5251
• Electronic ISSN: 1365-2125
• Publisher: British Pharmacological Society
• Peer Reviewed: Peer Reviewed
• DOI: https://doi.org/10.1111/bcp.14531
• Keywords: Polypharmacy; Problematic polypharmacy; Generalism; Multimorbidity
• Public URL: https://hull-repository.worktribe.com/output/3562419
• Publisher URL: https://bpspubs.onlinelibrary.wiley.com/doi/abs/10.1111/bcp.14531