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  • 1 July 2016 to 30 June 2018
  • Project No: 331
  • Funding round: FR 12
  • Multimorbidity

Medicines are the commonest treatment used by doctors to improve health. Doctors are looking after an ageing population with increasingly complicated medical needs. This is leading to a growing problem of “polypharmacy” - the use of multiple medicines in a single patient. Multiple medicines can often help improve a patient’s health. However, polypharmacy can also be inappropriate and can lead to problems, such as prescribing errors, side effects and reduced quality of life.

Although polypharmacy is widely recognised as a major problem, there is currently no useful way to measure if polypharmacy is inappropriate. If we could do this, it would help doctors or pharmacists to identify patients receiving inappropriate polypharmacy, and improve patients’ medicines. The aim of this research is to develop a measure of inappropriate polypharmacy that can be used in routine general practice. This will be done in three steps:

First, a group of clinical experts will be used to identify the most important aspects of prescribing that might lead to inappropriate polypharmacy. The different aspects of prescribing will then be combined to produce a single measure. Second, we will then test the accuracy of the measure by looking at whether the results it provides are comparable to the expert opinion of doctors and pharmacists. Finally, we will use the measure to quantify the extent of inappropriate polypharmacy in the UK population using a large electronic health record database.

This work is highly relevant to a large patient population in the UK and internationally, with the measure having the potential to be easily incorporated into routine clinical practice, as well as being useful for future research in this area.

Rupert Payne (University of Bristol) with co-applicants Alastair Hay, Richard Morris and John MacLeod (Bristol), Tony Avery and Sarah Rodgers (Nottingham), Jenni Burt (Cambridge) and Stephen Campbell (Manchester).


Amount awarded: £192,782

Evidence synthesis working group

The collaboration will be conducting 18 high impact systematic reviews, under four workstreams.

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