Originally released in January 2024, this podcast with guest speaker senior pharmacist Sarah Hafeez, focuses on the differences between inappropriate and appropriate polypharmacy.
Doctors Lisa and Sara talk through some typical cases and scenarios with Sarah, before going on to discuss prioritising concerns, weaning and/or stopping medications all together, counselling patients on the effects of opioids and gabapentinoids and how to involve community teams aiming for successful reductions of addiction forming medications.
They also discuss the potential long term risks of proton pump inhibitors and advice on weaning, remembering to consider anticholinergic burdens, as well as handy resources for tackling polypharmacy, structured medications reviews and medication reduction.
Listen to the podcast episode at https://pckb.org/e/2024-polypharmacy-summer-rewind/
Useful resources:
- Greater Manchester Medicines Management Group: Inappropriate Polypharmacy Review and Treatment Optimisation: Resource Pack (from Dec 2022, accessed Dec 2023): https://gmmmg.nhs.uk/wp-content/uploads/2023/02/GMMMG-Polypharmacy-resource-pack-v3.0.pdf
- Scotland Polypharmacy Resources for Professionals and for Patients: https://www.polypharmacy.scot.nhs.uk/for-patients-and-carers/
- Scottish Polypharmacy Guidance 2018: https://www.therapeutics.scot.nhs.uk/wp-content/uploads/2018/04/Polypharmacy-Guidance-2018.pdf
- Lewis T. Using the NO TEARS tool for medication review. BMJ. 2004 Aug 21;329(7463):434. doi: 10.1136/bmj.329.7463.434. PMID: 15321901; PMCID: PMC514207 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC514207/
- Toolkit for General Practice in Supporting Older People Living with Frailty (includes a great Appendix of the STOPP/START criteria (2017): https://www.england.nhs.uk/wp-content/uploads/2017/03/toolkit-general-practice-frailty-1.pdf
- Canadian Resource for Deprescribing including reducing medications and some patient information leaflets: https://deprescribing.org/
- Resource for help reducing and stopping medications: https://medstopper.com/
- Me and My Medicines Resource for Patients to look through their medications before reviews or for information: https://meandmymedicines.org.uk/
- Anticholinergic Medications and Risks of Dementia Cochrane Editorial with Reports in Link (Sept 2021): https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.ED000154/full
- Anticholinergic drugs and risk of dementia: Time for action? British Pharmacological Society. Bell B et al Jun 2021 (9:3). Accessed 15/1/2024: https://bpspubs.onlinelibrary.wiley.com/doi/full/10.1002/prp2.793
- Cognitive Effects of Anticholinergic Load in Women with Overactive Bladder. Clin Interv Aging. 2020; 15: 1493–1503: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7457731/
