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Prim Health Care Res Dev. 2017 Jan;18(1):24-34. Epub 2016 Jun 16.

Person-centred medicines optimisation policy in England: an agenda for research on polypharmacy.

Author information

1
1Research Fellow,Institute of Health Research, University of Exeter Medical School,Exeter,Devon,UK.
2
2Professor,Institute of Health Research, University of Exeter Medical School,Exeter,Devon,UK.
3
3Professor,Medway School of Pharmacy,Universities of Greenwich and Kent,Chatham Maritime,Kent,UK.
4
4Associate Clinical Professor,Warwick Primary Care, Division of Health Sciences, Warwick Medical School, University of Warwick,Coventry, Warwickshire,UK.

Abstract

Aim To examine how patient perspectives and person-centred care values have been represented in documents on medicines optimisation policy in England.

BACKGROUND:

There has been growing support in England for a policy of medicines optimisation as a response to the rise of problematic polypharmacy. Conceptually, medicines optimisation differs from the medicines management model of prescribing in being based around the patient rather than processes and systems. This critical examination of current official and independent policy documents questions how central the patient is in them and whether relevant evidence has been utilised in their development.

METHODS:

A documentary analysis of reports on medicines optimisation published by the Royal Pharmaceutical Society (RPS), The King's Fund and National Institute for Health and Social Care Excellence since 2013. The analysis draws on a non-systematic review of research on patient experiences of using medicines. Findings The reports varied in their inclusion of patient perspectives and person-centred care values, and in the extent to which they drew on evidence from research on patients' experiences of polypharmacy and medicines use. In the RPS report, medicines optimisation is represented as being a 'step change' from medicines management, in contrast to the other documents which suggest that it is facilitated by the systems and processes that comprise the latter model. Only The King's Fund report considered evidence from qualitative studies of people's use of medicines. However, these studies are not without their limitations. We suggest five ways in which researchers could improve this evidence base and so inform the development of future policy: by facilitating reviews of existing research; conducting studies of patient experiences of polypharmacy and multimorbidity; evaluating medicines optimisation interventions; making better use of relevant theories, concepts and tools; and improving patient and public involvement in research and in guideline development.

KEYWORDS:

guidelines; medicines optimisation; multimorbidity; patient-centred prescribing; person-centred care; polypharmacy

PMID:
27306579
DOI:
10.1017/S1463423616000207
[Indexed for MEDLINE]

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