Health services

Tender description

The aim of the service is to review the use of medicines for patients with complex care needs being prescribed multiple medicines to ensure they are receiving ‘appropriate polypharmacy’. Appropriate polypharmacy is defined as ‘prescribing for an individual for complex conditions or for multiple conditions in circumstances where medicine use has been optimised and where the medicines are prescribed according to best evidence’. The aim of the service is to review the use of medicines for patients with complex care needs being prescribed multiple medicines to ensure they are receiving ‘appropriate polypharmacy’. Appropriate polypharmacy is defined as ‘prescribing for an individual for complex conditions or for multiple conditions in circumstances where medicine use has been optimised and where the medicines are prescribed according to best evidence’. Polypharmacy is a term generally understood to refer to the concurrent use of multiple (usually 4 or more) medications by 1 individual. Polypharmacy is widespread and increasingly common occurring in primary and secondary care and in care homes. The occurrence of polypharmacy has risen dramatically over the last few decades driven by: 1) The growth of an ageing and increasingly frail population. 2) The increasing prevalence of multi-morbidity, where patients may be living with several long-term conditions often compounded by disability and/or frailty. 3) The increasing use of technology and technologically advanced medicine, which means that a greater number of conditions can be treated medically. 4) Guidelines driven prescribing. Polypharmacy is not an issue exclusively related to older people and it is important that medication reviews are undertaken regularly, especially for the higher risk patients to ensure that their medication regime is appropriate to their needs and that the perspective of the patient is taken into account when taking multiple medicines. Medicines optimisation is a significant issue facing many healthcare economies as ‘polypharmacy’ becomes an increasingly widespread and common issue. There is growing evidence that medicines use is sub-optimal in a number of patient pathways. Sub-optimal medicines use leads to poorer patient experiences and outcomes and the financial waste of limited resources. It can also place increasing pressure on the urgent and emergency care system as patients may be admitted for non-adherence or adverse drug reactions.