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Polypharmacy and preventing hospital admissions

Polypharmacy and preventing hospital admissions. Francesca Aaen Care Homes Pharmacist NHS Lanarkshire. POLYPHARMACY. Lots of medicines Lots of possible side effects Lots of possible interactions. POLYPHARMACY. Probably been on a lot of the medicines for a long time

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Polypharmacy and preventing hospital admissions

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  1. Polypharmacy and preventing hospital admissions Francesca Aaen Care Homes Pharmacist NHS Lanarkshire

  2. POLYPHARMACY • Lots of medicines • Lots of possible side effects • Lots of possible interactions

  3. POLYPHARMACY • Probably been on a lot of the medicines for a long time • Some medicines may be to treat the side effects of other medicines • Some of the conditions treated may not be a problem any more • A real problem for the frail/elderly

  4. FRAIL or ELDERLY • More susceptible to the side effects of medicines • Reduced renal function • Reduced clearance of medicines • Co-morbidities • You don’t have to be elderly to be frail!

  5. High Risk Combinations • Drugs Which Are Poorly Tolerated In The Elderly • Drugs Commonly Associated With Admissions Due To Adverse Reactions • Orthostatic Hypotension • Drugs With Shared Side-effects • Diabetic Treatment • Antipsychotic Medication In Dementia • Laxatives

  6. Polypharmacy review • Consider every patient individually and holistically • Ensure that every medicine prescribed has a relevant and current indication • What is the patient experience? • Consider drug effectiveness i.e. NNTs • Is the dose appropriate? • Dosing form and schedule appropriate? • Cost-effective prescribing • Housekeeping

  7. Why will this help prevent hospital admission?

  8. SPARRA • Scottish Patients at Risk of Readmission and Admission • Predicts an individual's risk of being admitted to hospital as an emergency inpatient within the next year • Predictive criteria includes polypharmacy

  9. Adverse Drug reactions • Cause 5% of all hospital admissions • Bleeds • Renal failure • Drug toxicity • Falls

  10. Reducing inappropriate polypharmacy will reduce risk of adverse drug reaction

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