Meeting complex patients with multi-morbidities, and a medication list stretching across two screens, is not uncommon in general practice. Some of this polypharmacy will be what the Kings Fund in their 2013 report called appropriate in improving quality and duration of life.
Sadly, problematic polypharmacy is also out there, putting patients at risk of adverse drug reactions (ADRs), drug interactions (common causes of unplanned hospital admissions), as well as poor compliance and is a huge waste of resources.
As locums, coming across patients on long lists of medications can be a challenge, but as a fresh pair of eyes you might spot a risky drug combination or ADs that could be making a patient’s life miserable.
In their excellent March 2015 Polypharmacy Guidance, NHS Scotland developed a “7- steps approach to medication review”. We’ve referenced it in developing an easy reference template for those “Where do I start?” moments. You could take it a step further by recording and reflecting on a series of medication reviews as a QIA for your appraisal.
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