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How can nurses help prevent people taking medicines they don’t need?
Popular media GP, Dr Mark Porter, reports in The Times this week that millions of people are taking pills they don’t need (Porter, 2016). Elderly patients’ are particularly at risk, because they frequently take multiple medications and are at greater risk from side effects and adverse reactions between drugs. This so called ‘polypharmacy’ isn’t restricted to the elderly and is shared by people of all ages who suffer from chronic health conditions and or have multiple morbidities but because these are more prevalent in the elderly, this group are most at risk (Duerden et al., 2013).
So, what can nurses do to protect patients from the side effects and adverse reactions caused by taking unnecessary drugs? Nurse prescribers working in primary care are in an ideal position, when treating patients with chronic and or multiple health conditions, to review patients’ medication as part of their assessment (Kaufman, 2016). This requires nurse prescribers to discriminate between ‘necessary polypharmacy’, in which all pf the patient’s drugs are required and are beneficial, and ‘problematic polypharmacy’ which has the potential to cause harm (Duerden & Payne, 2015). In addition, nurse prescribers in primary care have the opportunity to liaise with other members of the patient’s multidisciplinary care team to help achieve patient centered care by optimising the patient’s medication regime to suit their individual responses to the drugs being taken, to achieve the best possible health outcomes (National Institute for Care Excellence, 2015).
Furthermore, because practice nurses working in primary care often develop considerable knowledge about patients and form therapeutic relationships with them, they are ideally placed to identify possible side effects, adverse interactions and also determine patient’s adherence to their medication (Kaufman, 2016). The latter is a significant issue for patients who often face challenges to consuming medication particularly if required to take 10 items or more, more than once per day (Chaplin, 2014).
Chaplin S (2014) Polypharmacy: tackling the reality of multiple morbidities. Prescriber (Feb): 26–
Duerden, M., Avery, T. and Payne, R., 2013. Polypharmacy and medicines optimisation. Making it safe and sound. London, UK: Kings Fund.
Duerden M, Payne R., 2015 Medicines management: the importance of when to stop. Prescriber 26(8): 24–6.
Kaufman, G., 2016. Identifying polypharmacy in the primary care setting. Practice Nursing, 27(1), pp.28-33.
National Institute for Health and Care Excellence 2015. Medicines optimisation: the safe and effective use of medicines to enable the best possible outcomes. [online] available at www.nice.
org.uk/guidance/ng5 accessed 5th October 2016
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