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Theme: Person-Centred Care
With an ageing population, the concurrent use of multiple medicines, or polypharmacy, is increasing. Polypharmacy is associated with multiple conditions, and may be appropriate or problematic. Problems can result from treating side-effects of existing medicine(s), or poor communication between health professionals. Patients and clinicians report that problems are widespread. Multiple medicines and conditions can have a considerable burden on an individual, and up to one-half of all medication prescribed for long-term conditions are not taken as recommended. Supporting community-dwelling older people to manage their multiple medicines is therefore imperative.
What tools, strategies or resources are available for older people to self-manage multiple medicines or complex treatment regimens?
1. Provide a typology of tools or resources that are available for older people to manage their medicines
2. Examine the evidence, if any, of the effects of using these tools or resources and identify in what context and for whom they are beneficial.
To date, we have iteratively searched electronic databases (MEDLINE and CINAHL), Cochrane Database of Systematic Reviews, grey literature, select paper citations, conference presentations, and key authors with the support of an information specialist. We have developed inclusion and exclusion criteria for screening.
Title and abstract screening is underway, and random samples are being independently screened by two reviewers for consistency.
This review will provide a typology of the existing tools or resources for older people to self-manage multiple medicines, summarise the evidence for different tools, and identify any potential gaps in knowledge for further research. Evidence about such tools is warranted so that older people can optimise the use of their medicines, and consequently reduce the societal costs of the inappropriate use of multiple medicines.
Next, the full texts will be obtained and screened. Again, they will be independently screened for consistency by two reviewers.
Data from the selected studies will be extracted and will include the type of study, study setting, study population, self-management tool/strategy used, objective of the tools, and clinical and patient-reported outcome measures. We will then collate the extracted data into different categories and map the similarities and differences of tools.
We also plan to involve members of the PenCLAHRC Public Involvement Group (PenPIG) who take multiple medicines to ensure that our findings are clinically relevant and fit for purpose.