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Addressing the Polypharmacy Challenge in Older People

The Polypharmacy Challenge Blog


PhD Studentship Opportunity: Medicines as Emotional Objects

This 3-year PhD project "Medicines as Emotional Objects: Multimorbidity and Polypharmacy in Socio-Historical Perspective" is funded through the Life Sciences Initiative at Queen Mary University of London and is a collaboration between the Centre for Primary Care and Public Health and the Centre for the History of Emotions. It arises from the shared interests of two existing research programmes: a NIHR-funded project, Addressing the Polypharmacy Challenge in Older People with Multimorbidity (APOLLO-MM) and a Wellcome-funded project,Living with Feeling and the successful student will benefit from existing networks and events associated with these projects. The PhD will be jointly supervised by Dr Deborah Swinglehurst and Professor Thomas Dixon.

We are looking for a highly motivated graduate with a background (including a relevant Master’s degree) in a relevant social science or history. The project is interdisciplinary and an explicit aim of the project is the integration of knowledge gleaned from both social science and history disciplines.
The studentship includes PhD fees, a stipend (RCUK recommended rate: £16,553 p/a for 2017/18) and a £5K per year budget for consumables/conferences/travel.
For full details please take a look at the advertisement on FindaPhD.


Tackling Polypharmacy and Multimorbidity: Reflections on SAPC 2017

I have just returned from the annual scientific meeting of the Society for Academic Primary Care (SAPC), which was held at Warwick University last week. The central concerns of the APOLLO-MM project - multimorbidity and polypharmacy – featured prominently in this year’s meeting. This may seem unsurprising given that care of patients with multimorbidity is very much the ‘norm’ for the generalist medical practitioner. But it was encouraging to see an increasing emphasis on how to account for the complexity of multimorbidity in research contexts, and there is certainly a growing army of researchers trying to tackle ‘inappropriate’ polypharmacy.

One thing that became clear as I moved from presentation to presentation about polypharmacy is just how ‘baggy’ some of our definitions are. Researchers use a range of cut-off points to define polypharmacy (4+, 5+, 10+, 15+ medicines). They do so whilst acknowledging that definitions based on numbers alone are crude and inadequate, as these measures conceal crucial issues such as: the poor alignment between numbers of drugs prescribed, dispensed and consumed; the contribution of non-prescribed medicines to the medicines count; and the relative complexity of different medicines regimens to the individual patient. The terms ‘appropriate’ and ‘inappropriate’ which are frequent qualifiers of the ‘polypharmacy’ concept are widely used but beg further questions such as ‘appropriate to whom?’ and “appropriate for what purpose or with what in mind?” and cause us to stop and wonder how fixed and certain are these notions of appropriateness.
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