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Addressing the Polypharmacy Challenge in Older People

The Polypharmacy Challenge Blog


Welcome to our first APOLLO-MM blog post!

This blog will be a space to share our thoughts, ideas and progress as we journey through our research to understand the ‘polypharmacy challenge’ faced by older people living with multiple long-term conditions, their carers and health professionals.

The day-to-day research activities in the APOLLO-MM project will be carried out by Deborah and me. We are well supported by our advisory group and patient panel, and have three co-researchers who will be working with us at different stages of the research. You can read more about the people involved in the project here.

Deborah devised the project as part of her NIHR Clinician Scientist Award. Her interest in polypharmacy has grown primarily out of her work as a practising General Practitioner. In this role she has witnessed the difficulties patients face with their medicines and has experienced first-hand the complexities of managing polypharmacy as a clinician. She identifies polypharmacy as one of the most complex areas of generalist medical practice. A particular challenge is that much of the ‘gold standard’ evidence available to inform clinical practice hinges around a ‘single disease’ model, This is tricky when the reality is that many people are affected by several ongoing conditions. The APOLLO-MM project will contribute a different kind of evidence: evidence which is grounded in the complex realities of patients’ lives, professional practice, and health systems, based on studying closely what actually happens on the ground. Deborah believes this ‘practice-into-evidence’ approach holds promise for improving care by drawing attention to ‘what matters’ to patients and practitioners.

As a post-doctoral researcher, I was drawn to the APOLLO-MM project primarily because of the ethnographic approach it uses, in conjunction with other methods such as narrative interviewing, cultural probes and video-reflexive ethnography. I was also attracted to the research because of the prominence it gives to really understanding what medicines mean to the people who are expected to take them. The project is unusual in focusing on how people go about managing their daily lives with numerous medicines, rather than being preoccupied with the question of how healthcare professionals might get patients to take their medicines. For the past 12 years, I have worked closely with stroke survivors, many of whom had other long-term conditions and were prescribed lots of medicines. I’m curious to understand whether patients with multi-morbidity prioritise their conditions in particular ways, and if so, whether and how this influences their approach to taking their medicines (or not!). I’m also interested in how health shapes our roles as citizens in society. APOLLO-MM will give me the opportunity to explore the relationships between medicine-taking and peoples’ status and place as citizens.

Over the coming months and years of the project expect to see posts on:

  • how our research is progressing
  • reflections on our research methods and ethical conundrums
  • links to other peoples research on older people, medicines use, medicines optimisation
  • changes in policy and guidance on polypharmacy
  • guest posts from those at the front line of polypharmacy and medicines use.

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