Apollo logo

Addressing the Polypharmacy Challenge in Older People

The Polypharmacy Challenge Blog

Polypharmacy and the hidden work of managing medicines

Our research on polypharmacy reveals the burden of work that prescriptions for many drugs create for healthcare professionals and patients. In previous research, we took you behind the scenes of a community pharmacy to show you the work pharmacy staff do to dispense drugs. But polypharmacy creates work for patients too. In our latest paper, we show you the work patients do to organise their many medicines.

Photo by Laurynas Mereckas on Unsplash

Patients in our study took between 10 and 30 different items of medication daily, including tablets, creams, eye drops, injectables, inhalers, and inhaled oxygen. Patients' medicine regimens were complex and needed careful organising as patients strived to take their medicines as prescribed whilst finding ways of fitting them into their daily lives.

Patients often used ‘do-it-yourself’ dosette boxes, tins and bags to organise daily medicine taking. They often set up larger boxes, baskets and storage systems in cupboards to ensure surplus medicines and support processes of checking supplies and ordering. Managing medicines involved considerable resourcefulness, creativity, and collaboration with others.

An important message for doctors is that when patients are prescribed many medicines, work is also prescribed. Whether this work is done by pharmacy staff filling multi-compartment compliance aids (dosettes) or by patients at home with their DIY boxes, bags and trays, the burden of organising polypharmacy always falls somewhere. Greater appreciation amongst prescribers of the nature and complexity of this work may provide a useful point of departure for tackling the key issue that sustains this work: polypharmacy.

Organising polypharmacy: unpacking medicines, unpacking meanings—an ethnographic study by Deborah Swinglehurst and Nina Fudge is published here (open access and free to all to read).

Doing safety through care in the risky business of polypharmacy

Have you ever wondered what work goes into making up prescriptions? This paper, hot off the press, invites you behind the pharmacy counter, to witness the work pharmacy staff do to safely dispense medicines.

The number of prescription medicines is on the rise and this makes prescribing, dispensing and taking medicines ever more complex.
We show how pharmacy staff who are working within a fast-moving, high-risk environment achieve safe dispensing, through their focus on:
  • care for the technology
  • care for each other and
  • care for patients.
We join a number of authors who are bringing ‘care’ to the foreground to show what healthcare workers actually do, often within organisational cultures that reduce care to ‘tickboxes in an attempt to standardise this most unpredictable of human activities

Show more posts

Subscribe to receive our latest blog post

* indicates required
Queen Mary University of London logo
NIHR stamps without NHS logo
Barts and The London School of Medicine and Dentistry Queen Mary University of London logo