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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).

Organising polypharmacy: unpacking medicines, unpacking meanings

I recently presented some of our work from the APOLLO-MM project at the North American Primary Care Research Group (NAPCRG) Annual Meeting in Toronto, Canada. I presented a Distinguished Paper in a plenary session, having won the Society of Academic Primary Care senior presenter’s prize at the SAPC annual conference in Exeter in the summer of 2019.


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