Apollo logo

Addressing the Polypharmacy Challenge in Older People

Related projects

On this page you will find information and links to other research projects taking place within the Centre for Primary Care and Public Health which attend to similar concerns to those of APOLLO-MM: polypharmacy, multi-morbidity, medicines use and practices, medicines optimisation, patient experiences.

Experiences of Medicine Use amongst Urdu-speaking Londoners of Pakistani origin

Najia Sultan is an Academic Clinical Fellow in Primary Care. She is developing a qualitative research project using in-depth interviews to explore the experience of polypharmacy and multi-morbidity in Urdu-speaking patients of Pakistani origin. Najia is interested to discover how these patients make sense of their medicines and how they incorporate their medicines into their daily lives.

South Asian patients in London experience higher levels of multi-morbidity compared to white and black ethnic groups. Previous research has shown that South Asian patients are also at the receiving end of higher levels of prescribing than the general population, and less likely to take medicines prescribed in the context of polypharmacy.

According to census data, Urdu is the third most commonly spoken immigrant language in England and Wales. Patients who speak languages other than English are often excluded from research studies. As a bilingual English-Urdu speaker, Najia is well placed to extend the interests of the APOLLO-MM project to include this group.

The findings of Najia’s research will inform the delivery of culturally sensitive medicines optimisation in primary care.

Najia gained her medical degree from Imperial College London, with a BSc in Neuroscience. She completed Foundation training at Charing Cross and Ealing Hospitals. Najia splits her time between academic work and working as a GP registrar in Tower Hamlets. Previously she has been involved in several research projects: post-operative pain outcomes in abdominal surgery; gestational vitamin D levels and their link to diabetes; a historical study of nutritional guidance for pregnant women.

Medicines as emotional objects: Polypharmacy and Multimorbidity in Socio-Historical Perspective

Mirja Tervo is a PhD candidate, funded through the Life Sciences Initiative at Queen Mary University of London. She is based in the Centre for Primary Care and Public Health and the Centre for the History of Emotions. Her interdisciplinary project explores medicines as emotional objects past and present.

The aim of the study is to detail how different spatial, social and temporal contexts produce varied emotional responses and practices around medicines and polypharmacy. With the keywords “polypharmacy” and “multimorbidity”, she is applying an approach that embraces these as both mirrors and motors of social and intellectual change.

Mirja will engage with the emotional practices and meanings around medicines and polypharmacy beyond that of the medical professionals’ discourse. By entering into the emotional lives of both contemporary and historical patients, through their words, beliefs and actions, we can broaden our understanding of emotions associated with medicines: how medicines shape emotions, and how emotions shape medicines.

The study builds on the notions that: emotions are mutable and multi-vocal, both through time and experience, and that it is difficult to fully separate embodiment from material culture and bodies’ responses to objects.

Given that medicines and medicine-taking often includes engagement with the senses, Mirja will collect data on how contemporary older people define their medicines’ sensual traces in relation to their feelings and emotion. Evidence shows that with ageing, the special senses, which include smell, taste, vision, hearing and equilibrium, deteriorate. In addition, certain drugs and diseases cause changes in the senses. Mirja will prepare a public exhibition around the findings of her project.

Mirja holds an MA in ethnology and anthropology from the University of Jyväskylä, Finland. She is also a registered nurse, specializing in acute and emergency care. Mirja grew up in the northern part of Finland. After graduation, she moved to New York where she lived for almost ten years. Her previous research projects have included ideals around the physical appearances of cows and ‘high-heel’ culture in Manhattan. Both studies have been published in Finnish.

Medicine practices of people living with dementia

Lucie Hogger is a CLAHRC North Thames Research Fellow. She is developing a study to explore the experiences of taking multiple medicines on people living with dementia (PLWD) and their carers.

The risk of developing dementia increases with age, as does the likelihood of needing to take multiple medications for chronic health problems. One common effect of dementia is difficulty with communicating, including finding a particular word and remembering what has already been said in a conversation. This may impact on the way in which medicines and their side effects are discussed. Lucie is interested in how people living with dementia and their carers talk about medicines and how these interactions influence their medicines practices.

The outcomes of the study will contribute to our understanding of how PLWD take their medicines and produce guidance on how best to support PLWD and their carers in their interactions around medicines.

Lucie is a Clinical Specialist Speech and Language Therapist and has ten years of experience working with adults with acquired communication and swallowing disorders. She completed an MSc in Neuroscience and Communication from UCL in 2017 where her research project investigated interactions between people with acquired brain injury and their conversation partners. She has an interest in global healthcare development and has worked in Uganda to provide continuing professional development for East African Speech and Language Therapists.

Najia Sultan
Najia Sultan
Academic Clinical Fellow in Primary Care
Mirja Tervo - Life Sciences Initiative PhD Candidate
Mirja Tervo
Life Sciences Initiative PhD Candidate
Lucie Hogger - CLAHRC North Thames Research Fellow
Lucie Hogger
CLAHRC North Thames Research Fellow
Sarah Spencer - Academic Clinical Fellow in Primary Care
Sarah Spencer
Academic Clinical Fellow in Primary Care
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