A group of health professionals are working together to ensure patients who have been prescribed multiple medications (polypharmacy) are not at risk of side effects. 

These side effects include an increased risk of falls, hospital admissions, and various illnesses.

Secondary care and primary care clinicians, including general practitioners (GPs) and pharmacists, Primary Health Organisations (PHO) analysts and the Canterbury DHB Planning and Funding Pharmacy Portfolio Manager are involved in a Polypharmacy Working Group to look at the issue. 

Working Group Chair and general practitioner (GP) Marie Burke says it’s important to look at this group of patients to mitigate any risks to their health and wellbeing.

“Currently we are working to ensure all Canterbury general practitioners and pharmacists can easily identify patients on multiple medications, so they can review their medications.” 

“As well as improving patient wellbeing, this piece of work is about making sure everyone on multiple medications gets the same care no matter what general practice they are enrolled with,” says Marie.

The Working Group is also promoting the use of RNZCGP (Royal New Zealand College of General Practitioners) audits to help general practice identify patients on multiple medications. 

Work has been carried out to connect the patients at risk of inappropriate polypharmacy with existing services, including the Medication Management Service (MMS) and the Falls Prevention Programme.  

GPs, Nurse Practitioners and Practice Nurses making Falls Prevention referrals have been encouraged to also consider a patient’s medications and whether a Medicine Therapy Assessment (MTA) would help the patient. 

A MTA can identify many issues with polypharmacy patients. It involves meeting with the patient to talk about their medicines, but it is essentially a clinical review of their medicines with the view to optimising their current treatment and reducing inappropriate polypharmacy. 

"The MTA offers a great opportunity for patients and/or carers to become involved in the decision-making process when reviewing inappropriate polypharmacy,” says Jo Comper, Working Group member and Pharmacist.

Kezia Buttle who is also a Working Group member and Pharmacist says there are a number of qualified pharmacists in Canterbury and the West Coast that are doing MTAs. 

“Initial results show the MTA pharmacists are having a positive impact on the patients on multiple medications,” says Kezia.

The referrals to MTAs are being recorded and audited to measure the Polypharmacy Working Group’s impact.

The Polypharmacy Working Group has been working to address inappropriate polypharmacy since the group emerged as part of Canterbury’s response to the Ministry of Health’s System Level Measures (SLM) Framework in 2016.

The System Level Measures (SLM) Framework requires each district alliance to identify actions that will contribute to improvements in six high-level outcome measures; one of which is Acute Hospital Bed Days. Locally the prevention of, or reduction in, the risks associated with inappropriate polypharmacy was identified as a contributor to the Acute Hospital Bed Days SLM.  

Once this work has progressed there will be an update in the CCN newsletter.