- Design
- Qualitative semi-structured interviews with reflexive thematic analysis
- Population
- 12 patients, 7 clinical pharmacists and 5 GPs in Greater Manchester
- Primary outcome
- Experiences of identifying and managing polypharmacy
- Effect
- Inconsistent case-finding and unclear review purpose; deeper issues addressed only through continuity
Researchers in Greater Manchester interviewed 12 patients, seven clinical pharmacists and five GPs about how polypharmacy is found and managed in everyday primary care.
All agreed the work mattered, but case-finding was inconsistent and the purpose of a medication review was often unclear to both sides. Patients saw their medicines as what kept their lives going; clinicians saw potential harms. The work hid layers of complexity that weighed emotionally on everyone. Simple problems could be fixed by protocol, but deeper ones only moved with continuity, trust and conversations frank enough to allow disagreement.
This is a small qualitative study from one region of the UK, so it describes experience rather than measuring outcomes. Its practical point is that a single protocol-driven review is unlikely to deprescribe much in a complex patient, and a plan over several visits with the same clinician is more realistic.
- Agree the purpose of a medication review with the patient before starting it
- Ask what each medicine does for the patient's daily life, not only its clinical indication
- Tackle one or two changes per visit rather than a full rationalisation at once
- Keep complex polypharmacy patients with the same clinician where possible
Why it matters
It explains why one-off structured reviews have changed so little despite years of effort.
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