- Design
- Qualitative semi-structured interviews with reflexive thematic analysis
- Population
- 12 patients, 7 clinical pharmacists and 5 GPs in Greater Manchester, UK
- Primary outcome
- How polypharmacy is identified and managed in everyday primary care
- Effect
- Themes: inconsistent case-finding, unclear review purpose, hidden complexity, reliance on continuity and trust
Researchers interviewed patients, clinical pharmacists and GPs about how polypharmacy is actually handled in general practice.
Patients described their medicines as tools for keeping up work, family and daily function. Professionals focused on reducing harm. Reviews often began without either side knowing what they were meant to achieve, and simple protocols only dealt with simple problems.
The deeper issues, such as a patient reluctant to stop a long-standing drug, were addressed only where there was continuity and enough trust to disagree openly. For family physicians in short consultations, the practical step is to agree the review's purpose first and to spread complex decisions over more than one visit.
- Case-finding for polypharmacy reviews was inconsistent across practices.
- Reviews often had no clear purpose for either patient or clinician.
- Protocol-driven checks worked for simple problems, such as a duplicate prescription.
- Complex polypharmacy needed repeated conversations with the same clinician.
- Both patients and professionals described the work as emotionally heavy.
Why it matters
Reviews that only hunt for harm miss why patients value their medicines, which is why so many deprescribing efforts stall.
Don't overread it
This is a small qualitative study from one UK region; it describes experiences rather than measuring outcomes.
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