- Design
- Qualitative semi-structured interviews, reflexive thematic analysis
- Population
- 12 patients, 7 clinical pharmacists and 5 GPs in Greater Manchester
- Primary outcome
- How polypharmacy is identified and managed in primary care
- Effect
- Inconsistent case-finding and unclear review purpose; complex cases needed continuity and trust
Researchers in Greater Manchester interviewed 12 patients and 12 professionals — seven clinical pharmacists and five GPs — about how polypharmacy is found and managed in everyday general practice.
Everyone agreed polypharmacy mattered, but case-finding was inconsistent and the purpose of a medication review was often unclear. Patients saw their medicines as what kept them functioning; clinicians focused on avoiding harm. Reviews carried hidden complexity and emotional strain for both sides. Protocol-based reviews handled simple problems, but harder cases needed continuity, trust and room for honest disagreement.
This is a small qualitative study and cannot say what works. Its value is in naming why deprescribing so often stalls: a review without a shared goal tends to end with the same list.
- Start a medication review by asking what the patient wants their medicines to do for them.
- Agree one or two specific goals for each review rather than auditing the whole list.
- Book complex polypharmacy reviews with a clinician the patient knows, where possible.
- Expect disagreement and plan a follow-up, rather than forcing decisions in one visit.
Why it matters
It explains why protocol-driven deprescribing so often leaves the list unchanged.
Don't overread it
Twenty-four interviews in one UK region describe experience; they do not test any intervention.
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