The AHSN Network Polypharmacy Programme is working with healthcare professionals to address problematic polypharmacy by supporting easier identification of patients at potential risk from harm from multiple medications. Our evidence-based polypharmacy Action Learning Sets (ALS) are being rolled out across England to support GPs, pharmacists and other healthcare professionals who undertake prescribing or medication reviews to understand the complex issues around stopping inappropriate medicines safely. To drive and accelerate changes in practice, delegates complete a quality improvement project to address problematic polypharmacy in their workplace. This poster summary, Audit of Care Home Medication Reviews, can be viewed here. For more information about the polypharmacy programme, please visit https://www.ahsnnetwork.com/programmes/medicines/polypharmacy/

1. Reflecting on the results, it was surprising that so many medications were stopped from the number of
medicines interventions made. It was key that the nursing staff at the care home are very experienced
and this helped facilitate the decision-making process of which patients to focus on.
CONCLUSION
I learnt to revisit patients more than once especially if there is more than one change that should be dis-
cussed. One change per conversation works best if the discussion involved the patient. Next steps; I would
like to improve GP colleagues skills in deprescribing which runs in parallel to the national AHSN polyphar-
macy programme.
Patients within care homes have been identi-
fied as a group that would benefit from Struc-
tured Medication Review (SMR) *. This group of
patients often are prescribed multiple medi-
cines** that predispose them to adverse drug
events. In a structured medication review, clini-
cians and patients work as equal partners to
understand the balance between the benefits
and risks of and alternatives of taking medi-
cines. This shared decision-making conversa-
tion in these cases were often with relative and
nursing staff .
To reduce problematic polypharmacy in care home
patients attached to Twyford Surgery using struc-
tured medication reviews. There are 24 patients
within the home and my aim was to improve the
prescribing quality by visits of 1.5 hours every 2
weeks. My aim was to start a process of safe and
effective reduction or stopping of inappropriate
medication, with special attention to anticholinergic
medicine drugs which are known to produce wors-
ening mental function, constipation, urinary reten-
tion and dry mouth dizziness. To show that the ben-
efits of time spent reviewing the medications were
significant in reducing falls, AKI, hospital admissions
and improving quality of life.
Over 6 months SMRs were preformed on
12 patients; 19 medications were stopped,
5 medicines were switched to alternatives,
2 medicines doses were reduced and 1
medicine frequency was reduced. The
overall ACB score for all the patients re-
viewed was reduced from 13 to 8 which is
a 39% reduction.
One referral was made to SALT. Examples
of medication stopped were perindopril,
ramipril and amlodipine-reducing the risk
of falls and possible AKI.
REFLECTIONS & NEXT STEPS
RESULTS
AIM
INTRODUCTION
Hannah Copus Senior PCN Pharmacist, hannah.copus@nhs.net
Audit of Care Home Medication Reviews
•*Network contract Enhanced Service 30.9.22
•**Good for you Good for us Good for everyone 9.21