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Experience of Having Medicines Reviewed

We found that general awareness of medication review and of older people's entitlement to review was low.
Many participants were surprised to discover that there is a requirement for review for people over 75. Some wondered whether this had been communicated to the general public. Most people seemed quite bemused by the idea that they should be having their medicines reviewed once or twice a year, and sceptical that health professionals could ever find the time to deliver reviews.
"They don't have time. They are rushed off their feet."
Few people reported being asked about their medicines by their doctor or by another health professional. There were, however, two groups of patients who had personal experience of regular medication review:
  • Some patients under the care of a hospital specialist whose regular outpatient visits routinely included a review of their medication and how it was working
  • Some older people whose GP reviewed their medicines during a special appointment each year. In one case the patient was told to book a double appointment for these reviews.
There was a particularly striking example of a patient with rheumatoid arthritis who regularly reviewed her medicines with her hospital consultant.
"I see my specialist twice a year we review my medications
and I value it. It is a two way process he knows me and knows my history. He checks with me. It is a friendly exchange. It's for me to say how I am feeling on a particular medicine: how it's working, any particular side effects. I can also ask about new drugs."
However, few people we spoke to felt that they had a real opportunity to talk about their medicines and have their questions answered. People who took an active interest in their own health or that of the person they cared for, whose medicines were not being reviewed by professionals, appeared to have evolved a range of compensating strategies of their own. For example, some people under the care of different hospitals for different problems were concerned that individually their various specialists were unaware of medicines they were being prescribed for their other conditions. These patients tended to maintain their own list of medicines, sometimes with help from a family member, which they shared with their health professionals.
"I see my heart consultant and I don't know if he knows what I am on. I take in a list."
Many people read patient information leaflets carefully and asked their GP, nurse or pharmacist specific questions about individual drugs.
"I read in the leaflet that a person my age should only be taking 2 a day, but I was on 3. So I raised it with th doctor and he said 'You're right' so now I'm only on 2."
There were several examples of people discontinuing prescribed medication in the face of side effects they found intolerable.
"I was getting so many side effects bruising, urinating blood but he [GP] said I must take the tablets. I took the bull by the horns and stopped taking them and I felt better. The nurse did blood tests after that and they were all OK. The only thing was she suggested I went back on the ones for cholesterol."
Some people tested out any new medicine for a short period usually no more than one or two days before deciding whether it "suited them" and hence whether they would continue to take it. In one case a man abandoned several of his medicines after reading a newspaper article about side effects. These examples show that many people are prepared to take an active part in the management of their own medicines, but lack an opportunity to review medication with a health professional who listens to their experiences and takes their views and preferences into account.