PRIMM 28th Annual Scientific Meeting, 27th January 2017, London
Deprescribing – is less more?
The 2017 Annual Scientific Meeting of PRIMM (Prescribing Research in Medicines Management), was held at Coventry University London Campus, attended by 45 delegates. PRIMM’s tradition of high quality speakers continued with three outstanding presentations on polypharmacy, potentially inappropriate prescribing and how to address it.
Professor Nina Barnett, Consultant Pharmacist in the care of older people, Medicines Use and Safety team, NHS Specialist Pharmacy Service, (https://www.sps.nhs.uk/ ) entertained while informing us about the background to polypharmacy and its associated jargon. Most importantly, she emphasised how essential it is to use appropriate language/terminology when communicating with patients. She also described the cyclical approach to delivering patient-centred care which she has developed with colleagues.
Dr Joanne Reeve, Clinical Reader in Primary Care at the University of Warwick, described some of her early work carried out in Liverpool which led her to develop the SAGE consultation model for individually tailored prescribing. This model includes the need to reflect on whether the health professional carrying out the consultation gathered all appropriate data, used it to make shared decisions which support or improve health as a resource for living, and to evaluate whether the decision made a difference for the individual patient. She also described a UK-wide survey of doctors, pharmacists and nurse prescribers which found that, although many are providing some individually tailored prescribing, they do not all feel supported in this by their managers and/or organisations.
Professor Denis O’Mahony, from the Department of Medicine at University College Cork, described how the STOPP/START tool was developed and is being used. He described studies which demonstrated associations between STOPP and potentially inappropriate medicines and the results of Randomised Clinical Trials (RCTs) which show that applying the criteria can improve medication appropriateness, decrease adverse drug reactions and reduce polypharmacy. The difficulty he described in getting the first version of this internationally-recognised tool published is a lesson to all researchers to keep persevering in the face of rejection! He also exhorted us to remember one of the sayings of William Osler (1849-1919): “One of the first duties of the physician is to educate the masses not to take the medicine.” Hear, hear!
Many of the abstracts submitted were on the theme of deprescribing and/or polypharmacy. The winner of the Hugh McGavock** bursary, was Dr Shane Cullinan, from the School of Pharmacy, Royal College of Surgeons of Ireland, for his work on frailty and potential inappropriate medicines. Shane received a cheque for £200 and was invited to return next year to describe how he had used the funds to support his research.
There were 19 posters presented, plus five oral presentations. The winner of the poster prize was Iuri Marques et al, on behalf of the Bradford-Leeds Medicines Minimisation Research Team, which described a systematic review of published models of deprescribing. Dr Duncan Petty collected the £50 prize on behalf of the team. All abstracts presented will be published in Pharmacoepidemiology and Drug Safety, later this year.
DUR book published
Several of the committee members have contributed to the writing and/or editing of a major reference textbook, Drug Utilization Research: Methods and Applications.
The book is published by Wiley at a cost of £99 (Euro125) and was a EuroDURG initiative. http://eu.wiley.com/WileyCDA/WileyTitle/productCd-1118949781.html. It replaces the 1st edition of the Drug Utilisation Research Handbook, produced by PRIMM (formerly known as DURG UK and Ireland) in 2000, which was edited by Prof Hugh McGavock.
Dates for your diary
Next year, the 29th Annual Scientific Meeting will be on Friday January 26th with the theme: Optimising medicines – factoring in frailty.
There will be a EuroDURG conference in November 2017, which this year is being held in the UK. The conference theme is Patients, Medicines, Bytes: Drug utilisation research and e-health, 15th – 17th November Glasgow. Conference website: http://eurodurg2017.net/
Note for editors:
Prescribing Research in Medicines Management (PRIMM UK and Ireland) is a multi-disciplinary forum for researchers with interests in drug utilisation research and all other aspects of medicines management.
** Professor Hugh McGavock was Professor of Prescribing Science at Ulster University and a founding member of the Drug Utilisation Research Group, the forerunner of PRIMM. He made many major contributions to the safe and effective use of medicines in the UK.
For further information on PRIMM or Professor McGavock, see the PRIMM website at: https://primm.eu.com/
PRIMM contact details: firstname.lastname@example.org
Twitter account @PRIMM_UK_IRL.
PRIMM UK and Ireland is affiliated to the European Drug Utilisation Research Group (EuroDURG), which is a Special Interest Group of the International Society for Pharmacoepidemiology. https://www.pharmacoepi.org/eurodurg/