Community pharmacists will act as a safety net for older patients whose medications are being reduced or stopped, to catch dangerous side effects before they cause harm. This matters because many older adults in the UK—particularly in the North East of England—take five or more medicines daily, and some of those drugs no longer help or may cause harm. GPs often lack the time to safely reduce these prescriptions and follow up properly, leaving patients at risk of withdrawal reactions or other complications. Community pharmacists, who patients see more frequently, could fill that gap. Over 12 months, the researchers will set up an expert advisory group and a patient panel of adults aged 65 and over who take at least five medicines. They will interview patients and healthcare professionals to test whether a pharmacy-based safety net is practical and acceptable, and to identify the right ways to measure its success. If the approach proves feasible, the team will apply for further funding to run a full trial. In the longer term, safer deprescribing could reduce hospital admissions, ease pressure on GPs, and narrow health inequalities linked to problematic polypharmacy.
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Research Question: Can a community pharmacy deprescribing safety net improve deprescribing safety and feasibility in primary care for older adults with polypharmacy? Background: Problematic polypharmacy, characterised by the inappropriate use of multiple medicines, is a significant concern in healthcare, particularly in the North East of England, where health inequalities exacerbate its effects. Deprescribing, the process of reducing or stopping medicines that no longer benefit the patient, has emerged as a solution. However, current barriers, such as a lack of prescriber time and the need for consistent follow-up to prevent adverse drug withdrawal events, limit its effectiveness and routine implementation. Community pharmacists could play a pivotal role in overcoming these barriers by acting as a safety net during deprescribing. This research seeks to conduct development work on the feasibility of a community pharmacy deprescribing safety net in primary care. Aims: To conduct the development work necessary for a feasibility study involving a community pharmacy deprescribing safety net in primary care. Objectives: 1. To establish an expert advisory group and patient and public involvement (PPI) group to guide this and future research on the deprescribing safety in primary care. 2. To identify appropriate outcomes and methods for assessing these outcomes for a feasibility study for the intervention. 3. To support the principal investigator’s professional development in managing research grants, planning future research initiatives, involving PPI in research, and fostering research collaboration between universities and NIHR Patient Safety Research Collaborations (PSRCs). Methods: This 12-month project will establish an expert advisory group of healthcare professionals and patients and a PPI group of community-dwelling older adults (aged =65, on =5 medicines). These groups will provide input into the project research, inform an interview study, develop dissemination strategies and provide a legacy network. The interview study will explore the feasibility and acceptability of the Community Pharmacy Deprescribing Safety Net and appropriate outcome measures for its evaluation. Data will be collected through semi-structured interviews and analysed using Framework Analysis. The findings will inform a future feasibility study. Timelines for delivery: The project will run for 12 months, from study recruitment in month 1 to data analysis in month 4 and dissemination by month 12. Meetings with advisory and PPI groups will occur at key stages throughout. The Principal Investigator will have ongoing mentorship meetings and attend relevant research and leadership training during this period. Anticipated impact and dissemination: The findings will inform a future Research for Patient Benefit (RfPB) feasibility study application and be disseminated through academic publications and conferences. The principal investigator will develop through experience managing research, collaborations between universities and NIHR PSRCs, mentorship, training, and involving PPI in research. The long-term impact includes safer deprescribing practices, improved collaboration between community pharmacies and general practices, and reduced healthcare inequalities and problematic polypharmacy.
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