2. Sensible prescribing in older people with Jonathan and Lucy; Prescribing cascades

Welcome to the 2nd episode of Talking Meds and the PrescQIPP podcast, engaging conversations about medicines-related dilemmas. 

Today your host Jonathan Underhill, Medicines Clinical Adviser at PrescQIPP, introduces a new series within the Talking Meds podcast called ‘Sensible prescribing in Older people with Jonathan and Lucy’. Jonathan and Dr Lucy Pollock outline their plan to share some real patient stories that may help us think about how to ensure we consider what really matters to patients when we are reviewing their medicines.  

Lucy grew up in Northern Ireland, read medicine at Cambridge University and St Bartholomew’s Hospital and is eternally grateful for the advice of an early boss who hoped she would not be offended if he suggested she should become a geriatrician. She trained in general and geriatric medicine in London before taking up a consultant post in Somerset in 2001. She lives with her husband and dog Rose near Langport. They have three grown-up children.  

Lucy writes about her patients, their families and the complicated, funny, sad problems that arise as we age. The Book About Getting Older (2021) and The Golden Rule (2024) are both published by Penguin Random House.  @lucypollock | Linktree

In this episode, Jonathan and Lucy talk how about we need to be really careful when starting some medicines, making sure we are considering some of the potential, perhaps unintended consequences. Lucy tells about her experiences where sometimes the very best of intentions to try and help treat symptoms may lead to ‘prescribing cascades’ and how tricky that can be for our patients.

Useful sources referred to in this episode include:

Introduction to ‘prescribing cascades’ from Canadian Medication Appropriateness and Desprescribing Network: https://www.deprescribingnetwork.ca/blog/prescribing-cascade

BMJ Open Adverse drug reactions, multimorbidity and polypharmacy: a prospective analysis of 1 month of medical admissions

https://bmjopen.bmj.com/content/bmjopen/12/7/e055551.full.pdf

Useful PrescQIPP resources (need to be registered and logged into the website to access):

Polypharmacy and deprescribing webkit
https://www.prescqipp.info/our-resources/webkits/polypharmacy-and-deprescribing/

IMPACT Bulletin 268
https://www.prescqipp.info/our-resources/bulletins/bulletin-268-impact/

Clinical Masterclasses on Multimorbidity, Frailty and Polypharmacy in Older People
https://www.prescqipp.info/our-resources/clinical-webinars/clinical-masterclass-dec-2021/

A new episode of Talking Meds will be available every other Friday.
If you have feedback or suggestions for future topics and guests please submit them to talkingmeds@prescqipp.info

PrescQIPP is funded by the NHS for the NHS, and our aim is to improve medicines-related care for patients. We do this by producing high quality evidence-based resources and training, and by facilitating networks between NHS organisations and professionals.

The majority of pharmacists and other healthcare professionals across the UK can access our resources by registering and logging on to our website. If you have any difficulty accessing the website you can email help@prescqipp.info and we’ll aim to sort things out for you.

Find out more about PrescQIPP here