TY - JOUR T1 - Solutions to problematic polypharmacy: learning from the expertise of patients JF - British Journal of General Practice JO - Br J Gen Pract SP - 319 LP - 320 DO - 10.3399/bjgp15X685465 VL - 65 IS - 635 AU - Joanne Reeve AU - Michelle Dickenson AU - Jim Harris AU - Ed Ranson AU - Ulrica Dohnhammer AU - Lucy Cooper AU - Janet Krska AU - Richard Byng AU - Nicky Britten Y1 - 2015/06/01 UR - http://bjgp.org/content/65/635/319.abstract N2 - A lively debate in the final plenary at last year’s Royal College of General Practitioners (RCGP) Annual Primary Care Conference considered the provocation: ‘My Doctor Makes Me Sick — what can we do about it?’. The event was run by the Heseltine Institute for Public Policy & Practice at Liverpool University, in conjunction with Mersey Faculty and the RCGP. It followed on from a public debate ‘My doctor makes me sick’ held in Liverpool at the opening of the conference. The audience were invited to propose solutions to current concerns about overmedicalisation, treatment burden, and over- and under-diagnosis. Two of the final eight proposals related to reducing prescribing. GPs called for incentives not to use medicines and for deprescribing; both seen as necessary to support the individually-tailored care that GPs and patients1 seek. But GPs have described needing help in tailoring prescribing to individual needs, particularly when individual needs may appear to be at odds with the ‘ideal’ described by guidelines for best practice.2 So how can we help professionals and patients tackle a problem of perceived overprescribing and problematic polypharmacy?In 2013, the Royal Pharmaceutical Society called for a shift in how we think about medicines use.3 They proposed the need to move from thinking about medicines management (the safe and efficient process of issuing medication) to ‘medicines optimisation’ (supporting the best outcomes for patients). Four principles underpin medicines optimisation: the need to understand the patients experience; make evidence-based choices about medicines; ensure safe use; and make medicines optimisation part of routine practice. A greater role for pharmacists in supporting patient-centred use of medicines was advocated. Recent evidence suggests that some GPs are still unaware of the new approach.4More recently, the Kings Fund report, Polypharmacy and Medicines Optimisation, offered a timely … ER -