We have been awarded funding from the National Institute for Health Research (NIHR) to develop a way of reducing and stopping some medicines for older people living in care homes.
Background
Older people with multiple health problems often take many medicines. However, some medicines may not have benefits for those taking them and cause more harm than good, especially as we get older or more ill. Deprescribing means reducing or stopping some prescription medicines which may no longer be providing benefit. Previous research has found that deprescribing is generally safe, but we still don't really know how to make it work in real-life settings, like care homes. Implementing deprescribing in care homes can be challenging due to the different concerns of residents, staff, doctors, family members and carers as well as the differences in care home structures.
Our primary research question will be, 'How can an approach to reducing and stopping medicines in care homes be developed with the relevant people involved, taking account of the different circumstances in this setting?'
The overall aim of the study is to develop an approach to reducing and stopping some medicines that work in care homes. We will:
- Identify what helps and what hinders the reduction and stopping of some medicines in different types of care home providers
- Identify whether current approaches are acceptable, practicable and suitable
- Create guidance for developing a new way of reducing and stopping some medicine for care homes
Method
Work Stream One
We will use different research methods to identify the key barriers, facilitators and contextual factors which affect reducing and stopping medicines. We will interview residents and their family members/friends, hold focus groups with staff and healthcare professionals and make observations at care homes.
Work Stream Two
We will evaluate the acceptability, feasibility, and suitability of current approaches to reducing or stopping medicines by interviewing healthcare professionals and care home staff about their views of different approaches.
Work Stream Three
We will bring together the findings from the interviews, focus group discussions and observations in the other work streams. We will combine the findings with the help of an established method to produce an approach to reducing and stopping medicines suitable for care homes.
Our primary output will be guidance for an approach to reducing and stopping medicines. This will be developed and used for future intervention development for care homes.
Please find the study protocol here
Research Team
University of Hertfordshire
University of Exeter
Professor Ken Stein
Dr Emma Cockcroft
Dr Jo Day
Julia Heneker, Somerset Care Limited
George Coxon, Pottles Court and Summercourt Care Homes
Dr Lucy Pollock, Somerset NHS Foundation Trust
Bridget Walton, Royal Devon & Exeter NHS Foundation Trust
Contact
Krystal Warmoth, University of Hertfordshire (k.warmoth@herts.ac.uk)
Disclaimer
This project is funded by the National Institute for Health Research (Research for Patient Benefit, PB-PG-0418-20026). This is independent research supported by the National Institute for Health Research (NIHR) Applied Research Collaboration for the East of England and South West Peninsula. The views expressed are those of the authors and not necessarily those of the NHS, NIHR or the Department of Health and Social Care.