2300 A survey on the underlying knowledge of doctors’ in conducting polypharmacy review and medication optimisation in older adults.

Abstract

Abstract Introduction Polypharmacy is common among older adults and could result in adverse outcomes if not reviewed and optimised regularly (Davies et al, 2020). The aim of this survey is to assess and report on the variation in doctors’ understanding of medication reviews at Maidstone and Tunbridge Wells hospitals (MTW). Method A short, anonymised, online questionnaire was circulated to all current doctors at MTW via email and WhatsApp groups. Results 38 doctors of different grades (Foundation Year One-Consultant) from a variety of medical and surgical specialties responded. Of these, 41% could correctly define appropriate polypharmacy, but only 6% could define problematic polypharmacy. Most respondents (59.5%) had not received any training on structured medication reviews (SMR). 51.4% were not aware of any tools used in medication optimisation. 43% said they ‘always carry out’ medication reviews in clinical practice and 8.3% said that they never do. Less than half (38%) felt confident in completing SMR. The main barriers to routine implementation of SMR identified by the respondents were: lack of confidence (27%), time pressures (26%), senior clinicians not giving importance to SMR (16%), 3% felt it was not the doctor’s responsibility. Most respondents (91.7%) said that they would benefit from further training in SMR. Conclusions The results show that there is a wide variation in the respondents’ understanding and practice of medication reviews. Also, that there is a clear and well- founded demand for training. Once training has been formulated and delivered a follow up survey of those attending should be used to help gauge its effectiveness. The small sample size is a limitation of this study affecting its generalisability as is the fact that it was a self-selected group completing the survey.