Effective medicines optimisation

Welcome to this December issue of the Journal of Prescribing Practice.

Winter is very much upon us, and I know there is the usual increased pressure in many areas, with influenza and winter vomiting virus doing the rounds. This pressure to deal with acute situations can be overwhelming and takes focus away from the more day-to-day events, like reviewing medications and going over drug histories.

In the research round-up this month there is a focus on prescribing cascades. These can occur at any time and for any patient, but some populations are more at risk, particularly the elderly. It made me think about how good we are as prescribers, but also how good are we at deprescribing. We know that inappropriate polypharmacy occurs, and can be responsible for adverse effects and hospital admissions. This is especially true in the frail elderly population and can cause them to seek help at this time of year more than any other period.