Inequalities in SMRs for Older People
Research type
Research Study
Full title
Optimising Structured Medication Reviews for Older People with Severe Frailty and Care Home Residents to Reduce Overprescribing and Associated Inequalities
IRAS ID
342852
Contact name
Andrew Clegg
Contact email
Sponsor organisation
Bradford Teaching Hospital NHS Foundation Trust
Clinicaltrials.gov Identifier
62112, CPMS
Duration of Study in the UK
1 years, 9 months, 31 days
Research summary
This project aims to improve the quality and accessibility of medication reviews to ensure they meet the diverse needs of older people with severe frailty living in the community and in care homes.
Older people often take multiple medications which can cause harmful side effects, including falls, cognitive decline and loss of independence. The risk of harm from multiple medications increases with frailty. Care home residents and older people from ethnic minority groups are more likely to take multiple medications and to be living with severe frailty. In 2021 the NHS in England introduced routine structured medication reviews (SMRs) for older people with severe frailty and care home residents to reduce unnecessary medication use. Delivered through shared decision making and with a focus on deprescribing, SMRs are a comprehensive clinical review of a patient’s medicines. However, there are concerns that some groups of older people with frailty may not be able to access SMRs and the training pharmacists receive may not prepare them for the diverse needs of older people with frailty. This can cause unfair differences in health outcomes.
Informed by our analysis of routine data sets, to identify those who have unequal access to and poorer outcomes from SMRs, we plan to conduct qualitative observations and interviews with staff and patients to what may be leading to inequalities in SMR implementation and delivery in practice. This will be followed by a series of co-production workshops and meetings, bringing together older people, health and social care professionals and other experts to develop targeted staff training and detailed SMR guidance based on our research findings. Our project has been developed in full partnership with PPIE members and their active involvement is integrated throughout.
REC name
Yorkshire & The Humber - Bradford Leeds Research Ethics Committee
REC reference
24/YH/0212
Date of REC Opinion
21 Oct 2024
REC opinion
Favourable Opinion