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Medicines optimisation - polypharmacy

The polypharmacy prescribing comparators will help Sub Integrated Care Board Locations (SICBLs) and GP practices understand the variation in prescribing of multiple medicines. They'll also help to identify patients who are more likely to be exposed to the risks that can be associated with taking large numbers of medicines or certain combinations of medicines

The national Health Innovation Network, led by Health Innovation Wessex, has been working with us and NHS Digital to create a suite of polypharmacy prescribing comparators.  The first set of these comparators in England were published in June 2017.

Updates to the polypharmacy comparator tool are now available.

In addition to the volume and previous therapeutic comparators, the updated tool will help to identify patients prescribed:

  • multiple analgesic medicines at the same time
  • SSRIs, SNRIs, and medicines known to increase the risk of bleeding
  • 2, 3, 4 or more medicines that can have an unwanted hypotensive effect

The second iteration has new additional functionality for searching by different age groups.  

If you’re registered, you can access the polypharmacy comparators on ePACT2.

Access ePACT2

What the comparators show

The polypharmacy comparators consist of measures which show practices and Primary Care Networks (PCNs) how many patients they have on 8 or more, 10 or more, 15 or more, and 20 or more medicines.

The polypharmacy comparators also identify:

  • patients taking a combination of medicines known to increase risk of harm, such as multiple anticoagulants
  • medicines which, when taken together, can increase risk of cumulative anticholinergic side effects - these side effects can increase the risk of falls, confusion, constipation, and other issues

You can view the Medicines Safety portal for more information.

New polypharmacy comparators

This second iteration of the comparators includes therapeutic comparators and additional functionality to enable searching by different age groups.

This work has, where possible, used the evidence in literature to guide the comparator development. Where the evidence base is not sufficient, we have worked as a group of clinicians to ensure:

  • the comparators tool aims to be a risk stratification tool that PCNs and practices can use to identify patients considered to be at risk from problematic polypharmacy
  • PCNs can prioritise in relation to their workforce
  • in the future, ‘big data’ will be able to work backward from unplanned admissions to look at which combinations of medicines increase the risk of admissions – until then this data is available at national, regional, ICB, SICBL, Practice level and PCN level

View the Medicines Optimisation Polypharmacy Prescribing Comparator descriptions and specifications (PDF: 548KB)

Medicines Optimisation Polypharmacy - ACB1 (Word: 105KB)

Medicines Optimisation Polypharmacy - ACB2 (Word: 109KB)

Medicines Optimisation Polypharmacy - Analgesic (Word: 63KB)

Medicines Optimisation Polypharmacy - Hypotension (Word: 123KB)

Medicines Optimisation Polypharmacy - SSRI/SNRI (Word: 54KB)