AIM: The aim of this study was to investigate the impact of pharmacist-led person-centred medicines reviews in general practices on medicines appropriateness, polypharmacy indicators (high-risk prescribing markers), and patient-reported outcome measures (PROMs).

METHODS: Four pharmacists conducted person-centred medicines reviews in ten general practices between January 2021 and December 2022 for patients with hyperpolypharmacy (prescribed ≥10 regular medicines) and/or at high risk of medicines-related harm. Prescribing recommendations were provided to the general practitioner and followed up with patients and/or healthcare professionals. In this single arm study, pre and post intervention: (1) polypharmacy indicators were documented, and for a sample of patients, the (2) Person-Centred Medication Appropriateness Index (PC-MAI) scores and (3) PROMs were gathered.

RESULTS: Of the 1471 included patients, the mean age was 76 years, 88.4% had hyperpolypharmacy, whilst the mean number of medicines was 13.8 pre and 12.3 post review. Of the 1056 polypharmacy indicator occurrences identified, 70.7% were resolved post review. Of the 194 patients with pre-review and post-review PC-MAI scores, 99% had a reduction; the mean reduction was 17.3 (95% confidence interval [CI] 15.8-18.8, P < .0001) per patient and 1.2 (95% CI 1.0-1.3, P < .0001) per medicine. PROMs were collected for 179 patients; 87.7% reported the review helped their medicines understanding, 63.1% their experience of side effects, 36.9% their ability to take medicines correctly, and 30.5% the impact of medicines on their daily activities.

CONCLUSIONS: General practice pharmacist-led person-centred medicines reviews for patients with hyperpolypharmacy and/or at high risk of medicines-related harm delivered substantial improvements in medicines appropriateness and patient-reported outcomes, thus providing evidence to support their wider implementation.