SIG Special Interest Groups

Appropriate Polypharmacy & Adherence in Integrated care

PURPOSE: This SIG is for practitioners, pharmacists, managers, researchers, students, policy makers and health economists engaged in planning, designing and delivering appropriate polypharmacy reviews as a key component of the pathway for people centred integrated care.

Due to advances in pharmacotherapy, those with multiple morbidities are increasingly likely to be prescribed multiple medications. Prescribing is largely based on single disease evidence-based guidance which does not generally take account of multi-morbidity, now the norm in those over 65 years2. Consequently, patients are prescribed several medicines recommended by a disease specific guideline which is potentially harmful and challenging for them to manage. Inappropriate polypharmacy and medication non-adherence are two key, inter-related problems in elderly multimorbid patients, with negative effects on health outcomes. It is recognised that lifestyle can not only contribute to multimorbidities that require management with medication, but that addressing this might be appropriate when considering alternatives to medication.

Medication is the single most common intervention for those with multiple morbidities and is known to contribute to between 7-14% of all hospital admissions with these patients twice as likely to be admitted again due to their medication.  Despite this evidence, there is not usually a focus on medication appropriateness as part of the patient pathway.

The group would facilitate work across disciplines about developing guidelines, tools  for accelerating implementations of programmes as part of the patient pathway so that outcomes from medications are optimised whilst reducing harm, including economic modelling tools that can demonstrating that  models can be designed to demonstrate sustainability in different healthcare systems.  Collaboration will allow the group to build a repository of these relevant tools, best practice and outcomes from members, undertake twining activities and carry out joint evaluation of implementation so that scale up of programmes can be accelerated.

ACTIVITIES: The SIG provides a platform for members to share implementation experience, highlight good practice, signpost practical resources, and agree and collaborate on research, education and evaluation priorities for polypharmacy as a key component of people centred integrated care.  Members will shape the scope of SIG activities and outputs. These may include:

  • Webinars and online peer support
  • Good practice case studies
  • Practical resources – guidance and tools
  • Study / Twinning visits
  • Blogs
  • Evidence reviews
  • Consensus documents
  • Collaborative action research
  • Benchmarking
  • Presence in IFIC conferences and involvement in the development of workshops.  

GET INVOLVED:If you have an interest in Appropriate Polypharmacy and Adherence, practical experience or resources to share, a question or challenge for SIG members, or suggestions for future SIG activities please contact Marie Curran, SIG facilitator

Facilitated by:

Marie Curran
Coordinator of IFIC Scotland Special Interest Groups
International Foundation for Integrated Care (IFIC)


SIG Co-lead:

Alpana Mair
Head of Effective Prescribing and Therapeutics
Scottish Government