• Rebecca Joseph, Roger Knaggs, Carol Coupland, Amy Taylor, Yana Vinogradova, Debbie Butler, David Waldram, Barbara Iyen, Ralph Akyea, Darren Ashcroft, Anthony Avery, and Ruth Jack.
• University of Nottingham.
• Br J Gen Pract. 2023 Jul 1; 73 (suppl 1).

BackgroundMedication reviews are considered an opportunity for reducing polypharmacy. However, there is little evidence about their impact in a real-world setting.AimTo quantify numbers of older adults having a medication review in 2019, identify systematic differences in access to medication reviews, and assess the impact of medication reviews on the numbers of medicines prescribed.MethodWe defined a population of people aged ≥65 years with at least one active prescription on 01/01/2019 using anonymised electronic health records from the Clinical Practice Research Datalink. We used Cox regression to compare characteristics of people who did and did not have a medication review recorded in their health records in 2019. We compared the maximum number of concurrent prescriptions ('polypharmacy count') in the 3 months before and after a recorded medication review.ResultsOf 591 552 people (median age = 74 years, 54.5% female), 305 503 (51.6%) had a medication review in 2019. Living in a care home (hazard ratio [HR] 1.51, 95% confidence interval [CI] =1.40 to 1.62), a prior medication review in 2018 (HR 1.83, 95% CI = 1.69 to 1.98), and increasing baseline polypharmacy count (5-9 medicines versus 1 medicine HR 1.41, 95% CI = 1.37 to 1.46) were most strongly associated with having a review. Overall, there was a small mean increase in polypharmacy count after a review (+0.13 medicines, 0.12-0.14). For people prescribed ≥10 medicines before the review, polypharmacy count decreased on average (mean -0.14 medicines, -0.15 to -0.12).ConclusionAlthough a majority (>50%) of people had a recorded medication review in 2019, these reviews had a small overall impact on polypharmacy in this study population.© British Journal of General Practice 2023.

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