What we know about prescribing in older people in primary care

Prescribing can be a challenge for GPs and patients. As people get older they are often taking a number of different medicines and their bodies may react to medicines in different ways. Some drugs are more risky than others and a list of drugs that can be harmful in older people has been identified by a group of international experts. We know that GPs want to prescribe as safely and effectively as possible but this can sometimes be difficult when people are taking multiple medicines and are also attending different specialist doctors as well who may start them on new medicines. Most Irish GPs use computers to record details of patients and patient care, including details of prescribing. This provides an opportunity to provide computerised supports for GPs when they are prescribing in these circumstances.

What this study is exploring

We want to find out if we can improve prescribing for patients by developing a computer programme that highlights if there is a potential problem and then provides GPs with advice on alternative options. The final decision will always be down to the GP who knows the individual patient and their unique situation. This study will explore whether this approach improves prescribing in these difficult circumstances.

Why is this study important?

Medications can sometimes have very serious harmful effects that may even lead to hospitalisation in some people. We want to support GPs to reduce this risk for their patients.

Who can take part

The study will be recruiting GPs, we will not be recruiting patients directly. The study will be open to GPs who use computer records for their patient care and prescribing. While the study is directed towards GPs, if it is effective, it will lead to improved outcomes for their patients.

What will the study involve for a person taking part? 

GPs who agree to participate in this study will be divided at random into two groups. We will give the computer support system to the first group. The second group will act as controls for the study, that is, during the study there will be no change at all to the way the GPs usually prescribe. This will allow us to test if this new computer support system is effective compared to current GP care. As soon as the study is completed the second (control) group of GPs will be invited to use the computer support system.

For more information

Researchers at the HRB Centre for Primary Care Research at the Department of General Practice in RCSI Dublin are running this study. More information is available from Professor Susan Smith.