About the Project
Therefore, as a consequence of the potential for polypharmacy to cause harm, medication use among patients with limited life expectancy should be appropriate, regularly evaluated and optimised to align with achievable therapeutic outcomes that consider the remaining life expectancy of the patient. To date, however, there is a growing body of evidence that suggests medication continues to be prescribed inappropriately for patients with limited life expectancy.
Our previous work has shown that patients requiring specialist palliative care take many inappropriate medications in view of their life limiting diagnosis. These medications not only increase the pill burden for the patient but also increase the risk of developing a drug-related toxicity through drug-drug and drug-disease interactions. Indeed, one of the most commonly prescribed inappropriate medications that contribute to drug-drug interactions are those used for the treatment of hypertension. This medication is largely considered inappropriate for this patient group, as it can take several years to have time until benefit on reducing cardiovascular and cerebrovascular related events. However, many patients with limited life expectancy also lose weight as a consequence of their illness – possibly reducing their blood pressure. When this occurs, it poses the obvious question – is the antihypertensive medication still required?
It is, therefore, not clear when antihypertensive medication should be used in patients with limited life expectancy and, when it is no longer indicated, how and when should it be discontinued. This work seeks to address these questions and will establish an evidence-based role for antihypertensive medication in managing hypertension in patients with limited life expectancy.
(1) Determine the incidence of inappropriate antihypertensive medication use amongst patients with limited life expectancy.
(2) Establish the blood pressure of such patients before and after cessation of antihypertensive medication.
(3) Explore patients’ views and experiences of using and discontinuing their antihypertensive medication.
Applicants with a background in pharmacy or another health related discipline would be best suited to this project.
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