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Developing a model for systematic deprescribing on admission to care of the older person’s ward (WRIGHTDU16SCI)

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  • Full or part time
    Prof Wright
  • Application Deadline
    No more applications being accepted
  • Funded PhD Project (UK Students Only)
    Funded PhD Project (UK Students Only)

Project Description

Medication review most commonly occurs reactively when problems related with the medication are identified rather than proactively. Decisions to stop or change medicines are compounded by the need to monitor patients and concerns regarding the response of patients and their relatives to the change. Admission to hospital of older persons theoretically provides an opportunity to review therapy, involve patients and relatives and monitor for safety and efficacy.
The aim of this PhD, which is a collaboration between the Norfolk and Norwich University Hospital (Professor Carol Farrow, Chief Pharmacist, Dr Helen May and Dr Martyn Patel, Consultant geriatricians & co-leads for Ageing Research within the Eastern Clinical Research Network) and David Wright (Professor of Pharmacy Practice) is to develop a model for systematically reviewing therapy for older persons on admission to hospital.
The objectives of the PhD are in relation to medication review on admission are to:
• Identify different models for medication review in the hospital setting
• Identify those medicines which are most likely to be suitable for review
• Identify changes in patient condition which may trigger the need for therapeutic review
• Understand prescriber and patient concerns
• Design a model for effective and safe implementation

The output from this PhD would be an evidence based model for deprescribing which could be tested initially as a feasibility study and in the longer term as a definitive study.
The successful applicant will be expected to attend basic and advanced courses in health services research, undertake bespoke courses dependant on their identified training needs and attend conferences to ensure that their research and methodological approaches are current.
We are seeking a UK registered pharmacist or nurse, preferably with hospital experience, to undertake the PhD which will start in October 2016.

Funding Notes

This PhD studentship is funded by The Pharmacy Department, Norfolk and Norwich University Hospitals NHS Foundation Trust for three years. Funding includes tuition fees and an annual stipend of £14,057 for UK applicants only.

References

1. Holmes HM, Todd A. Evidence-based deprescribing of statins in patients with advanced illness. JAMA internal medicine. 2015;175(5):701-2
2. Garfinkel D, Mangin D. Feasibility study of a systematic approach for discontinuation of multiple medications in older adults: addressing polypharmacy. Arch Intern Med2010;170:1648-54.
3. van der Cammen TJ, Rajkumar C, Onder G, Sterke CS, Petrovic M. Drug cessation in complex older adults: time for action. Age Ageing2014;43:20-5.
4. Reeve E, Wiese MD, Hendrix I, Roberts MS, Shakib S. People’s attitudes, beliefs, and experiences regarding polypharmacy and willingness to deprescribe. J Am Geriatr Soc2013;61:1508-14.
5. Bain KT, Holmes HM, Beers MH, Maio V, Handler SM, Pauker SG. Discontinuing medications: a novel approach for revising the prescribing stage of the medication use process. J Am Geriatr Soc2008;56:1946-52.

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