What problem are we trying to tackle?

Evidence on overprescribing suggests it is linked to deprivation, ethnicity, and age:

• Lower socioeconomic status has been associated with higher polypharmacy usage in older people – individuals of lower educational backgrounds were found to have 21% higher odds to be in receipt of polypharmacy when compared to those of higher education backgrounds, and similar findings have been shown for occupation, income and social class.
• A report by NHS England and the NHS Business Services Authority found the Core20 population (the most deprived 20% of the national population by the national Index of Multiple Deprivation), generally receives more prescription items and that prescribing peaks 10-15 years earlier, compared with the non-Core20 population.
• According to an evidence review by Public Health England, prescribing rates for opioid pain medicines have been shown to have a strong association with deprivation, with higher rates observed in areas of greater deprivation. The review also described how the prescribing rates of medicines associated with dependence were found to be 1.5 times higher in women than in men, and that prescribing rates generally increased with age.
• In England, more than one in 10 people aged over 65 take at least eight different prescribed medicines each week, which increases to nearly one in 4 people aged over 85 years old (Age UK – More harm than good report).

It is important that these links are explored and understood so that that health inequalities can be reduced in different areas and in different patient groups.

Our aims in south east London:

• To reduce overprescribing through increase in Structured Medication Reviews in identified groups that are at higher risks of inequalities, making the best use of data (NOR report R15 and R19)

The work that we are doing:

• Overprescribing metrics and dashboard pilot
• Specialist support for Structured Medication Reviews in Learning Disability and Autism patients

Pilots described are based on preliminary results and will be updated once a full evaluation has been concluded.