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CompreHensive geriAtRician-led MEdication Review (CHARMER)

Background to the CHARMER study

As we get older, our bodies are less able to handle some medicines. Medicines that were once effective and safe, can become less beneficial, with increased risk of harm. Half of older people in hospital are prescribed a medicine with a safety risk but these medicines are rarely stopped. Nine out of ten patients and carers believe that risky medicines should be stopped in hospital and that doctors should start the discussion. To make this happen, we need to change doctor and pharmacist behaviour so that the idea of stopping medicines is more likely to be discussed with patients.

Our previous research with doctors and pharmacists working with older people identified one thing that helps proactive deprescribing and four things that hinder this process. We found that it helped to draw attention to prescribers who successfully stop risky medicines. We found the following four things hindered proactive deprescribing: wrong belief that patients don’t want to stop; pharmacists being unavailable when stopping decisions could be made; thinking that doing nothing is safer than stopping and medicine stopping is not a hospital priority.

What we will do in the CHARMER study?

The CHARMER study is an NIHR-funded programme of research to refine and test a behaviour change intervention. The intervention will support geriatricians and pharmacists to work with patients to deprescribe inappropriate medication in the hospital setting.

We will work with patients, carers and staff from hospitals to undertake this work.

In older people's wards we aim to:

  • develop our approach to increasing discussions with patients about stopping medicines by using what helps and removing what hinders
  • develop a list of things that people think are important to measure when stopping medicines in hospital (a core outcome set)
  • design and carry out a study testing whether our approach works and is value for money
  • make discussions about stopping medicines in hospital important
  • develop a way for getting our approach to be used in all hospitals.

Link to CHARMER study page: https://www.uea.ac.uk/groups-and-centres/charmer

Link to NIHR project funding page: https://arc-eoe.nihr.ac.uk/research-implementation/research-themes/ageing-and-multi-morbidity/amm17-comprehensive-geriatrician 

Funding

Funder

NIHR

Start Date

1st September 2020

End Date

31st August 2025

 

Members

Internal:

External:

Public Health and Society Research in the Department of Health Sciences