Polypharmacy Drug Errors in the Elderly Peri-operative population; Are we Providing a Disservice to an At-Risk Group?
Dr J Isherwood, Dr A Powell, Dr S Saxena

Background
There are 11.6 Mil people over the age of 65 in the UK, and by 2040 it is predicted that 1 in 4 UK residents will be over 65. This age group will usually have a number of medical conditions and therefore will have been prescribed a variety of medications by their GP.  These medications must be continued in secondary care and altered if necessary in the acute setting.

Materials and methods 
In this study, the admissions of 75 patients on 3 surgical wards were investigated for the maintenance of their routine medication regimes while admitted and whether its continuation was recorded on discharge. Further consideration was paid as to whether their usual dosage was moderated according to GFR. In addition, fluid maintenance for these patients was recorded and compared with the renal function to ascertain whether this was playing a role in the day to day control of fluid status.

Results and Discussion
We found that a large proportion of patients were not prescribed their regular medications in the first 48hrs of admission. Of those patients that suffered a drop in GFR during admission, the minority had their medications altered accordingly and approximately half had the fluid maintenance appropriate for their renal function.

Conclusion
The study demonstrated a clear discontinuity of care between primary and secondary care, as well as a lack of recognition of the complex interactions that are likely to be inherent in such polypharmacy.

Polypharmacy drug errors in the elderly peri-operative population; are we providing a disservice to an at-risk group?