Polypharmacy: putting the framework into practice

Which of the following statements best describes the 8 suggested steps within the article’s proposed polypharmacy framework:

When undertaking a polypharmacy medication review, which of the following statements best describes the issues to be taken into account when considering if each medication has a clear ongoing ‘need’:

With respect to Linda’s medicines, which of the following statements lists a medicine that appears (before assessing effectiveness, safety, acceptability etc) to have a valid ongoing clinical indication:

The SOCRATES mnemonic for pain assessment asks practitioners to consider which of the following factors:

Medstopper http://medstopper.com is an online deprescribing resource that references STOPP and Beers Criteria, and assists risk prioritisation through assigning ‘medicine stopping priorities’. Using Medstopper to consider Linda’s medicines, which 2 medicines are given the highest priority for stopping:

Numbers Needed to Treat (NNT) is a useful concept for pharmacists to be aware of when considering drug effectiveness. Which of the following NNT statements is correct with respect to Linda’s aspirin:

Anticholinergic burden score is an important concept for pharmacists to consider when undertaking polypharmacy reviews. The ACB calculator (acbcalc.com) is one of many tools available to pharmacists to support them in assessing anticholinergic burden scores for their patients. Using the ACB calculator, which statement is not correct:

Which of the following side effects is not typically associated with anticholinergic medicines:

Postural hypotension (i.e. a drop in BP on going from lying/sitting to standing) is a risk factor for falls. Which of the following statements correctly defines the criteria to meet a postural drop:

Which of the following statements correctly describes the incidence of postural hypotension amongst older adults living at home:

The Tasmanian Primary Health Network provides online guidance on the appropriateness of abrupt and tailored stops for individual medicines. Which of the following medicines would be appropriate for an abrupt stop in the context of a polypharmacy review if deemed to no longer be required:

Scottish Patient Safety Programme ‘Sick Day Rules’ identify medicines that increase the risk of acute kidney injury if they are continued during an episode of acute dehydrating illness. Which of the following medicines do NOT fall under these rules:

Pharmacists should consider the concept of cumulative toxicity when undertaking polypharmacy reviews. Which of the following statements does NOT describe a drug-drug or drug-disease combination that increase Linda’s risk of ADRs:

Frailty is a stronger predictor of medication related harm than age. Which aspects of Linda’s clinical presentation would positively contribute to your assessment of her as being “vulnerable” or “mildly frail” on the Rockwood Clinical Frailty Scale:

Grouping medicine together by indication is useful to identify tablet burden and potential therapeutic duplication. Which of the following groupings of medicines does NOT identify potential therapeutic duplication

For patients of Linda’s age (i.e. over 55 years), the National Institute for Health and Care Excellence (NICE) hypertension guidelines would favour a calcium channel blocker as the anti-hypertensive of choice. In Linda’s case, it is reasonable not to favour this as a first-line agent because: