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I rattle when I walk

by Rosanna Galvin

PhD student Emily Reeve.‘I rattle when I walk’ was a phrase Emily Reeve (pictured above), encountered regularly when, in her role as a clinical pharmacist, she talked to elderly patients about the amount of medication they were taking.

Concerned about what she was hearing, the experience prompted the PhD student to return to university to pursue research into the area of de-prescribing – the process of stopping medications.

Reeve, who was last year’s runner up in the University-wide Three Minute Thesis Competition, says she found some patients didn’t even know why they were taking certain medications.

“As a clinical pharmacist, I regularly found myself speaking to elderly patients who were taking 5, 10 or even 15 regular medications. They would say to me ‘I have my own pharmacy at home’,” she says.

“On further investigation I found that there were often one or two medications that they had been taking for a long time, and they actually didn’t know why they were taking it.

“Despite being unhappy with having to take lots of medications, I found patients can be quite reluctant when stopping a medication is recommended. We discovered the major patient barriers to de-prescribing include feeling that the medication is still needed and being scared of withdrawal reactions.”

Based at UniSA’s School of Pharmacy and Medical Sciences, Reeve is now in the final stages of her PhD, where she has developed a de-prescribing process that is patient-centred, to combat the overuse of medication in our community.

The PhD student says that a patient-centred approach has a number of potential benefits, including the reduction of side effects from unnecessary medications, reduced costs for patients and improved adherence.

“There are many processes in place to ensure patients are taking the right medicines,” Reeve says.

“Doctors, pharmacists, nurses as well as other health care professionals work together to provide the best care for patients, but unfortunately time restraints and often incomplete information may limit their ability to monitor medications entirely.

“Research has so far focused on how to identify inappropriate medications, but the best way to actually stop the medication has yet to be discovered.

“What I have developed is a process that involves patients in every step of the process – from finding out what their health goals are, to determining what medications are important for them, to deciding how quickly to withdraw the medication and how often they would like follow-up.

“There is still a lot more research that needs to be undertaken before this process can be put into practice, but hopefully my research will bring attention to this important issue.”

Reeve, who is set to complete her PhD mid-year, has already enjoyed some significant achievements on her doctoral journey. As well as her impressive performance in last year’s Three Minute Thesis Competition (3MT), she also spent a month volunteering with local clinical pharmacists in the Solomon Islands in 2011.

Division heats for the 3MT competition, in which PhD students have to explain their research in just three short minutes, are taking place at UniSA during July and August this year with the University-wide final scheduled for September 6. Students interested in taking part can go to the University’s 3MT website.